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 D
Explanation
Choice A reason:
Thickening of the walls of the ventricles is not typically associated with restrictive cardiomyopathy (RCM). This condition is more characteristic of hypertrophic cardiomyopathy (HCM), where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. In RCM, the walls of the ventricles are usually not thickened but become rigid due to fibrosis or infiltration, which restricts the heart’s ability to fill with blood during diastole.
Choice B reason:
Stretching of the ventricles is more commonly seen in dilated cardiomyopathy (DCM), not restrictive cardiomyopathy. In DCM, the heart’s ventricles become enlarged and weakened, which impairs the heart’s ability to pump blood efficiently. RCM, on the other hand, involves stiffening of the ventricular walls without significant dilation.
Choice C reason:
Thickening of the ventricular walls and septum is a hallmark of hypertrophic cardiomyopathy (HCM), not restrictive cardiomyopathy. In HCM, the thickened walls can obstruct blood flow and lead to various complications. RCM is characterized by the stiffening of the ventricular walls due to fibrosis or infiltration, which restricts diastolic filling.
Choice D reason:
When the ventricular tissue becomes fibrous and fatty is the correct description of restrictive cardiomyopathy (RCM). In RCM, the heart’s ventricles become stiff and less elastic due to fibrosis (scarring) or infiltration by abnormal substances, such as amyloid proteins. This rigidity impairs the heart’s ability to fill properly during diastole, leading to symptoms of heart failure
Correct Answer is C
Explanation
Choice A reason:
Serum phosphate levels are not the primary concern in the management of diabetes insipidus (DI). While phosphate levels are important for overall health, they do not directly relate to the condition or its treatment with desmopressin. DI primarily affects water balance and sodium levels in the body.
Choice B reason:
Serum calcium levels, although important, are not the most critical lab value to monitor in a client with DI receiving desmopressin. Calcium levels are crucial for bone health and various metabolic functions, but they do not directly reflect the effectiveness or complications of desmopressin therapy.
Choice C reason:
Serum sodium levels are the most important lab value to monitor in a client with DI receiving desmopressin. DI causes an imbalance in water regulation, leading to excessive urination and potential dehydration. Desmopressin helps to reduce urine output and maintain water balance, but it can also lead to water retention and hyponatremia (low sodium levels). Monitoring serum sodium is crucial to prevent complications such as seizures, confusion, and other neurological symptoms associated with hyponatremia.
Choice D reason:
Blood urea nitrogen (BUN) levels are useful in assessing kidney function and hydration status, but they are not the primary concern in the management of DI with desmopressin. While BUN levels can provide valuable information about renal function, they do not directly indicate the effectiveness or potential complications of desmopressin therapy.
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