make a nursing care plan CASE STUDYPeripheral Arterial Disease: A Case ReportFrom the Henry Ford HospitalShel D. Levine, MS, ACSM-CEP'CASE PRESENTATIONHbAlc was 8.0%. Her initial exercise sessions were limitedA.T. is a 65-year-old black female with claudication second-ary to peripheral arterial disease (PAD). She has a history ofcoronary artery disease, myocardial infarction, heart failure,endarterectomy, hypertension, hyperlipidemia, type 1 diabe-tes mellitus, and asthma.by bilateral claudication of her thighs and calves. Moderatepain occurred after 9 minutes of walking on day 1. A pain-rest walking program was initiated and followed for 12weeks. She then joined the Henry Ford PREVENT program,which provides patients with a low-cost, long-term super-vised exercise environment.She was referred to the Division of Vascular Surgery atHenry Ford Hospital complaining of fatigue and heavinessin her lower thighs and calves during walking. Restingankle-brachial index (ABI) was 0.50 and 0.70 at the rightand left dorsalis pedis, respectively. She was prescribed cilo-stazol and encouraged to “.walk through the pain as muchas possible."Due to worsening claudication, A.T. underwent anabdominal aortogram with arteriogram of the lower extremi-ties. Results showed aortoiliac disease with multiple steno-ses of varying degrees. Areas of calcification were notedfrom the lower aorta and iliac artery to the anterior tibialartery affecting both the left and right limbs.Results from a stress echocardiogram showed cardiacShe now exercises at least 3 d-wk for 60 minutes eachsession. She splits her exercise time between a seated step-per and a treadmill. On most days she is now able to walk 30continuous minutes without limiting claudication pain.DISCUSSIONThe natural history of arteriosclerosis involves an intimalplaque that progressively develops until it eventually causesa significant flow limiting occlusion of the vessel and reduc-tion of blood supply relative to demand. Arteriosclerosis is asystemic disorder affecting the major circulations, with theintimal plaque occurring segmentally in multiple locations.When the plaque occurs in the distal aorta or in the arteriesof the lower extremities, it is referred to as PAD.wall motion abnormalities consistent with exercise-inducedischemia. She exercised for 5.8 minutes on the Bruce proto-col, limited by general fatigue. The electrocardiogram dis-played left bundle branch block, resting ejection fractionwas 40%, peak blood pressure was 160/80 mmHg, and peakheart rate was 120 b'min'. No symptoms were reported. Hermedications are cilostazol, carvedilol, amlodipine, isosor-bide dinitrate, clopidogrel, simvastatin, potassium, triam-cinolone, ipratropium, and pirbuterol.She began supervised exercise training in cardiac reha-bilitation following a hospitalization for angina. At rest herblood pressure was 120/50 mmHg, heart rate was 79 b-min',blood glucose was 6.89 mmol-L" (266 mg-dL-") and herEpidemiologyMore than 8 million individuals in the United States abovethe age of 40 are estimated to have PAD (1). The prevalenceof PAD per ABI is 4.3% in persons older than 40 years andup (2) and 29% in those 70 years and older (3). Thus PADafflicts more than 4 million Americans and more than 200million people worldwide. The age-adjusted prevalence ofPAD increases to approximately 12% when more sensitivevascular imaging studies are used. Unlike coronary arterydisease, the incidence of PAD is similar in men and women.Coronary artery disease occurs in 60% to 90% of patientsDownloaded from http:/meridian.allerpress.com/jceplartice-pdf/7/1/15/1502066/2165-6193-7_115pdf by Phlippines user on 27 October 2021

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make a nursing care plan CASE STUDYPeripheral Arterial Disease: A Case ReportFrom the Henry Ford HospitalShel D. Levine, MS, ACSM-CEP'CASE PRESENTATIONHbAlc was 8.0%. Her initial exercise sessions were limitedA.T. is a 65-year-old black female with claudication second-ary to peripheral arterial disease (PAD). She has a history ofcoronary artery disease, myocardial infarction, heart failure,endarterectomy, hypertension, hyperlipidemia, type 1 diabe-tes mellitus, and asthma.by bilateral claudication of her thighs and calves. Moderatepain occurred after 9 minutes of walking on day 1. A pain-rest walking program was initiated and followed for 12weeks. She then joined the Henry Ford PREVENT program,which provides patients with a low-cost, long-term super-vised exercise environment.She was referred to the Division of Vascular Surgery atHenry Ford Hospital complaining of fatigue and heavinessin her lower thighs and calves during walking. Restingankle-brachial index (ABI) was 0.50 and 0.70 at the rightand left dorsalis pedis, respectively. She was prescribed cilo-stazol and encouraged to “.walk through the pain as muchas possible.&#34;Due to worsening claudication, A.T. underwent anabdominal aortogram with arteriogram of the lower extremi-ties. Results showed aortoiliac disease with multiple steno-ses of varying degrees. Areas of calcification were notedfrom the lower aorta and iliac artery to the anterior tibialartery affecting both the left and right limbs.Results from a stress echocardiogram showed cardiacShe now exercises at least 3 d-wk for 60 minutes eachsession. She splits her exercise time between a seated step-per and a treadmill. On most days she is now able to walk 30continuous minutes without limiting claudication pain.DISCUSSIONThe natural history of arteriosclerosis involves an intimalplaque that progressively develops until it eventually causesa significant flow limiting occlusion of the vessel and reduc-tion of blood supply relative to demand. Arteriosclerosis is asystemic disorder affecting the major circulations, with theintimal plaque occurring segmentally in multiple locations.When the plaque occurs in the distal aorta or in the arteriesof the lower extremities, it is referred to as PAD.wall motion abnormalities consistent with exercise-inducedischemia. She exercised for 5.8 minutes on the Bruce proto-col, limited by general fatigue. The electrocardiogram dis-played left bundle branch block, resting ejection fractionwas 40%, peak blood pressure was 160/80 mmHg, and peakheart rate was 120 b'min'. No symptoms were reported. Hermedications are cilostazol, carvedilol, amlodipine, isosor-bide dinitrate, clopidogrel, simvastatin, potassium, triam-cinolone, ipratropium, and pirbuterol.She began supervised exercise training in cardiac reha-bilitation following a hospitalization for angina. At rest herblood pressure was 120/50 mmHg, heart rate was 79 b-min',blood glucose was 6.89 mmol-L&#34; (266 mg-dL-&#34;) and herEpidemiologyMore than 8 million individuals in the United States abovethe age of 40 are estimated to have PAD (1). The prevalenceof PAD per ABI is 4.3% in persons older than 40 years andup (2) and 29% in those 70 years and older (3). Thus PADafflicts more than 4 million Americans and more than 200million people worldwide. The age-adjusted prevalence ofPAD increases to approximately 12% when more sensitivevascular imaging studies are used. Unlike coronary arterydisease, the incidence of PAD is similar in men and women.Coronary artery disease occurs in 60% to 90% of patientsDownloaded from http:/meridian.allerpress.com/jceplartice-pdf/7/1/15/1502066/2165-6193-7_115pdf by Phlippines user on 27 October 2021

Accepted Answer

Peripheral artery disease is also called as periphery artery occlusive disease, peripheral vascular…