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PAD med surg 1

memorize.ai (lvl 286)

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Section 1

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Last updated

6 years ago

Date created

Mar 1, 2020

Cards (25)

Section 1

(25 cards)

b

Front

Mr. Pauley is a 60-year-old male with a past medical history of hypertension. He has been having increasing intermittent claudication and is being seen for diagnostic evaluation. You are asked by the physician to measure an ankle-brachial index (ABI). Which of the following findings would be consistent with moderate arterial insufficiency? A. Brachial pressure of 60; ankle pressure 120 B. Brachial pressure of 100; ankle pressure 90 C. Brachial pressure of 140; ankle pressure of 140

Back

a

Front

The nurse is assessing a patient on admission to the hospital. The patient's leg appears as shown below: black toe What action by the nurse is best? A. Assess the patient's ankle-brachial index. B. Elevate the patient's leg above the heart. C. Obtain an ice pack to provide comfort. D. Prepare to teach about heparin sodium.

Back

a

Front

A patient is taking warfarin (Coumadin) and asks the nurse if taking St. John's wort is acceptable. What response by the nurse is best? A. "No, it may interfere with the warfarin." B. "There isn't any information about that." C. "Why would you want to take that?" D. "Yes, it is a good supplement for you."

Back

a,c,d,e

Front

A patient is being discharged on warfarin (Coumadin) therapy. What discharge instructions is the nurse required to provide? (Select all that apply.) A. Dietary restrictions B. Driving restrictions C. Follow-up laboratory monitoring D. Possible drug-drug interactions E. Reason to take medication

Back

b

Front

Which of the following nursing diagnoses has the highest priority for a newly admitted patient with acute femoral artery occlusion? A. Activity intolerance B. Altered tissue perfusion C. Risk for infection D. Risk for bleeding

Back

a

Front

The nurse is monitoring a patient who has returned to the unit after arterial revascularization. The patient reports pain in the affected limb that is similar to the pain experienced before the procedure. What is the nurse's best action? a. Assess the peripheral pulses in the limb. b. Elevate the affected extremity on pillows. c. Administer pain medication as prescribed. d. Place a warm blanket on the operative limb.

Back

d

Front

A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene? A. Assessing blood pressure in both upper extremities B. Auscultating the carotid arteries for any bruits C. Classifying capillary refill of 4 seconds as normal D. Palpating both carotid arteries at the same time

Back

c

Front

A patient with atherosclerosis asks a nurse which factors are responsible for this condition. What is the nurse's best response? A. "Injury to the arteries causes them to spasm, reducing blood flow to the extremities." B. "Excess fats in your diet are stored in the lining of your arteries, causing them to constrict." C. "A combination of platelets and fats accumulates, narrowing the artery and reducing blood flow." D. "Excess sodium causes injury to the arteries, reducing blood flow and eventually causing obstruction."b

Back

a

Front

A patient is receiving an infusion of alteplase (Activase) for an intra-arterial clot. The patient begins to mumble and is disoriented. What action by the nurse takes priority? A. Assess the patient's neurologic status. B. Notify the Rapid Response Team. C. Prepare to administer vitamin K. D. Turn down the infusion rate.

Back

a,b,d

Front

A nurse is caring for a patient on IV infusion of heparin. What actions does this nurse include in the patient's plan of care? (Select all that apply.) A. Assess the patient for bleeding. B. Monitor the daily activated partial thromboplastin time (aPTT) results. C. Stop the IV for aPTT above baseline. D. Use an IV pump for the infusion. E. Weigh the patient daily on the same scale.

Back

a

Front

A patient had a percutaneous transluminal coronary angioplasty for peripheral arterial disease. What assessment finding by the nurse indicates a priority outcome for this patient has been met? A. Pain rated as 2/10 after medication B. Distal pulse on affected extremity 2+/4+ C. Remains on bedrest as directed D. Verbalizes understanding of procedure

Back

a

Front

The nurse is recovering a patient with peripheral arterial disease who has just undergone percutaneous transluminal angioplasty. What complication does the nurse monitor for in the immediate postprocedure period? A. Bleeding B. Aspiration C. Hypertensive crisis D. Chest pain

Back

c

Front

The nurse is caring for a patient 6 hours after an aorto-bi-femoral bypass surgery. Which of the following findings would be significant to report to the physician post-operatively? A. 2+ pedal pulses bilaterally (pre-op pedal pulses 1+ bilaterally) B. 2 out of 10 pain on a 10 point scale and 1+ edema at the incision site C. A decreasing urine output D. A blood pressure reading of 138/74 (pre-op 144/78)

Back

d

Front

The nurse is reviewing the lipid panel of a male patient who has atherosclerosis. Which finding is most concerning? A. Cholesterol: 126 mg/dL B. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL C. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL D. Triglycerides: 198 mg/dL

Back

b

Front

Mr. Booth is a 49-year-old male who suffers from intermittent claudication. He smokes 1 pack per day of cigarettes and has hypertension that is medically controlled. Mr. Booth is fearful of undergoing amputation in the future. Your knowledge of the general progression of peripheral arterial disease allows you to instruct him that: A. If he follows a home walking program, his chances of needing surgery should be minimal. B. Smoking causes vasoconstriction and therefore smoking cessation would be a great goal. C. The majority of individuals with intermittent claudication do have amputations. D. The vasodilator he has been prescribed to take has been proven to reverse the progression of the disease.

Back

a

Front

A patient had a femoropopliteal bypass graft with a synthetic graft. What action by the nurse is most important to prevent wound infection? A. Appropriate hand hygiene before giving care B. Assessing the patient's temperature every 4 hours C. Clean technique when changing dressings D. Monitoring the patient's daily white blood cell count

Back

d,e

Front

A nurse is preparing a patient for a femoropopliteal bypass operation. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) A. Administering preoperative medication B. Ensuring the consent is signed C. Marking pulses with a pen D. Raising the siderails on the bed E. Recording baseline vital signs

Back

b

Front

Mrs. George is a 65-year-old female with a past medical history of hypertension. She has been having increasing intermittent claudication and is being seen for diagnostic evaluation. You are asked by the physician to measure an ankle-brachial index (ABI). The following findings would be consistent with arterial insufficiency: A. Brachial pressure of 60; ankle pressure 120 B. Brachial pressure of 100; ankle pressure 90 C. Brachial pressure of 140; ankle pressure of 140

Back

b

Front

The nurse is assessing a patient who reports claudication after walking a distance of one block. The nurse notes a painful ulcer on the fourth toe of the patient's right foot. What condition do these findings correlate with? A. Diabetic foot ulceration B. Peripheral arterial disease C. Peripheral venous disease D. Deep vein thrombosis

Back

c

Front

The nurse is caring for a patient recovering from a stent to the tibial artery. The pedal pulse was palpable at the beginning of the shift and now 4 hours later, the Doppler is unable located a pulse. The nurse's priority action at this point is to: A. Call the physician B. Give a prn dose of cilostazol (Pletal) C. Assess capillary refill, temperature, color, and sensation of the extremity D. Obtain a 12 lead electrocardiogram (ECG)

Back

a

Front

A patient has peripheral arterial disease (PAD). What statement by the patient indicates misunderstanding about self-management activities? A. "I can use a heating pad on my legs if it's set on low." B. "I should not cross my legs when sitting or lying down." C. "I will go out and buy some warm, heavy socks to wear." D. "It's going to be really hard but I will stop smoking."

Back

a,c,e

Front

A nurse reviews a patient's laboratory results. Which findings should alert the nurse to the possibility of atherosclerosis? (Select all that apply.) A. Total cholesterol: 280 mg/dL B. High-density lipoprotein cholesterol: 50 mg/dL C. Triglycerides: 200 mg/dL D. Serum albumin: 4 g/dL E. Low-density lipoprotein cholesterol: 160 mg/dL

Back

b

Front

Which of the following is NOT an appropriate teaching point for patients with Stage 2 (Claudication) Peripheral Arterial Disease? A. Always wear well-insulated, soft shoes, along with cotton socks. B. Avoid cold. Keep your legs warm with blankets or heating pads when needed. C. If you have pain when walking, rest but then try to walk just a little further. D. Don't cross your legs. Try to keep them in a dangling position to relieve pain.

Back

a

Front

A nurse is assessing a patient with peripheral artery disease (PAD). The patient states walking five blocks is possible without pain. What question asked next by the nurse will give the best information? A. "Could you walk further than that a few months ago?" B. "Do you walk mostly uphill, downhill, or on flat surfaces?" C. "Have you ever considered swimming instead of walking?" D. "How much pain medication do you take each day?"

Back

b

Front

A patient is 4 hours postoperative after a femoropopliteal bypass. The patient reports throbbing leg pain on the affected side, rated as 7/10. What action by the nurse takes priority? A. Administer pain medication as ordered. B. Assess distal pulses and skin color. C. Document the findings in the patient's chart. D. Notify the surgeon immediately.

Back