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FEATURES: CLINICAL MANAGEMENT EXTRA

Management of Vascular Leg Ulcers

Wipke-Tevis, Deidre D. PhD, RN, BC; Sae-Sia, Wipa MSN, PhD

Advances in Skin & Wound Care: October 2005 - Volume 18 - Issue 8 - p 446-447
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Abstract

1. A common consequence of chronic venous insufficiency is

a. decreased hydrostatic pressure in the veins.

b. release of hemosiderin in leg tissues.

c. smooth, softened skin at the ankles.

d. movement of serous fluid from the tissues to the veins.

2. A risk factor for developing venous ulcers is

a. vigorous exercise.

b. hormone therapy.

c. anorexia.

d. corticosteroid therapy.

3. A common finding in patients who have venous leg ulcers is

a. posterior tibial pulses that are difficult to palpate.

b. a foot skin temperature that is significantly different from that of the knee.

c. a capillary refill that takes <3 seconds.

d. an ankle-brachial index below 0.9.

4. Venous valvular incompetence is reflected in a photoplethysmography result that indicates a refill time of

a. 14 seconds.

b. 21 seconds.

c. 30 seconds.

d. 40 seconds.

5. A common characteristic of venous leg ulcers is

a. round, smooth wound margins.

b. pale, pink granulation tissue at the wound base.

c. minimal periulcer edema.

d. a location above the medial malleolus.

6. With venous leg ulcers, the skin on the affected leg typically is characterized by

a. pallor.

b. pruritis.

c. erythema.

d. thinning.

7. Before applying compression to help heal venous leg ulcers, it is absolutely essential to

a. measure the patient's ankle-brachial index.

b. keep the leg dependent for 30 minutes.

c. dorsiflex the foot.

d. apply lotion immediately before compression.

8. An Unna boot is typically

a. replaced daily.

b. applied using moderate tension.

c. applied over a primary dressing on the ulcer.

d. efficient for absorbing copious drainage.

9. Use of a pneumatic compression device is contraindicated for patients who have

a. yellow slough in the ulcer.

b. deep vein thrombosis.

c. refractory edema.

d. lipodermatosclerosis.

10. To prevent edema after a leg ulcer heals, patients should apply compression stockings daily

a. just before arising.

b. approximately 1 hour after arising.

c. at midday.

d. at bedtime.

11. A significant risk factor for developing arterial leg ulcers is

a. strenuous exercise.

b. deep vein thrombosis.

c. chronic heart failure.

d. hypertension.

12. Patients who have arterial leg ulcers can relieve ischemic pain in the toes or forefoot at rest by

a. placing the foot in a dependent position.

b. massaging the foot.

c. applying compression to the foot.

d. applying cold compresses to the foot.

13. Arterial leg ulcers are characterized by

a. edema of the affected extremity.

b. copious wound exudate.

c. friable, shiny skin in the affected extremity.

d. deep-red wound tissue.

14. Of the following, the most appropriate treatment option for patients who have arterial leg ulcers is to

a. wear a compression bandage.

b. keep the legs in a neutral position at rest.

c. exercise to relieve leg pain.

d. elevate the affected extremity.

15. Which solution is recommended for cleansing leg ulcers?

a. hydrogen peroxide

b. povidone-iodine

c. Dakin's solution

d. normal saline

16. The recommended antibiotic for treating venous leg ulcers of less than 1 month's duration and colonized with Staphylococcus aureus, group A beta hemolytic streptococci, and Pseudomonas aeruginosa is

a. cephalexin.

b. oxacillin.

c. ciprofloxacin.

d. dicloxacillin.

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© 2005 Lippincott Williams & Wilkins, Inc.