Question 1

The nurse advises a patient taking papaverine to consult the health care provider or pharmacist before taking which over-the-counter (OTC) medication?&#10;A) Laxatives&#10;B) Cough and cold remedies&#10;C) Vitamin supplements&#10;D) Acetaminophen

Accepted Answer

Papaverine is a vasodilator medication used to treat blood vessel spasms. Cough and cold remedies commonly contain decongestants, some of which can interact with papaverine and cause an increase in blood pressure. Therefore, it is important for patients taking papaverine to consult with their health care provider or pharmacist before using these types of OTC medications.

Question 2

Which are necessary steps in the assessment of the patient preparing for treatment of PVD with pentoxifylline (Trental)? (Select all that apply.)&#10;A) Check for intolerance to caffeine.&#10;B) Obtain baseline data on pain that may be present.&#10;C) Obtain test results for PT and aPTT.&#10;D) Perform baseline gastrointestinal assessment to determine if the patient has nausea, vomiting, or dyspepsia.&#10;E) Ask specifically if the patient has any cardiac symptoms or dizziness.&#10;F) Schedule the patient for an exercise stress test.

Accepted Answer

Checking for caffeine intolerance, assessing baseline pain, evaluating gastrointestinal symptoms, and inquiring about cardiac symptoms or dizziness are important steps in assessing a patient before starting pentoxifylline for PVD.

Question 3

The nurse has completed teaching to a patient recently prescribed cilostazol (Pletal). Which statement by the patient indicates a need for further teaching?&#10;A) &#34;I will sit down if I feel lightheaded or faint.&#34;&#10;B) &#34;Because this medication helps my circulation, I will try to quit smoking.&#34;&#10;C) &#34;Grapefruit juice will increase the effects of this medication.&#34;&#10;D) &#34;Diarrhea may occur but likely will stop with continued therapy.&#34;

Accepted Answer

Grapefruit juice can inhibit the metabolism of cilostazol, leading to increased levels of the drug and an increased risk for adverse effects. The patient should avoid grapefruit and grapefruit juice while taking cilostazol. Choices A, B, and D all demonstrate understanding of the medication and its potential side effects.

Question 4

Which are included in the baseline assessment of PVD? (Select all that apply.)&#10;A) History of heart disease&#10;B) Smoking and dietary habits&#10;C) Current medications&#10;D) Weight&#10;E) Limb pain&#10;F) Mental status

Accepted Answer

Age, gender, race, family history of incidence of symptoms of PVD, hypertension, and cardiac disease indicate risk factors for developing PVD.Smoking causes vasoconstriction, and dietary habits can cause atherosclerosis, predisposing the patient to PVD.Current medications are essential to know in order to prescribe a pharmacological agent without exposing the patient to possible drug interactions.Weight may factor into calculations for prescribing medications to treat PVD.Limb pain is a symptom of PVD and may allow the health care provider to assess the extent of existing disease.Mental status is not included in the baseline assessment of PVD.

Question 5

The nurse is preparing a teaching plan for a patient with Raynaud's disease who is soon to be discharged. Which information will be included to improve circulation and prevent complications of this disease? (Select all that apply.)

A) Begin a daily exercise program.
B) Keep hands and feet warm.
C) Surgery is often the most effective treatment.
D) Elevate the lower extremities when reclining.
E) Smoking cessation will improve outcomes.

Accepted Answer

Patients with Raynaud's disease should begin a daily exercise program to improve circulation, keep their hands and feet warm to prevent vasoconstriction, and quit smoking to improve outcomes. Surgery is not often recommended for Raynaud's and elevating the lower extremities may worsen symptoms.

Question 6

The nurse is assessing the patient's leg for peripheral vascular disease (PVD) and is unable to palpate the pedal pulse in either foot. Which action will the nurse take first?&#10;A) Contact the health care provider for further orders.&#10;B) Request x-ray studies of the lower extremities.&#10;C) Request that the patient lie flat.&#10;D) Obtain a Doppler ultrasound device for auscultation.

Accepted Answer

The nurse should obtain a Doppler ultrasound device for auscultation to assess for the presence or absence of pedal pulses. This is a non-invasive and quick method to assess peripheral vascular disease. If pedal pulses are not present, further assessment and intervention may be necessary. Contacting the healthcare provider or requesting x-ray studies may be necessary later, but obtaining a Doppler ultrasound device is the priority at this time. Requesting that the patient lie flat may not be necessary for this assessment.

Question 7

Which assessment verifies increased blood perfusion to the lower extremities?&#10;A) Toes cool to the touch&#10;B) Decreased sensation below the knees&#10;C) Increased amplitude of pedal pulses&#10;D) Paleness of the foot

Accepted Answer

Increased amplitude of pedal pulses indicates increased blood flow and perfusion to the lower extremities. A) Toes cool to the touch and D) Paleness of the foot are signs of decreased blood flow and perfusion. B) Decreased sensation below the knees may be indicative of a neurological issue rather than a vascular issue.

Question 8

When assessing a client recently prescribed pentoxifylline (Trental), which medication will alert the nurse to monitor closely for adverse effects?&#10;A) Antilipemic&#10;B) Antihypertensive&#10;C) Antibiotic&#10;D) Antipsychotic

Accepted Answer

Pentoxifylline is a vasodilator and can cause hypotension, therefore the nurse should closely monitor the client's blood pressure and any signs or symptoms of hypotension. Antihypertensive medication can exacerbate this effect, so this medication class is especially important to monitor for potential adverse effects. Antilipemic, antibiotic, and antipsychotic medications are not typically associated with adverse effects that would warrant closer monitoring in a client taking pentoxifylline.

Question 9

A patient has recently been prescribed cilostazol (Pletal). Which statement by the patient indicates that this medication is effective?&#10;A) &#34;I have less leg cramping when I walk.&#34;&#10;B) &#34;My pulse rate is more regular.&#34;&#10;C) &#34;I have had fewer episodes of angina.&#34;&#10;D) &#34;My blood pressure has decreased.&#34;

Accepted Answer

Cilostazol is a medication used to improve symptoms of intermittent claudication, which is pain or cramping in the legs during exercise. Therefore, if a patient reports having less leg cramping when walking, it indicates that the medication is effective. The other options are not directly related to the intended use of cilostazol.

Question 10

Which patient statement indicates to the nurse that the patient has a good understanding of peripheral vascular disease?&#10;A) &#34;Symptoms are warning signs of the increased potential to develop diseases.&#34;&#10;B) &#34;Pharmacologic treatments can reverse the disease process.&#34;&#10;C) &#34;Surgical interventions will cure the disease.&#34;&#10;D) &#34;Controlling contributing factors may affect the progression of the disease.&#34;

Accepted Answer

Option D is correct because it shows the patient understands that controlling contributing factors, such as controlling blood pressure and quitting smoking, can slow or prevent the progression of peripheral vascular disease. Options A, B, and C are incorrect because they provide inaccurate information about peripheral vascular disease.

Question 11

Which will the nurse include in the discharge teaching plan for a patient with PVD? (Select all that apply.)&#10;A) Intermittent cold applications to the extremities&#10;B) Heat therapy&#10;C) Stress reduction techniques&#10;D) An exercise program&#10;E) Bed positioning techniques

Accepted Answer

The answer of Which will the nurse include in the...

Question 12

What is the action of pentoxifylline (Trental), a hemorheologic agent used to treat chronic occlusive arteriole disease?&#10;A) Vasodilates the peripheral arteries&#10;B) Potentiates the blood clotting mechanism&#10;C) Increases erythrocyte flexibility&#10;D) Increases blood viscosity

Accepted Answer

The answer of What is the action of pentoxifylline (Trental),...

Question 13

The nurse is assessing a patient on papaverine therapy and notes tachycardia, which is a compensatory effect of which condition?&#10;A) Hypoventilation&#10;B) Hypotension&#10;C) Excessive sympathetic stimulation&#10;D) Adrenergic suppression

Accepted Answer

The answer of The nurse is assessing a patient on...

Deck 26: Drugs Used to Treat Peripheral Vascular Disease