A nurse is assessing a client with intermittent claudication. What client statement supports this information?

"My feet feel like I have pins and needles."

"When I stand or sit too long, my feet swell."

"My legs get a painful cramp when I walk over 30 minutes."

"I get short of breath when I climb a lot of stairs.”

Answer and Explanation

The Correct Answer is C

The client statement that supports the information of intermittent claudication is: "My legs get a painful cramp when I walk over 30 minutes.": Intermittent claudication is a symptom of peripheral artery disease (PAD) characterized by pain, cramping, or fatigue in the muscles of the lower extremities, typically the calves, thighs, or buttocks. This pain is usually triggered by physical activity, such as walking, and is relieved with rest. The pain is caused by inadequate blood flow and oxygen supply to the muscles due to narrowed or blocked arteries.

The other client statements do not specifically indicate intermittent claudication:

"My feet feel like I have pins and needles": This sensation of pins and needles is often associated with peripheral neuropathy, which is a condition involving nerve damage and does not directly relate to intermittent claudication.

"When I stand or sit too long, my feet swell": This statement suggests the possibility of venous insufficiency rather than intermittent claudication. Venous insufficiency involves impaired blood return from the legs to the heart and may result in swelling, aching, or heaviness in the legs.

"I get short of breath when I climb a lot of stairs": This symptom is more indicative of cardiovascular or respiratory issues, such as heart or lung disease, rather than intermittent claudication. It suggests that the client may experience exercise intolerance due to cardiopulmonary limitations.

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Correct Answer is A

Explanation

Elevated levels of LDL (low-density lipoprotein) cholesterol are associated with an increased risk of coronary artery disease (CAD). LDL cholesterol is often referred to as "bad" cholesterol because it can contribute to the formation of plaque in the arteries, leading to narrowing and blockage of the arteries supplying the heart. This increases the risk of developing CAD and related complications such as heart attack and stroke.

On the other hand, HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. HDL cholesterol helps remove excess cholesterol from the bloodstream and transport it back to the liver for processing and excretion. Higher levels of HDL cholesterol are associated with a decreased risk of CAD because it helps to prevent the accumulation of cholesterol on artery walls.

Therefore, understanding that increased LDL and decreased HDL levels increase the risk of coronary artery disease demonstrates a good understanding of the significance of cholesterol levels and their impact on cardiovascular health.

A. Assess pulse of affected extremity every 15 minutes at ﬁrst. B. Palpate the affected leg for pain during every assessment C. Assess the client for signs and symptoms of compartment syndrome every 2 hours. D. Perform Doppler evaluation once daily.

Correct Answer is ["A","B","C","D"]

Explanation

Assess pulse of the affected extremity every 15 minutes at ﬁrst: Frequent assessment of the pulse in the affected extremity is important to monitor for any changes in blood ﬂow. This allows the nurse to identify any potential complications such as graft occlusion or compromised circulation promptly.

Palpate the affected leg for pain during every assessment: Assessing for pain in the affected leg is crucial to identify any signs of ischemia or inadequate perfusion. Increased pain could indicate reduced blood ﬂow or other complications that require immediate attention.

Assess the client for signs and symptoms of compartment syndrome every 2 hours: Compartment syndrome can occur after vascular surgeries, and early recognition is vital. The nurse should assess for signs and symptoms such as pain, numbness, tingling, increased swelling, and tense compartments. Regular assessment every 2 hours can help detect compartment syndrome promptly and prevent further complications.

Perform Doppler evaluation once daily: Doppler evaluation may be ordered by the healthcare provider to assess blood ﬂow and graft patency. However, the frequency of Doppler evaluation may vary depending on the client's condition and the healthcare provider's orders. Once daily assessment is not suﬃcient if there are concerns regarding blood ﬂow or graft viability.

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A nurse is assessing a client with intermittent claudication. What client statement supports this information?

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