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Intermittent claudication leg pain is characterized as pain that occurs:
With activity and is relieved by rest.
As you examine a patient's lower extremity you observe a thin leg with dry skin
and very little hair; the ABI is 0.5. From this data, what condition would you
assess to be present?
Arterial insufficiency.
Which of the following statements about inelastic compression bandages is
accurate?
They are only effective in the ambulatory patient.
What is Mrs. Lang's foot deformity called when there is a rocker bottom
appearance to her foot?
Charcot's joint.
Which of the following statements about contact casting is correct?
The contact cast redistributes the weight of the diabetic foot.
,Mrs. Anderson has dependent rubor and elevation pallor of her right lower
extremity. The systolic pressure in her R. arm is 170 mmHg; L arm is 165 mmHg,
R. dorsal pedis systolic pressure was 100 mmHg and the posterior tibial pressure
was 95 mmHg. What is Mrs. Anderson's ABI for the RLE?
0.59
Record the highest brachial pressure in the arms. Record the highest pressure
from the dorsal pedis and posterior tibial pulse location. Calculate the ABI by
dividing the higher of two ankle pressures by the higher of the two brachial
pressures. 100 (highest of two ankle pressures) is divided by 170 (highest of 2
brachial pressures) = 0.588; round off to 0.59 ABI.
An ambulatory patient with insulin dependent diabetes has an ulcer located on
the plantar surface of the left foot over the third metatarsal head. The ulcer is 1
cm in diameter, with a dry red surface. The patient denies any pain in the ulcer.
What type of wound does this most likely represent?
Neuropathic Ulcer.
Which of the following assessments is most indicative of an arterial ulcer?
An ABI of 0.7. An ABI of less than 0.9 is indication that the wound has an arterial
insufficiency or LEAD (lower extremity arterial disease). Pain occurs with many
types of leg ulcers as well as arterial. Many factors can contribute to the color and
condition of the wound bed.
Which of the following statements is TRUE? Venous dermatitis:
results in erythema, crusting, scaling skin of the leg.
, Which of the following statements concerning the management of a mixed
venous/arterial ulcer with an ABI of .75 is TRUE?
Graduated compression can be provided at a modified level of support.
Mrs. James has an eschar covered heel ulcer and you decide that the best
approach to management is NOT to debride but to keep the eschar covered, dry
and intact. The rationale for your decision is that the:
TcPO2 (transcutaneous oxygen) is 15 mmHg.
A TcPO2 level below 40 mmHg demonstrates skin/tissue hypoxia and is a sign for
possible delayed healing. If the eschar is non-infected and dry, it is best left in
place because it provides a natural barrier to outside pathogens. Infection of an
ischemic leg ulcer requires aggressive systemic antibiotics and debridement of
necrotic tissue. Periwound erythema may also be a sign of infection, but further
data is needed. Albumin levels of 3.0 show some reduced protein stores but this is
not as important of a factor in non-debridement of an eschar covered wound.
A patient in the outpatient wound clinic has a venous ulcer and with palpation,
the skin around the ulcer feels firm and woody or hardened. This describes what
condition?
Lipodermatosclerosis.
Mrs. Jones has an ulcer located on the dorsal surface of the third toe on the left
foot. The ulcer is 1 cm in diameter, with a dry, pale pink wound bed. She reports
significant pain in the ulcer and denies any history of diabetes. What is the
MOST likely cause of this ulcer?
Arterial insufficiency.