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INSTRUCTIONS A closer look at lower extremity peripheral arterial disease



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A closer look at lower extremity peripheral arterial disease


GENERAL PURPOSE: To provide nurses with information about lower extremity PAD. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Identify the risk factors for PAD. 2. Describe the pathophysiology of PAD. 3. List the signs and symptoms of PAD.


1. Which patients tend to have a lower incidence of PAD?HispanicBlacknon-Hispanic White


2. The risk of death from a cardiac event is how much higher for those with PAD than for those without PAD?two to three timesfour to five timessix to eight times


3. Factors associated with the regulation of thrombosis includeprostacyclin.interleukins.interferons.


4. Risk factors for PAD include all of the following exceptcoronary artery disease.normotension.smoking.


5. Generally an artery has narrowed by at least how much before the patient with PAD begins to develop intermittent claudication?30%40%50%


6. Claudication is typically described asfatigue from the hips to the feet.induced by walking.relieved by exercise.


7. As PAD progresses, leg elevation causespallor.rubor.pain relief.


8. Which physical assessment finding of the lower extremities is consistent with PAD?normal pedal pulsespitting edemathickened, ridged toenails


9. When assessing for skin color changes, maximal pallor of the feet usually develops within 1 minute when thepatient is in a prone position.legs are elevated to about 60 degrees.legs are placed in a dependent position.


10. Nurses can assess for postural color changes in darker-skinned patients by inspecting thesoles of the feet.dorsal aspect of the feet.nailbeds of the feet.


11. According to Gerhard-Herman et al., what may be the only test required to establish the diagnosis of PAD?ABImagnetic resonance angiographyskin perfusion pressure


12. When calculating the ABI,divide the higher right or left arm pressure by the higher dorsalis pedis or posterior tibial pressure.divide the higher dorsalis pedis or posterior tibial pressure by the higher right or left arm pressure.divide the lower dorsalis pedis or posterior tibial pressure by the higher right or left arm pressure.


13. Normal resting ABI is0.40 to to to 1.40.


14. What's the most effective exercise to treat intermittent claudication?swimmingyogawalking


15. An adverse reaction to cilostazol isextremity pallor.palpitations.increased claudication.


16. In patients with PAD, where do ulcerations usually develop?points of trauma on feetlateral malleolusplantar aspect of foot


17. When claudication occurs, stenosis or occlusion is most commonly found in the superficial femoral andposterior tibial arteries.dorsalis pedis arteries.proximal popliteal arteries.


18. Education for a patient with PAD should includeapplying moisturizer between toes.wearing properly fitting footwear.inspecting feet and legs monthly.



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