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 A
Explanation
The correct answer is a) Serum potassium levels.
Choice A reason:
Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.
Choice B reason:
Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.
Choice C reason:
Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.
Choice D reason:
Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.
Correct Answer is D
Explanation
Choice A reason: Hypertension is not directly caused by hypokalemia. While potassium levels can influence blood pressure, hypokalemia is more critically associated with cardiac issues rather than hypertension alone.
Choice B reason: Ketosis is a metabolic state resulting from the body burning fat for fuel instead of carbohydrates. It is not directly related to hypokalemia. Hypokalemia does not cause ketosis, and monitoring for ketosis in a client with hypokalemia is not a priority.
Choice C reason: Insulin resistance is a condition where the body’s cells do not respond properly to insulin. While potassium levels can affect insulin secretion and action, hypokalemia is not primarily associated with insulin resistance. Therefore, it is not the main concern for a nurse monitoring a client with hypokalemia.
Choice D reason: Cardiac arrhythmias are a significant concern in clients with hypokalemia. Potassium is crucial for proper cardiac function, and low levels can lead to abnormal heart rhythms. This is why monitoring for cardiac arrhythmias is essential in clients with hypokalemia.
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