All of the factors contribute to the patient’s risk, but only hypertension can potentially be modified to decrease the patient’s risk for further expansion of the aneurysm.
Abdominal trauma history
Difficulty swallowing may occur with a thoracic aneurysm because of pressure on the esophagus. The other symptoms will be important to assess for in patients with abdominal aortic aneurysms.
changes in bowel habits.
low back pain.
The decreased urine output suggests decreased renal perfusion, and monitoring of renal function is needed. There is no indication that infection is a concern, so antibiotic therapy and a WBC count are not needed. The IV rate may be increased because hypov
blood urea nitrogen (BUN) level.
decrease in IV infusion rate.
Current research indicates that statin use by patients with PAD improves multiple outcomes. There is no research that supports the use of the other medication categories in PAD.
The patient’s history and clinical manifestations are consistent with acute arterial occlusion, and resting the leg will decrease the oxygen demand of the tissues and minimize ischemic damage until circulation can be restored. Elevating the leg or applyin
assist the patient in gently exercising the leg.
keep the patient in bed in the supine position.
apply a compression stocking to the leg.
elevate the leg above the level of the heart.
The nurse should assess for other clinical manifestations of peripheral arterial disease in a patient who describes intermittent claudication. Changes in skin color that occur in response to cold are consistent with Raynaud’s phenomenon. Tortuous veins on
assess for the presence of the dorsalis pedis and posterior tibial pulses.
assess for unilateral swelling, redness, and tenderness of either leg.
ask about any skin color changes that occur in response to cold.
check for the presence of tortuous veins bilaterally on the legs.
Capillary refill is prolonged in PAD because of the slower and decreased blood flow to the periphery. The other listed clinical manifestations are consistent with chronic venous disease.
swollen, dry, scaly ankles.
prolonged capillary refill in all the toes.
dilated superficial veins.
a serosanguineous drainage from the ulcer.
Because the patient has impaired circulation and sensation to the feet, the use of a heating pad could lead to burns. The other patient statements are correct and indicate that teaching has been successful.
use a heating pad on my feet at night to increase the circulation and warmth in my feet.”
walk to the point of pain, rest, and walk again until the pain returns for at least 30 minutes 3 times a week.”
change my position every hour and avoid long periods of sitting with my legs crossed.”
have to buy some loose clothes that do not bind across my legs or waist.”
Patients should avoid temperature extremes by exercising indoors when it is cold. To avoid burn injuries, the patient should use warm, rather than hot, water to warm the hands. Pseudoephedrine is a vasoconstrictor, and should be avoided. There is no reaso
The patient avoids taking nonsteroidal antiinflammatory drugs (NSAIDs).
The patient places the hands in hot water when they turn pale.
The patient exercises indoors during the winter months.
The patient takes pseudoephedrine (Sudafed) for cold symptoms.
The purpose of elevating the feet is to enhance venous flow from the feet to the right atrium, which is best accomplished by placing two pillows under the feet and one under the thighs. Placing the patient in the Trendelenburg position will lower the head
The patient is placed in the Trendelenburg position.
One pillow is placed under the thighs and two pillows are placed under the lower legs.
Two pillows are positioned under the affected leg.
The bed is elevated at the knee and pillows are placed under the feet.
IM injections are avoided in patients receiving anticoagulation. A PTT of 65 seconds is within the therapeutic range. Vitamin K is used to reverse warfarin. Pulse quality is not affected by VTE.
avoid giving any IM medications to prevent localized bleeding.
monitor posterior tibial and dorsalis pedis pulses with the Doppler.
decrease the infusion when the PTT value is 65 seconds.
have vitamin K available in case reversal of the heparin is needed.
Low molecular weight heparin (LMWH) is used because of the immediate effect on coagulation and discontinued once the international normalized ratio (INR) value indicates that the warfarin has reached a therapeutic level. LMWH has no thrombolytic propertie
“Lovenox will start to dissolve the clot, and Coumadin will prevent any more clots from forming.”
“Taking two blood thinners reduces the risk for another clot to form.”
“Because of the risk for a blood clot in the lungs, it is important for you to take more than one blood thinner.”
“Lovenox will work right away, but Coumadin takes several days to have an effect on preventing clots.”
Patients taking warfarin are taught to follow a consistent diet with regard to foods that are high in vitamin K, such as green, leafy vegetables. The other patient statements are accurate.
“I will need routine blood tests to monitor the effects of the Coumadin.”
“I should reduce the amount of green, leafy vegetables that I eat.”
“I will check with my health care provider before I begin any new medications.”
“I should get a Medic Alert device stating that I take Coumadin.”
Elastic compression stockings are applied with the legs elevated to reduce pressure in the lower legs. Walking is recommended to prevent recurrent varicosities. Sitting and standing are both risk factors for varicose veins and venous insufficiency. An asp
Taking an aspirin daily will help prevent clots from forming around venous valves.
Exercise, such as walking or jogging, can cause recurrence of varicosities.
Elastic compression stockings should be applied before getting out of bed.
Sitting at the work counter, rather than standing, is recommended.
Compression of the leg is essential to healing of venous stasis ulcers. High dietary intake of protein, rather than carbohydrates, is needed. Prophylactic antibiotics are not routinely used for venous ulcers. Moist dressings are used to hasten wound heali
Need to increase carbohydrate intake
Purpose of prophylactic antibiotic therapy
Methods of keeping the wound area dry
Application of elastic compression stockings
选择要在Apple App Store上查看的Topgrade应用程序。