Vascular Flashcards
(43 cards)
A patient with peripheral artery disease (PAD) complains of leg pain while walking that is relieved by rest. The nurse identifies this as which symptom?
A. Rest pain
B. Intermittent claudication
C. Neuropathic pain
D. Venous stasis pain
Correct Answer: B. Intermittent claudication
Rationale: Intermittent claudication is a hallmark symptom of PAD, caused by inadequate blood flow to the muscles during exercise. The pain is relieved with rest. Rest pain, in contrast, indicates more severe arterial insufficiency.
A nurse is teaching a patient with PAD about foot care. Which statement by the patient indicates a need for further education?
A. “I will inspect my feet daily for any sores or injuries.”
B. “I should soak my feet in warm water every evening to keep them clean.”
C. “I need to wear well-fitted shoes to prevent foot injuries.”
D. “I should avoid walking barefoot to prevent injuries.”
Correct Answer: B. “I should soak my feet in warm water every evening to keep them clean.”
Rationale: Patients with PAD should avoid soaking their feet because prolonged exposure to water can cause maceration and increase the risk of infection. Proper foot hygiene includes washing with mild soap and warm (not hot) water, drying thoroughly, and moisturizing (avoiding the spaces between the toes).
A patient with a history of deep vein thrombosis (DVT) presents with sudden shortness of breath, chest pain, and hemoptysis. What complication should the nurse suspect?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumothorax
D. Pleural effusion
Correct Answer: B. Pulmonary embolism
Rationale: Pulmonary embolism (PE) occurs when a clot from a DVT travels to the lungs, blocking pulmonary circulation. Classic signs include sudden dyspnea, chest pain, and hemoptysis. This is a medical emergency.
A patient with a suspected deep vein thrombosis (DVT) presents with unilateral leg swelling, warmth, and tenderness. Which nursing intervention is most appropriate?
A. Massage the affected leg to improve circulation
B. Apply ice packs to reduce swelling
C. Keep the affected leg in a dependent position
D. Maintain bed rest and elevate the leg
Correct Answer: D. Maintain bed rest and elevate the leg
Rationale: Elevation reduces swelling and promotes venous return. Massaging the leg is contraindicated as it may dislodge the clot, leading to a pulmonary embolism.
A patient is prescribed warfarin for long-term anticoagulation therapy after a DVT. Which statement indicates the patient understands the medication instructions?
A. “I will avoid eating green leafy vegetables.”
B. “I will take my medication at the same time every day.”
C. “I need weekly blood draws for INR monitoring.”
D. “If I miss a dose, I should take double the next dose.”
Correct Answer: B. “I will take my medication at the same time every day.”
Rationale: Consistency in taking warfarin is essential for maintaining a therapeutic INR. While patients should limit, not completely avoid, high-vitamin K foods (like leafy greens), frequent INR monitoring is typically needed but not always weekly.
A nurse is reviewing the medication list of a patient on anticoagulation therapy. Which over-the-counter medication should the patient avoid due to increased bleeding risk?
A. Acetaminophen
B. Ibuprofen
C. Loratadine
D. Omeprazole
Correct Answer: B. Ibuprofen
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, increase the risk of bleeding when taken with anticoagulants. Acetaminophen is a safer alternative for pain relief in these patients.
A patient with a recent diagnosis of PAD is advised to start an exercise program. What should the nurse include in the teaching?
A. “Stop exercising as soon as you feel pain in your legs.”
B. “Walking is the best exercise for improving circulation.”
C. “Limit walking to short distances to prevent fatigue.”
D. “Only exercise indoors to avoid temperature changes.”
Correct Answer: B. “Walking is the best exercise for improving circulation.”
Rationale: Walking is the best exercise for PAD as it promotes collateral circulation. Patients should walk until they experience discomfort, rest, and then continue walking again to improve endurance and blood flow.
A patient with a DVT is receiving heparin therapy. Which lab result should the nurse monitor to determine therapeutic effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. D-dimer level
Correct Answer: C. Activated partial thromboplastin time (aPTT)
Rationale: aPTT is used to monitor the effectiveness of heparin therapy. Warfarin, in contrast, is monitored using PT and INR.
A patient with peripheral artery disease (PAD) has critical limb ischemia. Which assessment finding requires immediate intervention?
A. Thickened toenails and dependent rubor
B. Pain in the affected limb that is relieved with rest
C. Ulcers on the toes with a pale wound bed
D. Absent pedal pulses and cold, cyanotic toes
Correct Answer: D. Absent pedal pulses and cold, cyanotic toes
Rationale: Absent pulses and cyanotic toes indicate severe arterial insufficiency and possible limb-threatening ischemia. This requires immediate intervention to restore blood flow and prevent necrosis.
A nurse is providing discharge instructions to a patient with venous thromboembolism (VTE) who is prescribed warfarin. Which statement by the patient indicates a need for further teaching?
A. “I will wear compression stockings daily.”
B. “I need to have my INR checked regularly.”
C. “I can take ibuprofen for pain as needed.”
D. “I will avoid prolonged sitting and keep my legs elevated when possible.”
Correct Answer: C. “I can take ibuprofen for pain as needed.”
Rationale: Ibuprofen (an NSAID) increases the risk of bleeding in patients on warfarin. Acetaminophen is a safer alternative for pain relief.
A patient with a suspected pulmonary embolism (PE) is receiving oxygen and anticoagulation therapy. Which assessment finding requires immediate action?
A. Sudden onset of confusion and restlessness
B. Mild pleuritic chest pain with deep breathing
C. SpO₂ of 94% on 2L nasal cannula
D. Low-grade fever of 37.8°C (100°F)
Correct Answer: A. Sudden onset of confusion and restlessness
Rationale: Confusion and restlessness indicate hypoxia, which may suggest worsening PE and impaired oxygenation. This requires immediate intervention.
A nurse is caring for a patient receiving heparin for deep vein thrombosis (DVT). Which finding would require the nurse to stop the infusion and notify the provider?
A. aPTT of 60 seconds
B. Platelet count of 90,000/mm³
C. Hemoglobin of 14 g/dL
D. Bruising at the IV site
Correct Answer: B. Platelet count of 90,000/mm³
Rationale: A platelet count below 100,000/mm³ may indicate heparin-induced thrombocytopenia (HIT), a serious complication requiring immediate discontinuation of heparin.
A patient with chronic venous insufficiency is at risk for venous stasis ulcers. Which nursing intervention is most appropriate?
A. Encourage prolonged sitting with legs dependent
B. Apply moist heat packs to improve circulation
C. Elevate legs above heart level when resting
D. Massage the lower extremities to improve blood flow
Correct Answer: C. Elevate legs above heart level when resting
Rationale: Elevating the legs improves venous return and reduces swelling. Prolonged sitting, heat, and massage are contraindicated due to the risk of clot dislodgment or worsening venous congestion.
A patient receiving enoxaparin (Lovenox) for DVT prevention asks why this medication is necessary after surgery. What is the nurse’s best response?
A. “It helps dissolve any clots that may have formed during surgery.”
B. “It prevents clots from forming by thinning your blood.”
C. “It stops the platelets from sticking together in your arteries.”
D. “It improves circulation by increasing blood flow to your legs.”
Correct Answer: B. “It prevents clots from forming by thinning your blood.”
Rationale: Enoxaparin is a low-molecular-weight heparin that prevents clot formation by inhibiting clotting factors, reducing the risk of DVT after surgery.
A patient with a history of deep vein thrombosis (DVT) is planning to take a long flight. Which teaching point should the nurse emphasize?
A. “Take aspirin before the flight to prevent clotting.”
B. “Remain seated as much as possible during the flight.”
C. “Wear compression stockings and perform leg exercises.”
D. “Drink caffeinated beverages to keep blood circulating.”
Correct Answer: C. “Wear compression stockings and perform leg exercises.”
Rationale: Wearing compression stockings and performing leg exercises help promote venous return and prevent DVT during prolonged immobility.
A nurse is monitoring a patient receiving thrombolytic therapy for a massive pulmonary embolism (PE). Which finding is most concerning?
A. Epistaxis (nosebleed)
B. Pink-tinged sputum
C. Sudden decrease in level of consciousness
D. Bruising at the IV site
Correct Answer: C. Sudden decrease in level of consciousness
Rationale: A sudden decrease in LOC may indicate intracranial bleeding, a serious complication of thrombolytic therapy. This requires immediate intervention.
A nurse is caring for a patient with peripheral artery disease (PAD). Which statement by the patient requires further teaching?
A. “I should avoid crossing my legs when sitting.”
B. “I will keep my legs elevated when resting.”
C. “I will quit smoking to help improve my circulation.”
D. “I will check my feet daily for any wounds or changes.
Correct Answer: B. “I will keep my legs elevated when resting.”
Rationale: Elevating the legs reduces venous congestion but worsens arterial circulation in PAD. Patients should keep their legs in a dependent position to promote blood flow
A patient with a newly diagnosed deep vein thrombosis (DVT) is prescribed warfarin and enoxaparin. The patient asks why they are taking both medications. What is the best response?
A. “Warfarin works immediately, while enoxaparin helps prevent clots.”
B. “Enoxaparin works right away, and warfarin takes a few days to be effective.”
C. “Both medications work the same way, so they are given together for better results.”
D. “Warfarin prevents new clots, while enoxaparin helps dissolve the existing clot.”
Correct Answer: B. “Enoxaparin works right away, and warfarin takes a few days to be effective.”
Rationale: Warfarin takes several days to reach a therapeutic INR level, so enoxaparin (a low-molecular-weight heparin) is used as a bridge therapy until warfarin becomes effective.
A nurse is reviewing discharge instructions with a patient who has a venous ulcer due to chronic venous insufficiency. Which statement indicates a need for further teaching?
A. “I will keep my legs elevated as much as possible.”
B. “I should apply a heating pad to improve circulation.”
C. “I will wear compression stockings daily.”
D. “I should report any signs of infection, such as redness or drainage.”
Correct Answer: B. “I should apply a heating pad to improve circulation.”
Rationale: Applying heat is contraindicated as it may cause burns due to impaired sensation in affected areas. Instead, compression and leg elevation are key to improving circulation.
A patient is diagnosed with heparin-induced thrombocytopenia (HIT). Which action should the nurse take first?
A. Continue monitoring platelet counts
B. Administer vitamin K
C. Stop the heparin infusion immediately
D. Prepare to administer a platelet transfusion
Correct Answer: C. Stop the heparin infusion immediately
Rationale: HIT is a serious immune-mediated reaction that increases the risk of thrombosis. The first priority is stopping heparin and switching to an alternative anticoagulant.
A nurse is caring for a patient with a history of peripheral artery disease (PAD). Which intervention should the nurse implement to promote circulation?
A. Apply warm compresses to the affected extremity
B. Encourage the patient to dangle their legs when sitting
C. Elevate the legs above heart level
D. Massage the affected limb to improve blood flow
Correct Answer: B. Encourage the patient to dangle their legs when sitting
Rationale: Patients with PAD should keep their legs in a dependent position (dangling) to improve arterial blood flow. Elevating the legs above heart level is appropriate for venous insufficiency but not for PAD. Warm compresses and massage can worsen ischemia and should be avoided.
A nurse is assessing a patient with a suspected deep vein thrombosis (DVT). Which finding requires immediate intervention?
A. Unilateral leg swelling and redness
B. Positive Homan’s sign
C. New onset of shortness of breath and chest pain
D. Warmth over the affected calf
Correct Answer: C. New onset of shortness of breath and chest pain
Rationale: Sudden shortness of breath and chest pain may indicate a pulmonary embolism (PE), a life-threatening complication of DVT. This requires immediate intervention.
A patient is receiving warfarin for DVT treatment. Which patient statement indicates a need for further teaching?
A. “I will avoid green leafy vegetables in my diet.”
B. “I should have my INR checked regularly.”
C. “I will take my medication at the same time every day.”
D. “I should report any unusual bleeding or bruising to my doctor.”
Correct Answer: A. “I will avoid green leafy vegetables in my diet.”
Rationale: Patients on warfarin should maintain a consistent intake of vitamin K foods (e.g., leafy greens), not avoid them completely. INR monitoring is essential to ensure proper anticoagulation.
A patient with a history of DVT is preparing for a long car trip. Which action should the nurse recommend to reduce the risk of another clot?
A. Take aspirin before the trip
B. Wear compression stockings and take breaks to walk
C. Keep legs in a dependent position while sitting
D. Avoid drinking fluids to reduce swelling
Correct Answer: B. Wear compression stockings and take breaks to walk
Rationale: Compression stockings and frequent movement help prevent venous stasis and reduce the risk of DVT. Keeping the legs dependent and dehydration increase clot risk.
