Certified Wound Ostomy Nurse (CWON) Practice Test

What symptom is indicative of chronic tissue ischemia in patients with LEAD?

1. Increased heart rate

2. Hair loss and nail ridges

3. Fever and sweating

4. Chest pain and shortness of breath

The correct answer is: Hair loss and nail ridges

The presence of hair loss and nail ridges in patients with lower extremity arterial disease (LEAD) is indicative of chronic tissue ischemia. In chronic ischemia, insufficient blood flow to the tissues occurs over an extended period, leading to various changes. Hair follicles and nail beds require good perfusion to maintain normal function and appearance; therefore, when blood supply is compromised, patients may experience hair loss in the affected area and the development of ridges or other abnormalities in their nails. This symptom reflects the long-term effects of inadequate oxygen and nutrient supply to peripheral tissues. As the ischemia progresses, the body’s ability to regenerate cells and maintain healthy tissue diminishes, resulting in visible signs such as hair loss and altered nail structure. The other symptoms, while they can indicate different health issues, do not specifically reflect chronic ischemia associated with LEAD. Increased heart rate, fever, sweating, chest pain, and shortness of breath are more associated with acute conditions or systemic responses rather than the chronic, localized effects seen in chronic tissue ischemia.