A nurse is assessing a client who has peripheral venous disease. Which of the following findings should the nurse recognize as a manifestation of venous disease?
Swollen and enlarged veins.
Loss of pigmentation over the shin area.
Shiny appearance to the lower extremities.
Diminished hair growth on the lower extremities.
The Correct Answer is A
Choice A Reason:
Swollen and enlarged veins, also known as varicose veins, are a common manifestation of peripheral venous disease (PVD). This condition occurs when the valves in the veins become weak or damaged, leading to blood pooling and increased pressure within the veins. This results in the veins becoming enlarged, twisted, and visible under the skin1. Varicose veins can cause discomfort, pain, and a heavy feeling in the legs. They are often exacerbated by prolonged standing or sitting and can be a cosmetic concern as well.
Choice B Reason:
Loss of pigmentation over the shin area is not typically associated with peripheral venous disease. This symptom is more commonly seen in conditions such as chronic venous insufficiency (CVI), where prolonged venous hypertension leads to skin changes, including hyperpigmentation and lipodermatosclerosis. However, it is not a primary manifestation of PVD itself.
Choice C Reason:
A shiny appearance to the lower extremities is more commonly associated with peripheral arterial disease (PAD) rather than peripheral venous disease. In PAD, reduced blood flow to the extremities can cause the skin to become thin, shiny, and hairless. This is due to the lack of oxygen and nutrients reaching the skin and underlying tissues. In contrast, PVD primarily affects the veins and does not typically cause these skin changes.
Choice D Reason:
Diminished hair growth on the lower extremities is another symptom more commonly associated with peripheral arterial disease (PAD). In PAD, the reduced blood flow to the extremities can lead to hair loss, as the hair follicles do not receive adequate oxygen and nutrients. Peripheral venous disease, on the other hand, does not usually cause hair loss. Instead, it is characterized by symptoms related to venous insufficiency, such as varicose veins, swelling, and skin changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
A client admitted for hip fracture surgery is at risk for various complications, but not specifically for hyperosmolar hyperglycemic syndrome (HHS). HHS is more commonly triggered by infections, severe dehydration, or other acute illnesses. While surgery can be a stressor, it is not as directly linked to HHS as infections are.
Choice B reason:
A client who is awaiting cataract surgery is not typically at high risk for developing HHS. Cataract surgery is generally a planned and controlled procedure that does not usually involve the acute stressors or infections that can precipitate HHS.
Choice C reason:
A client who is receiving an antibiotic for a urinary tract infection is at a higher risk for developing HHS. Infections are a common precipitating factor for HHS because they can cause significant stress on the body, leading to elevated blood glucose levels. The body’s response to infection can exacerbate hyperglycemia, especially in individuals with type 2 diabetes.
Choice D reason:
A client who is being evaluated for a breast lump is not typically at high risk for HHS. While the evaluation process can be stressful, it does not usually involve the acute physiological stressors or infections that are more directly linked to the development of HHS.
Correct Answer is A
Explanation
Choice A Reason:
Dietary and fluid restrictions are crucial for managing heart failure. Patients with heart failure often experience fluid retention, which can exacerbate symptoms such as swelling, shortness of breath, and fatigue. By restricting fluid intake, patients can help prevent fluid overload. Additionally, dietary modifications, such as reducing sodium intake, can help manage blood pressure and reduce the risk of fluid retention. Sodium causes the body to retain water, which can increase the workload on the heart. Therefore, a low-sodium diet is often recommended for heart failure patients. These restrictions are essential to prevent the worsening of heart failure symptoms and to improve the patient’s quality of life.
Choice B Reason:
Encouraging increased mobility is generally beneficial for overall health, but it must be approached cautiously in heart failure patients. While regular physical activity can help improve cardiovascular health and overall well-being, it is important to tailor the exercise regimen to the patient’s condition. Overexertion can lead to worsening symptoms or complications. Therefore, while increased mobility can be part of the management plan, it should be done under medical supervision and is not the primary lifestyle modification for heart failure management.
Choice C Reason:
Cessation of hormonal supplements may be relevant for some patients, particularly if the supplements are contributing to fluid retention or other adverse effects. However, this is not a standard recommendation for all heart failure patients. The decision to stop hormonal supplements would depend on the individual patient’s medical history and the specific supplements they are taking. It is not a general lifestyle modification for heart failure management.
Choice D Reason:
Cessation of intravenous (IV) drug use is important for patients who may be using IV drugs, as this can lead to infections, endocarditis, and other complications that can worsen heart failure. However, this recommendation is specific to patients with a history of IV drug use and is not a general lifestyle modification for all heart failure patients. The primary focus for most heart failure patients would be on managing fluid and dietary intake.
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