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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A Reason:

Conivaptan hydrochloride is a vasopressin receptor antagonist used to treat hyponatremia associated with SIADH. It works by blocking the action of ADH, thereby promoting water excretion without losing sodium. This medication is appropriate for managing SIADH.

Choice B Reason:

Vasopressin, also known as antidiuretic hormone (ADH), is not appropriate for a patient with SIADH. SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Administering vasopressin would exacerbate the condition by increasing water retention and further lowering sodium levels.

Choice C Reason:

Sodium chloride tablets are used to manage hyponatremia by increasing sodium levels in the blood. This treatment is appropriate for patients with SIADH to help correct the sodium imbalance caused by excessive ADH.

Choice D Reason:

Tolvaptan is another vasopressin receptor antagonist that is used to treat hyponatremia associated with SIADH. It helps to increase serum sodium levels by promoting water excretion while retaining sodium. This medication is suitable for managing SIADH.

A. Lower extremities edematous with decreased pulses and cool to the touch B. Pain, pallor, and paresthesia in the foot C. Presence of an open wound near the ankle with serous drainage and pruritus D. Murmur auscultated at the left sternal border, slight dyspnea, and lower extremity edema

Correct Answer is B

Explanation

Choice A reason: Lower Extremities Edematous with Decreased Pulses and Cool to the Touch

Lower extremities that are edematous with decreased pulses and cool to the touch can indicate severe peripheral artery disease (PAD) and poor blood circulation1. While this is a serious condition that requires medical attention, it is not necessarily an immediate emergency unless there are signs of acute limb ischemia, such as sudden pain or loss of function. Chronic symptoms like these often require ongoing management and monitoring rather than immediate intervention.

Choice B reason: Pain, Pallor, and Paresthesia in the Foot

Pain, pallor, and paresthesia (the three Ps) in the foot are classic signs of acute limb ischemia, a medical emergency that requires immediate intervention. Acute limb ischemia occurs when there is a sudden decrease in blood flow to a limb, leading to tissue damage and potential loss of the limb if not treated promptly4. The presence of these symptoms indicates that the limb is not receiving adequate blood supply, necessitating urgent medical attention to restore circulation and prevent permanent damage.

Choice C reason: Presence of an Open Wound Near the Ankle with Serous Drainage and Pruritus

An open wound near the ankle with serous drainage and pruritus (itching) suggests a chronic wound or ulcer, which is common in patients with PAD5. While this condition requires medical treatment to prevent infection and promote healing, it does not typically constitute an immediate emergency unless there are signs of severe infection, such as increased redness, warmth, or purulent drainage. Chronic wounds need regular care and monitoring but are not usually life-threatening.

Choice D reason: Murmur Auscultated at the Left Sternal Border, Slight Dyspnea, and Lower Extremity Edema

A murmur auscultated at the left sternal border, slight dyspnea (shortness of breath), and lower extremity edema can indicate heart valve disease or heart failure. These symptoms are concerning and require medical evaluation, but they do not typically represent an immediate emergency unless the patient is experiencing severe symptoms such as acute heart failure or cardiogenic shock. These conditions require prompt but not necessarily emergent intervention.

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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?

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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