Mr j a 76 year old man was admitted to the hospital with rest pain in both legs and a non healing ulcer on the right foot. Subjective data History of MI, stroke, hypertension, chronic heart failure and diabetes mellitus Underwent a left femoral popliteal by pass 5 years ago. Has been on insulin for 30 yrs Complains of sudden, increase in right foot pain for 2 hours Has slept on recliner with right leg in dependent position for several months. Current medications Furosemide 40 mg po daily Aspart( Novolog) insulin with meals Diltiazem sustained release 240 mg PO daily. Aspirin. 325 mg P.O daily Objective data Physical examination BP 148/92 mm Hg, respiratory rate 22/minute. Alert and oriented but anxious, no apparent physical/mental deficits from previous stroke Has a diminished right femoral pulse, popliteal pulse by doppler only, posterior tibial pulse and dosalis pedis pulse absent. Right leg ABI 0.4 left leg ABI 0.4 Has a 2 cm necrotic ulcer on tip of right toe Right foot is very cool, pale, and motteld in color No peripheral edema present. Questions What are Mr Js risk factors for peripheral arterial disease. Are Mr Js signs and symptoms evidence of acute or chronic peripheral arterial disease? Explain your answer.( 4 mks) What is the possible cause of sudden, intense increase in right foot pain. What additional diagnostic tests may be perforemd to assess the extent of his PAD. Based on assessment data, identify two priority nursing diagnoses What are the Nursing responsibilites in caring for Mr J.
Mr j a 76 year old man was admitted to the hospital with rest pain in both legs and a non healing ulcer on the right foot.
Subjective data
History of MI, stroke, hypertension, chronic heart failure and diabetes mellitus
Underwent a left femoral popliteal by pass 5 years ago.
Has been on insulin for 30 yrs
Complains of sudden, increase in right foot pain for 2 hours
Has slept on recliner with right leg in dependent position for several months.
Current medications
Furosemide 40 mg po daily
Aspart( Novolog) insulin with meals
Diltiazem sustained release 240 mg PO daily.
Aspirin. 325 mg P.O daily
Objective data
Physical examination
BP 148/92 mm Hg, respiratory rate 22/minute.
Alert and oriented but anxious, no apparent physical/mental deficits from previous stroke
Has a diminished right femoral pulse, popliteal pulse by doppler only, posterior tibial pulse and dosalis pedis pulse absent.
Right leg ABI 0.4 left leg ABI 0.4
Has a 2 cm necrotic ulcer on tip of right toe
Right foot is very cool, pale, and motteld in color
No peripheral edema present.
Questions
- What are Mr Js risk factors for peripheral arterial disease.
- Are Mr Js signs and symptoms evidence of acute or chronic peripheral arterial disease? Explain your answer.( 4 mks)
- What is the possible cause of sudden, intense increase in right foot pain.
- What additional diagnostic tests may be perforemd to assess the extent of his PAD.
- Based on assessment data, identify two priority nursing diagnoses
- What are the Nursing responsibilites in caring for Mr J.
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