Risk Factor & Prevention
Name the strongest modifiable risk factor for developing and worsening lower-extremity atherosclerotic PAD
Tobacco use/smoking.
Episodic finger color changes triggered by cold or stress are characteristic of what vasospastic disorder?
Raynaud phenomenon
What does the abbreviation AAA stand for?
Abdominal aortic aneurysm
Name one major factor from Virchow’s triad that promotes venous thrombosis.
Venous stasis, endothelial injury, or hypercoagulability
After femoral arterial catheterization, what distal assessment is essential to compare with baseline?
Distal pulses plus color, temperature, capillary refill, sensation, and movement compared with baseline.
Name two chronic conditions that accelerate atherosclerosis and increase PAD risk.
Examples: diabetes mellitus, hypertension, and dyslipidemia (any two)
What is the most important intervention for a patient with thromboangiitis obliterans (Buerger disease) who uses tobacco?
Complete tobacco/nicotine cessation
Which imaging study is commonly used to screen/measure an abdominal aortic aneurysm noninvasively?
Abdominal ultrasonography
Why is routine calf massage inappropriate in a patient with suspected DVT?
Manipulation is avoided because a suspected thrombus requires evaluation and treatment rather than massage; embolization is a serious concern
A groin access site begins bleeding after angiography. What is the immediate nursing priority?
Apply firm direct pressure per protocol, keep the patient appropriately positioned, assess hemodynamic status, and escalate/notify promptly.
Why should a patient with PAD be taught to inspect the feet every day even if no ulcer is present?
Poor perfusion can delay healing, and small unnoticed injuries can progress to infection, ulceration, or tissue loss.
A patient with Raynaud phenomenon asks how to reduce attacks. Give two appropriate teaching points
Examples: keep the whole body/hands warm, avoid sudden cold exposure, manage stress, avoid nicotine, and review vasoconstricting drugs with the prescriber
A patient with a known AAA develops sudden severe abdominal/back pain, hypotension, and diaphoresis. What complication must be suspected?
Possible aneurysm rupture - a life-threatening emergency
A patient with DVT suddenly develops dyspnea, tachycardia, and pleuritic chest pain. What complication is suspected?
Pulmonary embolism
Why is kidney function reviewed before and after iodinated contrast procedures?
Iodinated contrast can contribute to acute kidney injury in susceptible patients, so renal function and hydration/contrast risk are considered.
A patient with PAD uses a heating pad on cold feet. What safety teaching is most important?
Avoid direct heating pads/hot water on poorly perfused feet; reduced perfusion or sensation can increase burn and tissue-injury risk. Use safe warmth and protective footwear instead.
Why are beta blockers and other vasoconstricting agents sometimes reviewed carefully in patients with severe Raynaud symptoms?
They can increase peripheral vasoconstriction in susceptible patients and may worsen symptoms; medication decisions are individualized and require provider review
Why should the nurse avoid repeatedly or vigorously palpating a known pulsatile abdominal aneurysm?
Vigorous/repeated palpation is unnecessary and may be unsafe; assessment should not manipulate the aneurysm.
Give two nursing measures that help reduce VTE risk in an appropriate hospitalized patient.
Examples: early/regular ambulation when appropriate, prescribed mechanical prophylaxis, prescribed anticoagulant prophylaxis, leg/ankle exercises, hydration when appropriate, and avoiding prolonged immobility.
Following lower-extremity revascularization, which neurovascular changes could indicate acute loss of perfusion?
New pain, pallor, coolness, decreased/absent pulses, paresthesia, or weakness/paralysis
Explain why PAD should trigger cardiovascular risk-reduction teaching even when symptoms are limited to one leg.
PAD is a manifestation of systemic atherosclerosis and is associated with cardiovascular and limb events, so risk-factor control protects more than the symptomatic leg.
Contrast Raynaud phenomenon with atherosclerotic PAD in terms of the basic vascular problem
Raynaud is episodic vasospasm of small vessels, often triggered by cold/stress; atherosclerotic PAD is fixed or progressive arterial narrowing/occlusion from plaque
After endovascular aneurysm repair, name two findings that require prompt reporting.
Examples: new severe abdominal/back/groin pain, hypotension, tachycardia, reduced distal pulses/limb ischemia, expanding access-site bleeding/hematoma, or other signs of bleeding/complication.
Explain why anticoagulants treat DVT but do not instantly dissolve the existing clot.
Anticoagulants prevent clot extension and new thrombus formation; the body’s fibrinolytic system gradually breaks down the existing clot.
A patient returns from angioplasty with increasing groin swelling, falling blood pressure, and tachycardia. What complication should be suspected and what is the priority response?
Suspect significant access-site/retroperitoneal bleeding. Treat as urgent: assess ABCs/hemodynamics, apply/maintain appropriate site pressure if indicated, and rapidly notify/escalate per protocol