When teaching a client with peripheral vascular disease about foot care, a nurse should include which instruction?

Appeared in: NORCET 2 -2021 (Shift-2)

Explanation

Clients with PVD require sturdy, protective footwear to prevent injuries to their feet, which have compromised circulation and sensation.
Canvas shoes are soft and offer minimal protection from trauma, pressure, or sharp objects, increasing the risk of non-healing ulcers.
Proper footwear, such as well-fitted leather shoes, provides essential support and protection, reducing the likelihood of foot injuries.
The primary goal of foot care in PVD is to prevent skin breakdown and infection, which can lead to severe complications like gangrene and amputation.

Option A: This instruction is incorrect. Cornstarch or talcum powder is actually recommended for use between the toes.
Option B: This instruction is incorrect. Using a nail file is the recommended and safest method for nail care in PVD.
Option D: This instruction is incorrect. Cotton socks are recommended for patients with PVD.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient education and preventative care for clients with Peripheral Vascular Disease (PVD) to guide bedside assessment, documentation, and the next nursing action.
Effective patient education on foot care is a critical nursing intervention that can prevent limb-threatening complications in patients with PVD.
Nurses must assess the client's ability to perform self-care and involve family members or refer to a podiatrist if the client has poor eyesight, limited mobility, or thickened nails.
What if? If the client also has significant peripheral neuropathy (loss of sensation), the instruction to avoid canvas shoes becomes even more critical. The client would not be able to feel a small stone or rough seam inside the shoe, leading to an unnoticed injury that could become a major ulcer.

How to Approach the Question

First, identify the core subject of the question: patient teaching for Peripheral Vascular Disease (PVD).
Recall the pathophysiology of PVD: decreased arterial blood flow to the extremities.
Consider the primary risks associated with PVD: poor wound healing, high risk of infection from minor trauma, and potential for decreased sensation (neuropathy).
The goal of all interventions is to prevent injury and infection. Evaluate each option against this goal.
Option A (corn-starch): Does it prevent or cause injury? It prevents moisture buildup, reducing infection risk. So, avoiding it is bad advice.
Option B (nail file): Does it prevent or cause injury? Filing is safer than cutting, preventing injury. So, avoiding it is bad advice.

Concept Tested & Keywords

Concept Tested: Patient education and preventative care for clients with Peripheral Vascular Disease (PVD).
Stem keywords: peripheral vascular disease, foot care, teaching, instruction
Lead-in keywords: which instruction

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E6 Nursing Fundamentals Taylor p. 549-551

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 65-67

Practise the full NORCET 2 -2021 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.