The client who has been diagnosed with PAD has a nursing diagnosis of Risk for Impaired Skin Integrity related to decreased peripheral circulation. Which of the following interventions is most appropriate for this client?
1. Instruct client on protecting the legs from injury because tissue is fragile and any wound is likely to heal slowly.
2. Instruct client on appropriate level of activity to promote circulation.
3. Instruct client on risk factors that may increase problems with PAD.
4. Instruct client on PAD signs and symptoms.
Instruct client on protecting the legs from injury because tissue is fragile and any wound is likely to heal slowly.
Rationale: The client with risk for impaired skin integrity related to decreased peripheral circulation will need instruction on protecting the legs from injury. Any wound the client acquires is likely to heal slowly. The client will need instruction on the appropriate level of activity, risk factors, and signs and symptoms of PAD, but these do not relate to risk for impaired skin integrity.
You might also like to view...
The nurse schedules a patient for her first prenatal appointment with the certified nurse-midwife (CNM) in the clinic. About what topics does the nurse help the patient formulate questions to ask the CNM? (Select all that apply.)
A. An opportunity to meet other patients who have delivered with this practice B. The CNM's beliefs and practices concerning epidural anesthesia and episiotomies C. Use of complementary and alternative methods during labor and birth D. What happens if the patient gives birth when the CNM is not available E. Whether the CNM will be available by phone or Internet to answer questions
The population health nurse is reviewing the State Children's Health Insurance Programs (SCHIP) with a mother who has seven children. During this conversation the nurse explains that this program was established by Congress to provide health insurance
coverage for low-income children whose parents did not have insurance coverage or who did not qualify for Medicaid benefits and is administered by the state. What process is the nurse reviewing that highlights the transfer of federal oversight and responsibility to the states for this program? 1. Devolution. 2. Shared responsibility. 3. Block grant funding. 4. Health care innovation.
Which option reflects the nurse's duty to prevent patient falls?
1. The nurse has a duty to assess the patient for risk for falls. 2. The nurse has a duty to provide minimal assistance. 3. The nurse has a duty to provide continual observation of patients. 4. The nurse has a duty to see that siderails on all beds are raised at all times.
A patient with schizophrenia receives a dose of risperidone [Risperdal Consta] IM. The nurse teaching this patient about this medication will make which statement?
a. "You will experience therapeutic levels of this drug in 1 to 2 weeks." b. "You will need injections of this drug every 6 weeks." c. "You will need to take an oral antipsy-chotic drug for 3 weeks." d. "You probably will not have extrapyra-midal symptoms with this drug."