Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What symptom is associated with chronic tissue ischemia in LEAD?

1. Swelling in the lower extremities

2. Hair loss and nail ridges

3. Increasing blood pressure

4. Frequent headaches

The correct answer is: Hair loss and nail ridges

Chronic tissue ischemia, particularly in lower extremity arterial disease (LEAD), often manifests through specific symptoms related to decreased blood flow and oxygen supply to the tissues. Hair loss and nail ridges are direct indicators of inadequate circulation. As blood flow diminishes, the skin and appendages, such as hair follicles and nails, do not receive essential nutrients and oxygen, leading to atrophic changes. In LEAD, hair loss typically occurs on the lower extremities due to insufficient blood supply, reflecting a chronic state of ischemia. Nail ridges can form as a result of intermittent ischemic episodes affecting nail growth. Therefore, the presence of hair loss and nail ridges is a classic sign associated with chronic ischemia in patients suffering from LEAD, indicating ongoing tissue compromise. While swelling in the lower extremities might suggest fluid retention or venous issues, it is not specifically tied to ischemia. Increasing blood pressure is more related to systemic factors than local ischemic conditions. Frequent headaches do not have a direct correlation with lower extremity ischemia, making those options less relevant in the context of the question. Understanding the underlying mechanisms of ischemia is crucial for identifying its symptoms accurately.