Certified Wound Care Nurse (CWCN) Practice Exam

When recommending compression therapy for a patient with venous stasis ulcers and ABI of 0.7, what principle should be considered?

1. A therapeutic compression level (at least 30 mmHg sustained compression) is needed at the ankle.

2. Compression is contraindicated in patients with CHF.

3. Modified compression (20-27 mmHg) should be used for patients with ABI of 0.6-0.8.

4. Compression is contraindicated in patients with ABI less than 0.8.

The correct answer is: Compression is contraindicated in patients with ABI less than 0.8.

The principle of contraindications in compression therapy is crucial in wound care management, particularly for patients with venous stasis ulcers. In this context, an Ankle-Brachial Index (ABI) of 0.7 indicates that the patient has some compromised arterial blood flow, leading to a potential risk for ischemia when subjected to high levels of compression. Compression therapy is generally advocated because it promotes venous return and reduces edema in venous stasis ulcers; however, applying compression to a limb with insufficient arterial circulation can exacerbate the situation. For patients with an ABI less than 0.8, especially those with an ABI of 0.7, the risk of further compromise to limb perfusion increases, making it essential to avoid therapeutic levels of compression (which are typically around 30 mmHg or higher). Therefore, this response outlines the fundamental safety concerns that healthcare providers must consider when recommending compression therapy in individuals with varying degrees of peripheral arterial disease.