Question

Mr. Edwards is a 43-year-old man with a history of peripheral vascular disease and hypertension. He smokes two packs of cigarettes per day. He reports calf pain during minimal exercise that decreases with rest.

1. Highlight the one (1) priority nursing diagnosis related to Mr. Edward’s symptoms, and write a client outcome for it.

a. Ineffective Peripheral Tissue Perfusion related to compromised circulation

b. Fatigue related to pain on exertion

c. Impaired Physical Mobility related to pain and muscle spasms

d. Ineffective Coping related to stress associated with pain

2. Explain what happens when intermittent claudication occurs.

3. Why does rest decrease the pain?

4. Describe how smoking contributes to decreased circulation.

Answer 1

Patient reports calf pain during minimal exercises that decreases with rest

It is a sign of ineffective tissue perfusion due to atherosclerosis as patient have history of peripheral vascular disease and hypertension

1) The priorty nursing diagnosis related to Mr. Edward symptoms is

Ineffective peripheral tissue perfusion related to compromised circulation

Client outcome for it -

a) patient identifies factor that improves circulation

b) patient identifies necessary lifestyle changes

c) patient involves in behaviour or action that improves tissue perfusion

d) patient maintains maximum tissue perfusion to vital organs as evidenced by warm, dry skin and strong peripheral pulses

e) patient exhibit growing tolerance to activity .

2. In Intermittent Claudication occurs when our extermities doesn't get enough oxygen or blood supply while exercising , it means that plaque has accumulated in our lower leg arteries and causing blockages. When Intermittent Claudication occurs it causes pain in lower extermities due to insufficient blood supply to lower extermities causing strain on the lower limb and thus pain occurs , it occurs Intermittent as pain reduces when body stop exercising and do rest due to which it is named as Intermittent Claudication.

3. Rest decreases the pain because pain basically occur in lower extermities on exercising on patient who have atherosclerosis and plaque in exercise didn't permit proper blood supply in limb , when the person stops exercising the flow of blood in lower extermities increases as during exercising demand of oxygen in limb has increased but on resting time limb get enough blood supply and due to getting sufficient blood supply in resting state , pain decreases .

4.Smoking together with disease condition such as hypertension and peripheral vascular disease caused reduced blood flow to lower extermities as smoke contributes in plaque formation causing atherosclerosis which is blockage of arteries and due to plaque blood flow reduces. Chemicals in tobacco harms blood cells and is major risk factor of peripheral artery disease because chemicals of smoking damage our vital organs such as heart and also structure and function of blood vessels which contributes in condition called as atherosclerosis . Atherosclerosis is formation of plaque in arteries and this plaque doesn't allow the blood to pass due to causing blockage in arteries hence decreasing the circulation . Thus ultimately smoke contributes to decreased circulation by harming blood vessels and contribute in plaque formation.

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