A client with peripheral arterial disease is visiting the health clinic. The nurse completes a health assessment. Which statement by the client indicates a priority need for follow-up teaching?

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11ecbb05_c945_ad90_b433_cdd03d0c806c_MD0009_00 Clients with peripheral arterial disease (PAD) have decreased sensations from nerve ischemia or coexisting diabetes mellitus. They should never apply direct heat to the extremity due to the risk for a burn wound. Wound healing is impaired in these clients. Swelling in the extremities (edema) could result from venous stasis (venous valve incompetence or varicose veins); these clients are asked to elevate their extremities during rest. However, clients with PAD usually do not have swelling, but rather have decreased blood supply. The extremities should not be elevated above the level of the heart because extreme elevation further impedes arterial blood flow to the feet. Additional teaching for the client with PAD includes the following: Smoking cessation Regular exercise Achieving or maintaining ideal body weight Low-sodium diet Tight glucose control in diabetics Tight blood pressure control Use of lipid management medications Use of antiplatelet medications Proper limb and foot care (Option A) Most cholesterol is synthesized by the liver during the fasting state, at night. Statins (eg, simvastatin, atorvastatin) are typically taken in the evening as they are more effective during that period. This is an appropriate statement. (Option C) Regular exercise is important for clients with PAD. The client should be encouraged to walk 30-40 minutes a day, 3-5 times a week. If claudication is present, the client should be instructed to walk to the point of discomfort, stop and rest, and then resume walking until the discomfort recurs. (Option D) Lack of hair, brittle nails, dry skin, and skin atrophy are due to decreased blood supply to these structures and are common, expected findings in PAD. Educational objective: The nurse should instruct the client with peripheral arterial disease to never apply direct heat to extremities due to the risk of a burn from decreased sensitivity.

A Client with Peripheral Arterial Disease Is Visiting the Health