A nurse is collecting data from a client who has peripheral arterial disease (PAD). Which of the following findings should the nurse expect?

Choice A reason: Pain assessment is a critical priority for postoperative patients. After aortic valve replacement surgery, patients may experience discomfort or pain related to the incision site, chest tube placement, or other surgical interventions. Pain assessment allows the nurse to evaluate the effectiveness of pain management strategies, adjust medications as needed, and ensure the patient's comfort and well-being. Pain can also impact vital signs and overall recovery, so addressing it promptly is essential.

Choice B reason: Monitoring blood pressure is important, but it is not the highest priority immediately after surgery. Blood pressure assessment is part of routine postoperative care, but it does not directly address the patient's immediate comfort or potential complications. However, if the patient's blood pressure becomes significantly abnormal, it would require immediate attention.

Choice C reason: Checking bowel sounds is relevant for assessing gastrointestinal function, but it is not the top priority immediately postoperatively. Bowel sounds may be diminished initially due to anesthesia, surgical manipulation, or bowel rest. However, assessing pain and other vital signs takes precedence over bowel sounds in the immediate recovery period.

Choice D reason: Assessing the catheter insertion site is essential, especially if the patient has an indwelling urinary catheter. However, it is not the highest priority immediately after aortic valve replacement. Pain assessment and monitoring for complications related to surgery (such as bleeding, infection, or cardiac issues) take precedence. The catheter site can be assessed during routine nursing care.

Choice A reason: Walking is a highly beneficial activity for individuals with peripheral vascular disease (PVD). It helps improve circulation, which can be compromised in PVD due to narrowed or blocked blood vessels. Regular walking can lead to the development of collateral circulation, which is the formation of new blood vessels that bypass the blockages and improve blood flow to the affected areas. This can help alleviate symptoms such as pain and cramping during walking, known as claudication. Walking should be done at a pace that is comfortable and should be stopped if pain occurs. Over time, walking can increase the distance a person with PVD can walk without pain.

Choice B reason: Compression stockings are often recommended for individuals with PVD to help improve blood flow. Knee-length stockings exert pressure on the lower legs, helping to reduce edema and discomfort associated with PVD. They can also help prevent deep vein thrombosis, a potential complication of PVD.

Choice C reason: Elevating the legs can help reduce swelling and improve venous return in clients with PVD. It is recommended to elevate the legs above the level of the heart to maximize the effect. This can be done by placing pillows under the legs while lying down.

Choice D reason: Shopping for shoes in the morning is advised because feet can swell throughout the day, especially in clients with PVD. Fitting shoes in the morning can help ensure a more accurate fit, reducing the risk of pressure points that could lead to skin breakdown and ulcers.