Ambulatory Care Nurse Certification Practice Exam

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If an elderly patient presents with lower extremity swelling, which differential diagnosis is relevant?

Hepatic venous obstruction

Local venous obstruction

Idiopathic edema

All of the above

In cases of lower extremity swelling in elderly patients, considering multiple potential causes is crucial. This approach highlights the complexity of the symptoms and the range of possible underlying conditions.

Hepatic venous obstruction can lead to increased venous pressure and subsequent fluid buildup in the extremities, particularly if there is heart failure or liver dysfunction.

Local venous obstruction, such as deep vein thrombosis (DVT), is a common and serious cause of unilateral or bilateral leg swelling. The risk of DVT increases with age and can present as swelling, pain, and sometimes redness.

Idiopathic edema is often seen in elderly patients as well, where swelling occurs without a clear underlying cause, and it can fluctuate depending on factors such as diet, fluid intake, and activity levels.

Considering all these possibilities is essential in the differential diagnosis, as the evaluation may lead to necessary interventions or treatments for the underlying cause of the swelling. Therefore, recognizing that each of these conditions can contribute to the presentation of lower extremity swelling emphasizes the importance of a comprehensive assessment in elderly patients.

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