PATHOPHYSIOLOGY
intermittent claudication, rest pain, paresthesias, diminished or absent peripheral pulses, pallor with extremity,
elevation, dependent rubor when dependent, thin, shiny, hairless skin, thickened toenails, areas of discolorization or
skin breakdown
INTERDISCIPLINARY CARE
DIAGNOSIS
segmental pressure measurements, stress testing, doppler ultrasound, transcutaneous oximetry, angiography or
magnetic resonance angiography
MEDICATION
aspirin or plavix, pletal (platelet inhibitor with vasodilation), pentoxifylline (lowers blood viscosity, increases rbc
flexibility)
TREATMENTS
smoking cessation, meticulous foot care, diabetes and htn control, lowering cholesterol, weight loss
REVASCULARIZATION
COMPLEMENTARY THERAPIES
NURSING CARE
HEALTH PROMOTION
assess peripheral pulses, pain color temp and cap refill, position with extremities dependent, discuss benefits of regular
exercise, use foot cradle, lightweight blankets, socks, slippers, keep extremities warm; encourage frequent position
changes, don’t cross legs or use pillow under knee
PAIN
tissue ischemia, lactic acid build up, assess pain, keep extremities warm, teach pain relief
chronic tissue ischemia leads to dry scaly and atrophied skin; meticulous skin care; bed cradle; egg-crate mattress,
flotation pad, sheepskin or heel protectors
ACTIVITY INTOLERANCE
assist with self care as needed, encourage gradual increases in duration and intensity of exercise; rest with extremities
dependent; provide diversional activities; encourage frequent position changes and rom exercises
smoking cessation, medications, signs of excess bleeding, skin surveillance and foot care, diet and exercise.
Revascularization: incision care, complications, limitations.