Medical-surgical Nursing Demystified

(^18) Medical-Surgical Nursing Demystified

• Stress management


• Hospital-based cardiac rehabilitation programs

Peripheral Arterial Disease (PAD)

WHAT WENT WRONG?

Large peripheral arteries become narrowed and restricted (stenosis) leading to

the temporary (acute) or permanent (chronic) reduction of blood flow to tissues

(ischemia). This is most commonly due to atherosclerosis (plaque on the inner

walls of arteries), but may also be caused by a blood clot (embolism), or from an

inflammatory process. Severe peripheral arterial occlusive disease can lead to skin

ulceration and gangrene. Peripheral arterial occlusive disease is more common in

patients with diabetes or hypertension, in older adults, in those with hyperlipi-

demia, and in those who smoke, as these conditions can predispose to diminished

circulation. Vascular disease that happens in one area of the body, e.g. coronary

arteries, is not an isolated process. The plaque build-up caused by long-term ele-

vated cholesterol levels will happen throughout the body. The most common area

of involvement is the lower extremities.

PROGNOSIS

Patients typically have progressive disease. It is a chronic problem, getting worse

with age. Symptoms may not be present until there is a 50 percent or greater occlu-

sion of the vessel. Suspect disease in patients who have risk for other cardiovascular

diseases. Medications can help to improve blood flow to the area and increased

activity will improve exercise tolerance and quality of life. Vascular intervention

may be necessary as the disease progresses.

HALLMARK SIGNS AND SYMPTOMS

• Femoral, popliteal arteries.
  
  
  • Sudden pain in the affected area because of spontaneous muscle contrac-
    tions due to the reduced oxygenation of tissue.
  
  
  • Intermittent claudication—pain, numbness, and/or weakness with walk-
    ing due to increased oxygen demand of the muscle during activity.
  
  
  
  

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