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Chapter 36: Care of Patients with Vascular
Problems Ignatavicius: Medical- Surgical
Nursing, 8th Edition
MULTIPLE CHOICE
1.
A student nurse is assessing the peripheral vascular system of an older adult. What
action by the student would cause the faculty member to intervene?
a.
Assessing blood pressure in both upper extremities
b.
Auscultating the carotid arteries for any bruits
c.
Classifying capillary refill of 4 seconds as normal
d.
Palpating both carotid arteries at the
same time ANS: D
The student should not compress both carotid arteries at the same time to avoid brain
ischemia. Blood pressure should be taken and compared in both arms. A prolonged
capillary refill is considered to be greater than 5 seconds in an older adult, so classifying
a refill of 4 seconds as normal would not require intervention. Bruits should be
auscultated.
DIF: Remembering/Knowledge REF: 707
KEY: Nursing assessment| neurologic system| neurologic
assessment MSC: Integrated Process: Communication and
Documentation
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
2.
The nurse is reviewing the lipid panel of a male client who has atherosclerosis.
Which finding is most concerning?
a.
Cholesterol: 126 mg/dL
b.
High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c.
Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
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d.
Triglycerides: 198
mg/dL ANS: D
Triglycerides in men should be below 160 mg/dL. The other values are appropriate for
adult males.
DIF: Remembering/Knowledge
REF: 708 KEY: Laboratory values|
lipid alterations
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
3.
The nurse is evaluating a 3-day diet history with a client who has an elevated lipid
panel. What meal selection indicates the client is managing this condition well with
diet?
a.
A 4-ounce steak, French fries, iceberg lettuce
b.
Baked chicken breast, broccoli, tomatoes
c.
Fried catfish, cornbread, peas
d.
Spaghetti with meat sauce, garlic
bread ANS: B
The diet recommended for this client would be low in saturated fats and red meat, high
in vegetables and whole grains (fiber), low in salt, and low in trans fat. The best choice
is the chicken with broccoli and tomatoes. The French fries have too much fat and the
iceberg lettuce has little fiber. The catfish is fried. The spaghetti dinner has too much
red meat and no vegetables.
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DIF: Evaluating/Synthesis REF:
708 KEY: Nutrition| fiber|
self-care
MSC: Integrated Process: Nursing Process: Evaluation
NOT: Client Needs Category: Health Promotion and Maintenance
4.
A nurse is working with a client who takes atorvastatin (Lipitor). recent The client’s
laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of
2.8 mg/dL. What action by the nurse is best?
a.
Ask if the client eats grapefruit.
b.
Assess the client for dehydration.
c.
Facilitate admission to the hospital.
d.
Obtain a random
urinalysis. ANS: A
There is a drug-food interaction between statins and grapefruit that can lead to acute
kidney failure. This client has elevated renal laboratory results, indicating some degree
of kidney involvement. The nurse should assess if the client eats grapefruit or drinks
grapefruit juice. Dehydration can cause the BUN to be elevated, but the elevation in
creatinine is more specific for a kidney injury. The client does not necessarily need to
be admitted. A urinalysis may or may not be ordered.
DIF: Applying/Application REF: 709
KEY: Laboratory values| statins| nursing assessment| medication-food
interaction MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral
Therapies
5.
A client has been diagnosed with hypertension but does not take antihypertensive
medications because of a lack of symptoms. What response by the nurse is best?
a.
“Do medications?” you have trouble affording your
b.
“Most people with hypertension do not have symptoms.”
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c.
“You are lucky; most people get severe morning headaches.”
d.
“You need to take your medicine or you will get kidney
failure.” ANS: B
Most people with hypertension are asymptomatic, although a small percentage do
have symptoms such as headaches. The nurse should explain this to the client. Asking
about paying for medications is not related because the client has already admitted
nonadherence. Threatening the client with possible complications will not increase
compliance.
DIF: Understanding/Comprehension REF: 711
KEY: Hypertension| antihypertensive medications| medication
adherence MSC: Integrated Process: Communication and
Documentation
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
6.
A student nurse asks what “essential hypertension” is. What response by the
registered nurse is best?
a.
“It means it is caused by another disease.”
b.
“It ‘essential’ treated.” means it is that it be
c.
“It cause.” is hypertension with no specific
d.
“It refers to severe and lifethreatening
hypertension.” ANS: C
Essential hypertension is the most common type of hypertension and has no specific
cause such as
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an underlying disease process. Hypertension that is due to another disease process is
called secondary hypertension. A severe, life-threatening form of hypertension is
malignant hypertension.
DIF: Understanding/Comprehension REF: 710
KEY: Hypertension| pathophysiology| patient
education MSC: Integrated Process:
Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
7.
A nurse is interested in providing community education and screening on
hypertension. To reach a priority population, to what target audience should the nurse
provide this service?
a.
African-American churches
b.
Asian-American groceries
c.
High school sports camps
d.
Women’s health
clinics ANS: A
African Americans in the United States have one of the highest rates of hypertension in
the world. The nurse has the potential to reach this priority population by providing
services at African- American churches. Although hypertension education and
screening are important for all groups, African Americans are the priority population for
this intervention.
DIF: Remembering/Knowledge REF: 711
KEY: Hypertension| primary prevention| secondary prevention| cultural
awareness MSC: Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Health Promotion and Maintenance
8.
A client has hypertension and high-risk factors for cardiovascular disease.
The client is overwhelmed with the recommended lifestyle changes. What
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action by the nurse is best?
a.
Assess the support system.client’s
b.
Assist in finding one change the client can control.
c.
Determine what stressors the client faces in daily life.
d.
Inquire about delegating some of the client’s
obligations. ANS: B
All options are appropriate when assessing stress and responses to stress. However,
this client feels overwhelmed by the suggested lifestyle changes. Instead of looking at all
the needed changes, the nurse should assist the client in choosing one the client feels
optimistic about controlling. Once the client has mastered that change, he or she can
move forward with another change. Determining support systems, daily stressors, and
delegation opportunities do not directly feelings of control.impact the client’s
DIF: Applying/Application REF: 712
KEY: Hypertension| patient education| coping| psychosocial
response MSC: Integrated Process: Nursing Process:
Assessment
NOT: Client Needs Category: Psychosocial Integrity
9.
The nurse is caring for four hypertensive clients. Which drug laboratory value –
combination should the nurse report immediately to the health care provider?
a.
Furosemide (Lasix)/potassium: 2.1 mEq/L
b.
Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L
c.
Spironolactone (Aldactone)/potassium: 5.1 mEq/L
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d.
Torsemide (Demadex)/sodium: 142
mEq/L ANS: A
Lasix is a loop diuretic and can cause hypokalemia. A potassium level of 2.1 mEq/L is
quite low and should be reported immediately. Spironolactone is a potassium-sparing
diuretic that can cause hyperkalemia. A potassium level of 5.1 mEq/L is on the high side,
but it is not as critical as the low potassium with furosemide. The other two laboratory
values are normal.
DIF: Applying/Application REF: 714
KEY: Hypertension| antihypertensive medications|
laboratory values MSC: Integrated Process: Nursing
Process: Analysis
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
10.
A nurse is assessing a client with peripheral artery disease (PAD). The client states
walking five blocks is possible without pain. What question asked next by the nurse will
give the best information?
a.
“Could you walk further than that a few months ago?”
b.
“Do you walk mostly uphill, downhill, or on flat surfaces?”
c.
“Have you ever considered swimming instead of walking?”
d.
“How much pain medication do you take
each day?” ANS: A
As PAD progresses, it takes less oxygen demand to cause pain. Needing to cut down
on activity to be pain-free indicates the disease is worsening. The other client’s
questions are useful, but not as important.
DIF: Applying/Application REF: 719
KEY: Pain| exercise| activity| peripheral vascular disease| pain
assessment MSC: Integrated Process: Nursing Process:
Assessment
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
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11.
An older client with peripheral vascular disease (PVD) is explaining the daily foot
care regimen to the family practice clinic nurse. What statement by the client may
indicate a barrier to proper foot care?
a.
“I nearly always wear comfy sweatpants and house shoes.”
b.
“I’m glad I get energy assistance so my house isn’t so cold.”
c.
“My daughter makes sure I have plenty of lotion for my feet.”
d.
“My hands shake when I try to do things requiring
coordination.” ANS: D
Clients with PVD need to pay special attention to their feet. Toenails need to be kept
short and cut straight across. The client whose hands shake may cause injury when
trimming toenails. The nurse should refer this client to a podiatrist. Comfy sweatpants
and house shoes are generally loose and not restrictive, which is important for clients
with PVD. Keeping the house at a comfortable temperature makes it less likely the
client will use alternative heat sources, such as heating pads, to stay warm. The client
should keep the feet moist and soft with lotion.
DIF: Analyzing/Analysis REF: 725
KEY: Peripheral vascular disease| self-care|
home safety MSC: Integrated Process: Nursing
Process: Analysis
NOT: Client Needs Category: Health Promotion and Maintenance
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12.
A client is taking warfarin (Coumadin) and asks the nurse if taking St. John’s wort is
acceptable. What response by the nurse is best?
a.
“No, warfarin.” it may interfere with the
b.
“There isn’t any information about that.”
c.
“Why that?” would you want to take
d.
“Yes, it is a good supplement for
you.” ANS: A
Many foods and drugs interfere with warfarin, St. being one of them. The John’s wort
nurse should advise the client against taking it. The other answers are not accurate.
DIF: Understanding/Comprehension REF: 733
KEY: Anticoagulants| herbs and supplements| medication-food interactions| patient
education MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral
Therapies
13.
A nurse is teaching a larger female client about alcohol intake and how it affects
hypertension. The client asks if drinking two beers a night is an acceptable intake.
What answer by the nurse is best?
a.
“No, rule.” women should only have one beer a day as a general
b.
“No, you should not drink any alcohol with hypertension.”
c.
“Yes, alcohol.” since you are larger, you can have more
d.
“Yes, two beers per day is an acceptable amount of
alcohol.” ANS: A
Alcohol intake should be limited to two drinks a day for men and one drink a day
for women. A “drink” is classified as one beer, 1.5 ounces of hard liquor, or 5
ounces of wine. Limited alcohol intake is acceptable with hypertension. The
woman’s size does not matter.
DIF: Understanding/Comprehension REF: 712
KEY: Hypertension| lifestyle choices| patient
10
education MSC: Integrated Process:
Teaching/Learning
NOT: Client Needs Category: Health Promotion and Maintenance
14.
A nurse is caring for four clients. Which one should the nurse see first?
a.
Client who needs a beta blocker, and has a blood pressure of 92/58 mm Hg
b.
A client who had the first dose of captopril (Capoten) and needs to use the bathroom
c.
Hypertensive client with a blood pressure of 188/92 mm Hg
d.
A client who needs pain medication before a dressing change of a
surgical wound ANS: B
Angiotensin-converting enzyme inhibitors such as captopril can cause hypotension,
especially after the first dose. The nurse should see this client first to prevent falling if
the client decides to get up without assistance. The two blood pressure readings are
abnormal but not critical. The nurse should check on the client with higher blood
pressure next to assess for problems related to the reading.
The nurse can administer the beta blocker as standards state to hold it if the systolic
blood pressure is below 90 mm Hg. The client who needs pain medication before the
dressing change is not a priority over the client safety and assisting the other client to ’s
the bathroom.
DIF: Analyzing/Analysis REF: 716
KEY: Hypertension| angiotensin-converting enzyme (ACE) inhibitors| antihypertensive
medications| patient safety
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MSC: Integrated Process: Nursing Process: Analysis
NOT: Client Needs Category: Safe and Effective Care Environment: Management of
Care
15.
A client had a percutaneous transluminal coronary angioplasty for peripheral
arterial disease. What assessment finding by the nurse indicates a priority outcome
for this client has been met?
a.
Pain rated as 2/10 after medication
b.
Distal pulse on affected extremity 2+/4+
c.
Remains on bedrest as directed
d.
Verbalizes understanding of
procedure ANS: B
Assessing circulation distal to the puncture site is a critical nursing action. A pulse of
2+/4+ indicates good perfusion. Pain control, remaining on bedrest as directed after the
procedure, and understanding are all important but do not take priority over perfusion.
DIF: Evaluating/Synthesis REF: 722
KEY: Peripheral vascular disease| perfusion| nursing
assessment MSC: Integrated Process: Nursing Process:
Evaluation
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
16.
A client is 4 hours postoperative after a femoropopliteal bypass. The client reports
throbbing leg pain on the affected side rated as 7/10. What action by the nurse takes
priority?
a.
Administer pain medication as ordered.
b.
Assess distal pulses and skin color.
c.
Document the findings in the client’s chart.
d.
Notify the surgeon
immediately. ANS: B
Once perfusion has been restored or improved to an extremity, clients can often feel a
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throbbing pain due to the increased blood flow. However, it is important to differentiate
this pain from ischemia. The nurse should assess for other signs of perfusion, such as
distal pulses and skin color/temperature. Administering pain medication is done once
the nurse determines perfusion status is normal. Documentation needs to the client’s
be thorough. Notifying the surgeon is not necessary.
DIF: Applying/Application REF: 724
KEY: Peripheral vascular disease| pain assessment| nursing process assessment|
postoperative nursing
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Safe and Effective Care Environment: Management of
Care
17.
A client had a femoropopliteal bypass graft with a synthetic graft. What action by
the nurse is most important to prevent wound infection?
a.
Appropriate hand hygiene before giving care
b.
Assessing every 4 hoursthe client’s temperature
c.
Clean technique when changing dressings
d.
Monitoring the client’s daily white blood
cell count ANS: A
Hand hygiene is the best way to prevent infections in hospitalized clients. Dressing
changes should be done with a sterile technique. Assessing vital signs and white blood
cell count will not prevent infection.
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DIF: Applying/Application REF: 724
KEY: Infection control| hand hygiene| wound infection
MSC: Integrated Process: Nursing Process: Implementation
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
18.
A client is receiving an infusion of alteplase (Activase) for an intra-arterial clot. The
client begins to mumble and is disoriented. What action by the nurse takes priority?
a.
Assess the neurologic status.client’s
b.
Notify the Rapid Response Team.
c.
Prepare to administer vitamin K.
d.
Turn down the infusion
rate. ANS: B
Clients on fibrinolytic therapy are at high risk of bleeding. The sudden onset of
neurologic signs may indicate the client is having a hemorrhagic stroke. The nurse does
need to complete a thorough neurological examination, but should first call the Rapid
Response Team based on the manifestations. The nurse notifies the Rapid client’s
Response Team first. Vitamin K is not the antidote for this drug. Turning down the
infusion rate will not be helpful if the client is still receiving any of the drugs.
DIF: Applying/Application REF: 726
KEY: Critical rescue| Rapid Response Team| medical emergencies|
fibrinolytic agents MSC: Integrated Process: Nursing Process:
Implementation
NOT: Client Needs Category: Safe and Effective Care Environment: Management of
Care
19.
A nursing student is caring for a client with an abdominal aneurysm. What action
by the student requires the registered nurse to intervene?
a.
Assesses the client for back pain
b.
Auscultates over abdominal bruit
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c.
Measures the abdominal girth
d.
Palpates the abdomen in four
quadrants ANS: D
Abdominal aneurysms should never be palpated as this increases the risk of rupture.
The registered nurse should intervene when the student attempts to do this. The other
actions are appropriate.
DIF: Applying/Application REF: 726
KEY: Aneurysms| nursing process assessment| supervision| abdominal
assessment MSC: Integrated Process: Communication and
Documentation
NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection
Control
20.
A nurse is caring for a client with a deep vein thrombosis (DVT). What nursing
assessment indicates a priority outcome has been met?
a.
Ambulates with assistance
b.
Oxygen saturation of 98%
c.
Pain of 2/10 after medication
d.
Verbalizing risk
factors ANS: B
A critical complication of DVT is pulmonary embolism. A normal oxygen saturation
indicates that this has not occurred. The other assessments are also positive, but not
the priority.
15
DIF: Analyzing/Analysis REF: 729
KEY: Pulmonary embolism| deep vein thrombosis| respiratory assessment|
thromboembolic event MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
21.
A client has a deep vein thrombosis (DVT). What comfort measure does the
nurse delegate to the unlicensed assistive personnel (UAP)?
a.
Ambulate the client.
b.
Apply a warm moist pack.
c.
Massage the client’s leg.
d.
Provide an ice
pack. ANS: B
Warm moist packs will help with the pain of a DVT. Ambulation is not a comfort measure.
Massaging the client’s legs is contraindicated to prevent complications such as
pulmonary embolism. Ice packs are not recommended for DVT.
DIF: Understanding/Comprehension REF: 731
KEY: Thromboembolic event| deep vein thrombosis| comfort measures|
nonpharmacologic comfort interventions| unlicensed assistive personnel (UAP)
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Physiological Integrity: Basic Care and Comfort
22.
A nurse is assessing an obese client in the clinic for follow-up after an episode
of deep vein thrombosis. The client has lost 20 pounds since the last visit. What
action by the nurse is best?
a.
Ask if the weight loss was intended.
b.
Encourage a high-protein, high-fiber diet.
c.
Measure for new compression stockings.
d.
Review a 3-day food recall
diary. ANS: C
Compression stockings must fit correctly to work. After losing a significant amount of
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weight, the client should be re-measured and new stockings ordered if needed. The other
options are appropriate, but not the most important.
DIF: Applying/Application REF: 731
KEY: Thromboembolic event| deep vein thrombosis| nursing
assessment MSC: Integrated Process: Nursing Process:
Assessment
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
23.
A nurse wants to provide community service that helps meet the goals of Healthy
People 2020 (HP2020) related to cardiovascular disease and stroke. What activity
would best meet this goal?
a.
Teach high school students heart-healthy living.
b.
Participate in blood pressure screenings at the mall.
c.
Provide pamphlets on heart disease at the grocery store.
d.
Set up an the booth at the pet “Ask nurse”
store. ANS: B
An important goal of HP2020 is to increase the proportion of adults who have had their
blood pressure measured within the preceding 2 years and can state whether their
blood pressure was normal or high. Participating in blood pressure screening in a public
spot will best help meet that goal. The other options are all appropriate but do not
specifically help meet a goal.
17
DIF: Applying/Application REF:
711 KEY: Hypertension| primary
prevention
MSC: Integrated Process: Nursing Process:
Implementation NOT: Client Needs Category: Health
Promotion and Maintenance
24.
A client has been diagnosed with a deep vein thrombosis and is to be discharged
on warfarin (Coumadin). The client is adamant about refusing the drug because “it’s
dangerous.” What action by the nurse is best?
a.
Assess the reason behind the client’s fear.
b.
Remind the client about laboratory monitoring.
c.
Tell the client drugs are safer today than before.
d.
Warn the client about the consequences of non-
compliance. ANS: A
The first step is to assess the reason behind the fear, which may be related to client’s
the experience of someone the client knows who took warfarin. If the nurse cannot
address the specific rationale, teaching will likely be unsuccessful. Laboratory
monitoring once every few weeks may not make the client perceive the drug to be safe.
General statements like are safer not address the root cause of the “drugs today” do
problem. Warning the client about the possible consequences of not taking the drug is
not therapeutic and is likely to lead to an adversarial relationship.
DIF: Applying/Application REF: 709
KEY: Psychosocial response| anticoagulants| therapeutic communication|
patient-centered care MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Psychosocial Integrity
25.
A client with a history of heart failure and hypertension is in the clinic for a
follow-up visit. The client is on lisinopril (Prinivil) and warfarin (Coumadin). The client
reports new-onset cough. What action by the nurse is most appropriate?
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a.
Assess the c lung sounds and oxygenation.lient’s
b.
Instruct the client on another antihypertensive.
c.
Obtain a set of vital signs and document them.
d.
Remind the client that cough is a side effect of
Prinivil. ANS: A
This client could be having an exacerbation of heart failure or be experiencing a side
effect of lisinopril (and other angiotensin-converting enzyme inhibitors). The nurse
should assess the client’s lung sounds and other signs of oxygenation first. The client
may or may not need to switch antihypertensive medications. Vital signs and
documentation are important, but the nurse should assess the respiratory system first.
If the cough turns out to be a side effect, reminding the client is appropriate, but then
more action needs to be taken.
DIF: Applying/Application REF: 715
KEY: Nursing assessment| angiotensin-converting enzyme (ACE) inhibitors| heart
failure| adverse effects MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral
Therapies
26.
A nurse is caring for a client with a nonhealing arterial lower leg ulcer. What action
by the nurse is best?
a.
Consult with the Wound Ostomy Care Nurse.
b.
Give pain medication before dressing changes.
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c.
Maintain sterile technique for dressing changes.
d.
Prepare the client for eventual
amputation. ANS: A
A nonhealing wound needs the expertise of the Wound Ostomy Care Nurse (or Wound
Ostomy Continence Nurse). Premedicatbeforer to painful procedures and maintaining
sterile technique are helpful, but if the wound is not healing, more needs to be done. The
client may need an amputation, but other options need to be tried first.
DIF: Applying/Application REF: 734
KEY: Peripheral vascular disease| consultation|
wound care MSC: Integrated Process: Communication
and Documentation
NOT: Client Needs Category: Safe and Effective Care Environment: Management of
Care
27.
A client has the peripheral arterial disease (PAD). What statement by the
client indicates misunderstanding about self- management activities?
a.
“I can use a heating pad on my legs if set on it’s low.”
b.
“I should not cross my legs when sitting or lying down.”
c.
“I will go out and buy some warm, heavy socks to wear.”
d.
“It’s going to be hard but I will stop
smoking.” ANS: A
Clients with PAD should never use heating pads as skin sensitivity is diminished
and burns can result. The other statements show a good understanding of self-
management.
DIF: Evaluating/Synthesis REF: 722
KEY: Peripheral arterial disease| patient education|
patient safety MSC: Integrated Process: Nursing
Process: Evaluation
NOT: Client Needs Category: Health Promotion and Maintenance
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28.
A client presents to the emergency department with a severely lacerated artery.
What is the priority action for the nurse?
a.
Administer oxygen via a non-rebreather mask.
b.
Ensure the client has a patent airway.
c.
Prepare to assist with suturing the artery.
d.
Start two large- bore IVs with normal
saline. ANS: B
The airway always takes priority, followed by breathing and circulation. The nurse
ensures the client has a patent airway before providing any other care measures.
DIF: Applying/Application REF: 736
KEY: Critical rescue| primary survey| trauma
MSC: Integrated Process: Nursing Process: Implementation
NOT: Client Needs Category: Safe and Effective Care Environment: Management of
Care
29.
The nurse is assessing a client on admission to the hospital. The client’s leg
appears as shown below:
What action by the nurse is best?
a.
Assess the ankle- brachial index.client’s
b.
Elevate the leg above the heart.client’s
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c.
Obtain an ice pack to provide comfort.
d.
Prepare to teach about heparin
sodium. ANS: A
This client has dependent rubor, a classic finding in peripheral arterial disease. The
nurse should measure the client’s anklebrachial index. Elevating the leg above the
heart will further impede arterial blood flow. Ice will cause vasoconstriction, also
impeding circulation and perhaps causing tissue injury. Heparin sodium is not the
drug of choice for this condition.
DIF: Applying/Application REF: 720
KEY: Peripheral vascular disease| nursing
assessment MSC: Integrated Process: Nursing
Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Physiological
Adaptation
