The nurse is caring for a client with a diagnosis of chronic peripheral arterial disease. Which statement by the client warrants immediate intervention by the nurse?

"I noticed that the hair on my feet and on my legs, is gone."

"My legs were so cold I had to put a heating pad on them."

"My legs start to hurt when I walk to get my mail."

"My feet look reddish when I put them down."

Answer and Explanation

The Correct Answer is B

A.   Loss of hair on the lower extremities can be a common sign of chronic PAD, indicating reduced blood
flow. While it’s an important observation, it is not an immediate concern.
B.   Cold legs can indicate poor blood flow, which is a significant concern in PAD. The use of a heating pad can pose a risk of burns due to impaired sensation, especially in clients with poor circulation. This statement warrants immediate intervention, as the nurse should educate the client against using heat sources that can cause injury and assess the client's circulation and potential complications.
C.   This describes claudication, a common symptom of PAD, where pain occurs in the legs due to inadequate blood flow during physical activity. While it indicates worsening symptoms of PAD, it is not an immediate emergency.
D.   Reddish discoloration (rubor) when the legs are dependent can indicate blood pooling due to decreased venous return or arterial insufficiency. While this observation is significant and requires monitoring, it is not as urgent as the concern related to using a heating pad.

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Correct Answer is D

Explanation

A. While testing for occult blood can help rule out hematuria (blood in the urine), it’s not the immediate priority. Dark urine could be related to several factors, including dehydration or changes in liver function, making this not the best first step.
B. While monitoring weight is important, it doesn't directly address the issue of dark urine. Weight changes might indicate fluid retention or loss but are not as immediately relevant to the urine color change.
C. Increasing water intake can help dilute the urine and may help with hydration. However, before suggesting this, it's important to understand the underlying cause of the urine change.
D. Glipizide and other sulfonylureas can affect liver function, and dark urine can indicate potential liver issues, such as bilirubinuria (bilirubin in the urine). Reviewing liver function studies would provide critical information to assess if the change in urine color is related to liver dysfunction or other serious issues.

A. weight gain of 40 lbs. (18 kg) over the past 2 months B. currently prescribed aripiprazole, a second-generation antipsychotic agent C. sits & plays video games for 10-14 hours per day D. frequently eats salads with grilled chicken E. random blood glucose was 218 mg/dL with labs drawn 1 month ago

Correct Answer is ["B","C","E"]

Explanation

A. While rapid weight gain is a concern, it's important to consider the underlying cause. If the weight gain is medication-related (as in option B), it's a significant risk factor. However, if it's due to other factors like increased appetite or decreased activity, it might not be as directly linked to diabetes risk.
B. Many antipsychotic medications, including aripiprazole, have been linked to metabolic side effects like weight gain, increased blood glucose levels, and dyslipidemia. These metabolic changes can increase the risk of developing type 2 diabetes.
C. A sedentary lifestyle is a well-known risk factor for type 2 diabetes. Reduced physical activity can lead to insulin resistance, a condition where the body's cells become less responsive to insulin.
D. A diet rich in vegetables and lean protein is generally healthy and can help prevent chronic diseases. This option does not directly increase the risk of type 2 diabetes.
E. A random blood glucose level above 200 mg/dL is indicative of diabetes. This is a clear marker of impaired glucose metabolism and a significant risk factor for type 2 diabetes.

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The nurse is caring for a client with a diagnosis of chronic peripheral arterial disease. Which statement by the client warrants immediate intervention by the nurse?

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Explanation

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