Question

Mr. L, 70 years old si sent to hospital after visiting his physician with increasing painful muscle cramps after ambulating. He also hast rest pain and a non-healing ulcer of the big toe on the right foot. He lives alone and his medical history is significant for hypertension.

Dx: Peripheral artery disease

• VS q4h
• I&O
• Pedal pulse check q4h
• Bed rest with Bathroom privileges
• CBC, Electrolytes
• Insert saline lock
• Dressing changes: clean uncerated area on right lateral ankle with NS - apply dry sterile 4x4 dressing
• Diet: soft
• Routine med: Pentoxifylline 400 mg po tid; Dipyridamole 50 mg po tid; Tylenol plain i to ii tabs for pain

Based on the management of clients with peripheral vascular and lymphatic disorders answer the following questions:

1. What else would you do in this situation with Mr. L?
2. What other options or alternatives would you explore and why for Mr. L?
3. What referrals might you make for Mr. L at this time?
4. Who else on the interprofessional team would you involve in Mr. L’s care?

Answer 1

I will suggest to do some physical exercise to Mr L, this will improve his condition

Exercise has been shown to increase the walking time of patients with claudication by 15 sec.

Aspirin reduces risk of serious vascular events in patients with PVD, with doses of 75 to 150 mg being as effective as higher doses.

Patients with PVD and hypercholesterolemia should be treated with appropriate dietary modification and lipid-lowering agents, as needed.

Aggressive blood pressure reduction should be pursued in patients with PVD.