Peripheral Vascular Disease: A Case Study

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Definition and Pathophysiology The leading cause of PVD/PAD is atherosclerosis of the arteries. Atherosclerosis occurs when deposits of lipids and cholesterol obstruct and harden the arteries. This leads to progressive narrowing of the artery. When this takes place in the peripheral vessels, blood flow id compromised to the lower extremities, and is known as PVD/PAD.
There are actually three types of Peripheral Vascular Disease. Type 1(10-15% of patients) involves the aorta and ileac arteries, type 2 (~ 25% of patients) involve the aorta and the common and external ileac arteries, and the most common type 3(~60-70% of patients) which involves the aorta, ileac, popliteal, and tibial arteries.
This plaque usually forms at arterial bifurcations
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Vital signs would include blood pressure, heart rate, skin color and temperature, and a peripheral pulse check.
Examining for edema, calculating a body mass index, and noting any medications the patient is taking would be necessary. Nursing interventions include patient positioning. Position patient with extremities dependent to increase tissue perfusion and pain relief. Frequent changes in positioning promote blood flow and can reduce damage caused by pressure. Avoid crossing of the legs and placing pillows under the knees. Doing so can occlude already partially obstructed vessels and further impair blood flow to the lower extremities. Educate the patient. Instruct the patient to stop smoking if necessary. An order for nicotine gum or a nicotine patch can be obtained. The gum and patches contain less nicotine than cigarettes, and can be helpful to reduce the stress of smoking cessation. Discussing regular exercise and how important it is to the PVD patient. Exercise helps to promote the development of collateral circulation to ischemic tissues, and can help slow the progression of atherosclerosis. Keep the extremities warm. By doing so, heat is conserved, arterial blood flow is promoted, and vasospasm is reduced. Avoid using heating blankets or hot water bottles to reduce the risk of burns in the patient with decreased

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