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
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. Dopamine: Dopamine is a catecholamine often used to increase blood pressure and cardiac output in hypotensive states. It does not directly reduce intracranial pressure (ICP).
B. Mannitol: Mannitol is an osmotic diuretic commonly used to reduce intracranial pressure in clients with conditions such as subarachnoid hemorrhage, traumatic brain injury, or cerebral edema. It works by drawing fluid from brain tissue into the bloodstream, thereby reducing cerebral edema and ICP.
C. Nicardipine: Nicardipine is a calcium channel blocker used primarily to lower blood pressure in hypertensive emergencies. While it can indirectly impact intracranial pressure by reducing cerebral perfusion pressure, its primary mechanism of action is not targeted at reducing ICP.
D. Phenytoin: Phenytoin is an antiepileptic medication used to prevent and control seizures. While it may be indicated in clients who have experienced a subarachnoid hemorrhage to prevent seizures, it does not directly reduce intracranial pressure.
Correct Answer is C
Explanation
A. "Since my parent suffered from Alzheimer's disease, I know that I am at an increased risk for developing the disease myself." This statement is accurate. Family history is a significant risk factor for Alzheimer's disease. Individuals with a first-degree relative (such as a parent or sibling) with Alzheimer's disease are at a higher risk of developing the condition themselves.
B. "The cause of Alzheimer's disease is still not fully known or understood." This statement is also accurate. While there are theories about the underlying causes of Alzheimer's disease, such as genetics, brain changes, and environmental factors, the exact cause is still not fully understood. Research into the etiology of Alzheimer's disease is ongoing.
C. "I do not have to worry about this because I do not have Down syndrome and I have never had a stroke." This statement indicates a need for further teaching. While it is true that individuals with Down syndrome and those who have had a stroke are at increased risk for developing Alzheimer's disease, they are not the only populations at risk. Alzheimer's disease can affect individuals without Down syndrome or a history of stroke. Other risk factors include age, family history, genetics, and lifestyle factors.
D. "My child is at risk for developing Alzheimer's disease because they have trisomy 21." This statement is accurate. Trisomy 21, also known as Down syndrome, is associated with an increased risk of developing Alzheimer's disease. Individuals with Down syndrome have three copies of chromosome 21, which contains the gene for amyloid precursor protein (APP). Overproduction of amyloid beta protein, derived from APP, is thought to contribute to the development of Alzheimer's disease in individuals with Down syndrome.
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