A nurse is planning care for a client who has peripheral venous disease. Which of the following interventions should the nurse include in the plan of care? (Select All that Apply.)

Intermittent pneumatic compression pumps

Ankle-brachial index test

Layered wraps

Elevation of legs

Exercise

Answer and Explanation

Correct Answer : A,C,D,E

A. Intermittent pneumatic compression pumps: Intermittent pneumatic compression pumps can help improve circulation in the lower extremities by assisting with venous return. These devices inflate and deflate sequentially, promoting venous blood flow and reducing edema in clients with peripheral venous disease.

B. Ankle-brachial index test: The ankle-brachial index (ABI) test is a non-invasive vascular study used to assess peripheral arterial disease (PAD). It compares the blood pressure in the ankle with the blood pressure in the arm to evaluate arterial circulation.

C. Layered wraps: Layered wraps, such as compression bandages or stockings, are typically used in the management of venous insufficiency and venous ulcers. They are not as commonly utilized in peripheral venous disease, however, they may be beneficial for some clients with PVD.

D. Elevation of legs: Elevating the legs above the level of the heart can help reduce edema and improve venous return in clients with peripheral venous disease. Gravity assists in draining blood from the lower extremities back toward the heart, thereby reducing swelling and discomfort.

E. Exercise: Regular physical activity, particularly lower extremity exercises such as walking, can promote venous return and improve circulation in clients with peripheral venous disease. Exercise helps to pump blood back to the heart, reducing venous stasis and the risk of complications such as venous thrombosis.

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Correct Answer is B

Explanation

A. "Blood flow is altered and causes blood to pool in the legs." This statement inaccurately describes venous insufficiency rather than peripheral arterial disease (PAD). In PAD, blood flow is reduced or obstructed due to atherosclerosis, leading to inadequate oxygen supply to tissues rather than pooling of blood in the legs.

B. "Blood flow is altered due to atherosclerosis affecting the tissues' ability to receive oxygen-rich blood." This statement correctly explains the underlying pathology of peripheral arterial disease (PAD). Atherosclerosis, characterized by the buildup of plaque in the arteries, narrows or blocks blood flow, impairing the delivery of oxygen-rich blood to the tissues. This can result in symptoms such as pain, cramping, and tissue damage, especially during activity when oxygen demand increases.

C. "Blood flow is altered due to incompetent valves causing increased venous pressure." This statement describes venous insufficiency rather than PAD. In venous insufficiency, faulty valves in the veins result in increased venous pressure, leading to symptoms such as swelling, heaviness, and varicose veins, but it does not involve arterial obstruction as seen in PAD.

D. "Blood flow is altered due to excessive stretching of the ventricles impairing the heart to contract." This statement describes a condition related to the heart's function rather than peripheral arterial disease. Excessive stretching of the ventricles may occur in conditions such as heart failure, but it does not directly affect blood flow in the peripheral arteries as seen in PAD.

A. "Pentoxifylline can be administered to help the platelets from sticking together and occluding the vessels." B. "A heparin bolus is administered and followed with a continuous infusion to help keep the blood thinner." C. "A flexible catheter will be inserted into a vessel of the arm, neck, or groin and advanced to the heart to dilate a narrowed or occluded artery." D. "A small catheter with a balloon on the end is threaded into a vessel in the groin and advanced to the heart where the balloon will be inflated, and the narrowed valve will be dilated. "

Correct Answer is D

Explanation

A) "Pentoxifylline can be administered to help the platelets from sticking together and occluding the vessels": Pentoxifylline is a medication used to improve blood flow by decreasing the viscosity of blood. However, it is not typically used to treat mitral valve stenosis. This statement does not accurately reflect treatment options for this condition.

B) "A heparin bolus is administered and followed with a continuous infusion to help keep the blood thinner": Heparin is an anticoagulant used to prevent blood clot formation, but it is not a treatment for mitral valve stenosis itself. While anticoagulants may be used in certain situations with mitral valve stenosis (such as in the setting of atrial fibrillation), they do not directly address the underlying valve narrowing.

C) "A flexible catheter will be inserted into a vessel of the arm, neck, or groin and advanced to the heart to dilate a narrowed or occluded artery": This statement describes a procedure known as percutaneous transluminal mitral valvuloplasty (PTMV), which is a minimally invasive intervention used to treat mitral valve stenosis. During this procedure, a catheter with a deflated balloon on its tip is inserted into a vessel and guided to the heart, where the balloon is inflated to widen the narrowed valve.

D) "A small catheter with a balloon on the end is threaded into a vessel in the groin and advanced to the heart where the balloon will be inflated, and the narrowed valve will be dilated": This statement accurately describes balloon valvuloplasty, which is a common procedure used to treat mitral valve stenosis. By inflating the balloon within the narrowed valve, the procedure aims to widen the valve opening, thus improving blood flow through the heart.

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A nurse is planning care for a client who has peripheral venous disease. Which of the following interventions should the nurse include in the plan of care? (Select All that Apply.)

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