While working in the outpatient clinic, the nurse notes that the client has a history of intermittent claudication. Which statement by the client would support this information?

"My legs cramp when I walk more than a block."

"I get short of breath when I climb a lot of stairs."

"When I stand for too long, my feet start to swell."

"My fingers hurt when I go outside in cold weather."

Answer and Explanation

The Correct Answer is A

A. Intermittent claudication is characterized by cramping pain in the legs during physical activity, such as walking, due to insufficient blood flow, typically caused by peripheral arterial disease (PAD). This statement aligns with the symptoms of claudication.

B. Shortness of breath during physical exertion is more indicative of cardiovascular or pulmonary issues, not intermittent claudication.

C. Swelling in the feet from standing for extended periods is more consistent with venous insufficiency rather than intermittent claudication.

D. Pain in the fingers due to cold weather suggests Raynaud’s phenomenon, not intermittent claudication.

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Correct Answer is D

Explanation

A. Although monitoring hemodynamic parameters is important, this option does not address the immediate issue of low preload, as indicated by the low CVP and PAWP, suggesting hypovolemia.

B. Furosemide is a diuretic and would further decrease intravascular volume, which is inappropriate given the signs of hypovolemia.

C. Decreasing IV fluids would exacerbate the low preload and worsen the client's condition by reducing intravascular volume even further.

D. Administering 0.9% Normal Saline @ 150 mL/hr is the most appropriate intervention. The low CVP and PAWP indicate hypovolemia, and increasing fluid administration will help to increase the preload, thereby improving the client's hemodynamic status.

A. Client who describes intense squeezing pressure across the chest. B. Client who reports moderate pain that is worse on inspiration. C. Client who reports cramping substernal pain. D. Client who describes pain as a dull ache.

Correct Answer is A

Explanation

A. This description is indicative of possible myocardial infarction (MI), a life-threatening emergency. Immediate evaluation and intervention, such as administering oxygen, obtaining an EKG, and providing pain relief, are crucial to prevent further damage to the heart and reduce mortality.

B. Moderate pain worse on inspiration suggests pleuritic pain, often associated with conditions like pleuritis or pulmonary embolism, which are serious but generally not as immediately life-threatening as an MI.

C. Cramping substernal pain may indicate a gastrointestinal issue, such as gastroesophageal reflux disease (GERD), which is less urgent than a potential MI.

D. A dull ache may be related to musculoskeletal or gastrointestinal issues and does not suggest the immediate need for intervention seen in MI.

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While working in the outpatient clinic, the nurse notes that the client has a history of intermittent claudication. Which statement by the client would support this information?

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