A nurse is reinforcing teaching with a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching?

"incorporate walking into your daily routine."

"Elevate your legs while in bed."

"Shop for new shoes during the morning hours."

"Wear knee length stockings."

Answer and Explanation

The Correct Answer is A

(A) “Incorporate walking into your daily routine.”: This is the most appropriate instruction for a client with peripheral arterial disease (PAD). Regular exercise, such as walking, can help improve circulation, increase the distance a person can walk without pain, and promote overall cardiovascular health. It’s important to start slow and gradually increase the duration and intensity of the exercise as tolerated. The client should be advised to stop and rest if they experience any pain.

(B) “Elevate your legs while in bed.”: While elevating the legs can help reduce swelling in some conditions, it’s not typically recommended for clients with PAD. Elevation can actually decrease arterial blood flow to the legs, which could worsen symptoms.

(c) “Shop for new shoes during the morning hours.”: This instruction is more relevant for clients with conditions that cause foot swelling, such as heart failure or venous insufficiency. In PAD, the size of the feet does not typically change throughout the day.

(D) “Wear knee length stockings.”: Compression stockings are often used to improve venous circulation in conditions like deep vein thrombosis or chronic venous insufficiency. However, they’re not typically recommended for clients with PAD as they can restrict arterial blood flow.

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Correct Answer is D

Explanation

(A) Metabolic alkalosis: This condition is characterized by a high blood pH (>7.45) and a high bicarbonate level (>26 mEq/L). The client’s pH and bicarbonate levels are both lower than normal, which rules out metabolic alkalosis.

(B) Respiratory acidosis: This condition is characterized by a low blood pH (<7.35) and a high PaCO2 level (>45 mm Hg). Although the client’s pH is low, the PaCO2 level is also low, which rules out respiratory acidosis.

(c) Respiratory alkalosis: This condition is characterized by a high blood pH (>7.45) and a low PaCO2 level (<35 mm Hg). The client’s pH is low, which rules out respiratory alkalosis.

(D) Metabolic acidosis: This condition is characterized by a low blood pH (<7.35) and a low bicarbonate level (<22 mEq/L). The client’s pH is 7.26 and bicarbonate level is 14 mEq/L, both of which are lower than normal. This indicates metabolic acidosis, which is common in clients with acute kidney injury as the kidneys are unable to excrete hydrogen ions and reabsorb bicarbonate. Therefore, the nurse should identify that the client is experiencing metabolic acidosis.

A. "If a client refuses a medication, you can place it in your pocket to administer later." "You are required to have a second nurse witness disposal of a controlled substance." B. "We use an automated dispensing device to track the use of controlled substances." C. "Activities of the automated dispensing machine will be reviewed periodically." D. "We count the amount of a controlled substance available before removal from a medication drawer."

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

Explanation

A) "If a client refuses a medication, you can place it in your pocket to administer later."
This statement is incorrect. Placing a medication in the pocket for later administration is not an appropriate practice and can lead to unauthorized possession and potential diversion of controlled substances. However, the second part of the statement, "You are required to have a second nurse witness disposal of a controlled substance," is correct.

B) "We use an automated dispensing device to track the use of controlled substances."
Automated dispensing devices are commonly used to track the administration and removal of controlled substances. This helps to ensure accountability and prevents diversion.

C) "Activities of the automated dispensing machine will be reviewed periodically."
Regular review of the activities of the automated dispensing machine helps to monitor for any discrepancies or irregularities in the handling of controlled substances, thus enhancing safety measures.

D) "We count the amount of a controlled substance available before removal from a medication drawer."
Counting the amount of controlled substance available before removal from a medication drawer is a crucial step in ensuring accurate inventory management and preventing unauthorized removal or diversion.

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A nurse is reinforcing teaching with a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching?

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Explanation

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