Peripheral Artery Disease

Question 1

Peripheral Arterial Disease

Answer 1

a. Obstruction of large arteries in the periphery
b. Typically due to stenosis due to atherosclerosis or inflammatory process
c. Chronic or acute

Question 2

Risk Factors for Atherosclerosis & PAD

Answer 2

Modifiable
-Nicotine
-Diabetes
-Diet
-Hypertension
-Obesity
-Stress
-Sedentary lifestyle

Nonmodifiable
-Age (>60)
-Female
-Familial predisposition & genetics
-Black

Question 3

PAD Clinical Manifestations

Answer 3

-Intermittent claudication  ischemic pain with exercise
-Changes in peripheral pulses
-S/S of decreased perfusion & signs of atrophy
-Temperature intolerance
-Color changes
-Skin, hair, and nail changes
-Wounds
-Consequences: wounds & limb ischemia

Question 4

PAD management (pharmacological)

Answer 4

-Goals: symptom management & risk reduction
-Vasodilators, antiplatelet, statins

Question 5

PAD management (surgical)

Answer 5

-Angioplasty & stents
-Bypass surgery

Question 6

PAD Nursing management

Answer 6

-Major goal includes increased arterial blood supply, promotion of vasodilation, prevention of vascular compression, relief of pain, attainment or maintenance of tissue integrity, and adherence to self-care program

-Assessment & monitoring

Question 7

Maintaining tissue integrity in PAD

Answer 7

-Protection of extremities and avoidance of trauma and cold temperatures
-Regular inspection of extremities with referral for treatment and follow-up for any evidence of infection or inflammation
-Good nutrition, low fat diet
-Weight reduction as necessary

Question 8

Encourage activity in PAD

Answer 8

a. Exercise increases contralateral circulation
b. Supervised exercise program
i. Offer a supervised exercise program to all people with intermittent claudication
ii. Example supervised exercise program could include:
1. 2hours of supervised exercise a week for 3 month period
2. Encourage patient to exercise to the point of pain – then rest until pain subsides
3. Exercise tolerance should increase over time