A nurse is teaching a client with chronic peripheral artery disease. What client statement indicates the need for further teaching?

Wear fitted closed toe shoes daily: It is important for clients with peripheral arterial disease to wear properly fitted closed toe shoes. This helps protect the feet from injury and provides support. Closed toe shoes also help maintain warmth and prevent heat loss, which is especially important for individuals with impaired circulation.

Let's review the other options and explain why they may not be appropriate:

Soak feet in warm water for an hour each day: Soaking the feet in warm water for a prolonged period can actually worsen symptoms in individuals with peripheral arterial disease. It can cause further dilation of blood vessels, leading to increased blood pooling and potential tissue damage. Therefore, soaking the feet for extended periods of time is not recommended.

Set heating pads on a low temperature: Using heating pads, especially at high temperatures, can be harmful to individuals with peripheral arterial disease. It can increase the risk of burns or thermal injury due to reduced sensation in the affected areas. Heating pads should be used with caution and on a low temperature setting, if necessary.

Use callus remover for corns or calluses: Individuals with peripheral arterial disease have reduced blood flow to the lower extremities, which can impair wound healing. It is important to avoid self-treatment of corns or calluses, as it can increase the risk of skin breakdown and infection. Clients should be advised to consult a healthcare professional, such as a podiatrist, for appropriate management of corns and calluses.

ST-segment elevation during exercise stress testing is a concerning finding that may indicate reduced blood flow to the heart muscle. It can be a sign of myocardial ischemia or coronary artery disease. Cardiac catheterization is a diagnostic procedure that allows direct visualization of the coronary arteries and helps identify any blockages or narrowing that may be causing the ST-segment elevation.

Here's an explanation of why the other options are not the most appropriate procedures:

Transesophageal echocardiogram: Transesophageal echocardiogram (TEE) is a diagnostic test that involves inserting a probe into the esophagus to obtain detailed images of the heart. It is not typically used to evaluate ST-segment elevation, which primarily indicates coronary artery issues rather than structural abnormalities.

Telemetry monitoring: Telemetry monitoring involves continuous monitoring of a patient's heart rhythm and can be used for various cardiac conditions. While telemetry monitoring may be necessary for ongoing cardiac assessment, it is not a specific procedure to address the ST-segment elevation found during the exercise stress test.

Pharmacologic stress test: A pharmacologic stress test is an alternative to an exercise stress test for patients who cannot exercise. It involves administering medications that stimulate the heart to mimic the effects of exercise. While a pharmacologic stress testcan also reveal ST-segment changes, the presence of ST-segment elevation usually requires further evaluation with a more invasive procedure like cardiac catheterization.