Brunner and Suddarth's Textbook of Medical Surgical Nursing; Chapter 30: Assessment and Management of Patients With Vascular Disorders Questions & Answers (2025)

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• brunner and suddarths textbook of medical stuvia

• the nurse is taking a health history of a new pati

• while assessing a patient the nurse notes that the

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Brunner and Suddarth's Textbook of
Medical Surgical Nursing; Chapter 30:
Assessment and Management of
Patients With Vascular Disorders
Questions & Answers
The nurse is taking a health history of a new patient. The patient reports experiencing
pain in his left lower leg and foot when walking. This pain is relieved with rest. The
nurse notes that the left lower leg is slightly edematous and is hairless. When planning
this patient's subsequent care, the nurse should most likely address what health
problem?

-Coronary artery disease (CAD)
-Intermittent claudication
-Arterial embolus
-Raynaud's disease - ANSWERSAnswer: Intermittent Claudication

Feedback: A muscular, cramptype pain in the extremities consistently reproduced with
the same degree of exercise or activity and relieved by rest is experienced by patients
with peripheral arterial insufficiency. Referred to as intermittent claudication, this pain is
caused by the inability of the arterial system to provide adequate blood flow to the
tissues in the face of increased demands for nutrients and oxygen during exercise. The
nurse would not suspect the patient has CAD, arterial embolus, or Raynaud's disease;
none of these health problems produce this cluster of signs and symptoms.

While assessing a patient the nurse notes that the patient's anklebrachial index (ABI) of
the right leg is 0.40. How should the nurse best respond to this assessment finding?

-- Assess the patient's use of overthecounter dietary supplements.

-- Implement interventions relevant to arterial narrowing.

--Encourage the patient to increase intake of foods high in vitamin K.

,--Adjust the patient's activity level to accommodate decreased coronary output. -
ANSWERSAnswer: implement interventions relevant to arterial narrowing.

Feedback: ABI is used to assess the degree of stenosis of peripheral arteries. An ABI of
less than 1.0 indicates possible claudication of the peripheral arteries. It does not
indicate inadequate coronary output. There is no direct indication for changes in vitamin
K intake and OTC medications are not likely causative.

The nurse is providing care for a patient who has just been diagnosed with peripheral
arterial occlusive disease (PAD). What assessment finding is most consistent with this
diagnosis?

- Numbness and tingling in the distal extremities

-Unequal peripheral pulses between extremities

-Visible clubbing of the fingers and toes

-Reddened extremities with muscle atrophy - ANSWERSAnswer: Unequal peripheral
pulses between extremities

Feedback: PAD assessment may manifest as unequal pulses between extremities, with
the affected leg cooler and paler than the unaffected leg. Intermittent claudication is far
more common than sensations of numbness and tingling. Clubbing and muscle atrophy
are not associated with PAD.

The nurse is admitting a 32yearold woman to the presurgical unit. The nurse learns
during the admission assessment that the patient takes oral contraceptives.
Consequently, the nurse's postoperative plan of care should include what intervention?

-Early ambulation and leg exercises

-Cessation of the oral contraceptives until 3 weeks postoperative

- Doppler ultrasound of peripheral circulation twice daily

-Dependent positioning of the patient's extremities when at rest - ANSWERSAnswer:
Early ambulation and leg exercises

Feedback: Oral contraceptive use increases blood coagulability; with bed rest, the
patient may be at increased risk of developing deep vein thrombosis. Leg exercises and
early ambulation are among the interventions that address this risk. Assessment of
peripheral circulation is important, but Doppler ultrasound may not be necessary to
obtain these data. Dependent positioning increases the risk of venous

, thromboembolism (VTE). Contraceptives are not normally discontinued to address the
risk of VTE in the short term.

A nurse is creating an education plan for a patient with venous insufficiency. What
measure should the nurse include in the plan?

-Avoiding tightfitting socks.

-Limit activity whenever possible.

-Sleep with legs in a dependent position.

-Avoid the use of pressure stockings. - ANSWERSanswer: Avoiding tightfitting socks.

Feedback: Measures taken to prevent complications include avoiding tightfitting socks
and panty girdles; maintaining activities, such as walking, sleeping with legs elevated,
and using pressure stockings. Not included in the teaching plan for venous insufficiency
would be reducing activity, sleeping with legs dependent, and avoiding pressure
stockings. Each of these actions exacerbates venous insufficiency.

The nurse is caring for a patient with a large venous leg ulcer. What intervention should
the nurse implement to promote healing and prevent infection?

-Provide a highcalorie, highprotein diet.

-Apply a clean occlusive dressing once daily and whenever soiled.

-Irrigate the wound with hydrogen peroxide once daily.

-Apply an antibiotic ointment on the surrounding skin with each dressing change. -
ANSWERSAnswer: Provide a highcalorie, highprotein diet.

Feedback: Wound healing is highly dependent on adequate nutrition. The diet should be
sufficiently high in calories and protein. Antibiotic ointments are not normally used on
the skin surrounding a leg ulcer and occlusive dressings can exacerbate impaired blood
flow. Hydrogen peroxide is not normally used because it can damage granulation tissue.

The nurse is caring for a patient who returned from the tropics a few weeks ago and
who sought care with signs and symptoms of lymphedema. The nurse's plan of care
should prioritize what nursing diagnosis?

- Risk for infection related to lymphedema

-Disturbed body image related to lymphedema

-Ineffective health maintenance related to lymphedema