Pathology

It is related to Arteriosclerosis Obliterans, defined as arteriosclerosis in which proliferation of the intima has caused complete obliteration of the lumen of the artery, is also known as atherosclerotic occlusive disease. Occlusive disease of the femoral and popliteal arteries usually occurs at the point at which the superficial femoral artery passes through the adductor magnus tendon into the popliteal space. Occlusion of these regions is also marked by intermittent claudication of the calf & foot that may radiate to the ipisilateral popliteal region and lower thigh. Occlusive disease of the aorta & iliac arteries, usually begins just proximal to the bifurcation of the common iliac arteries, causing changes in both of the lower extremities. Bilateral, progressive, intermittent claudication (pain, ache, or cramp in the muscles causing limping) is almost always present in the calf muscles and usually present in the gluteal and quadriceps muscles. The distance a person !

can walk before the onset of pain is indicative of the degree of circulatory inadequacy (esp. 2 blocks or more is mild, 1 block is moderate, and ½ block or less is severe). The primary symptom may only be a sens

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bid

Surgeries

-laser angioplasty (A guide catheter is threaded into the diseased coronary artery to the narrowed area. The light vaporizes the plaque)

-bypass graft (replacement or bypass section of a blood vessel if the client has an aneurysm or obstructed vessel)

-embolectomy (removal of an embolus)

-thrombectomy (removal of a thrombus)

-endarterectomy (resection & removal of the lining of an artery)

Prognosis

Occlusive diseases are not life threatening unless a thrombus breaks off from the blood vessel wall and is carried to the heart, brain, lungs as an embolism. Catergory-Perputal/Cognitive

Rationale:

Comfort is important to the pt. , is participating in passive/active exercises, ambulates length of hall bid, but still needs asst. x1 for prevention of clotting formation

-administer Anti-infective: Kefzol 1g IV Q8hr to kill bacteria

-administer Vasodilator : Nitrostat . Progressive disabilities from pain, ulceration, gangrene, and loss of functions or limbs are more likely to occur than death as a result of Peripheral occlusive diseases. e of weakness or “tiredness” in these same areas; both the pain & weakness or fatigue are relieved by rest. to relax , & verbalizes that the pain has gone away & is a 0-1 on pain scale. I&O don’t match cc/cc

KCL 20 meq po is effective potassium levels are normal 4. Q2 hr

-r/r type, location, duration, & intensity of pain

-observe condition of dressing & appearance of incision when dressing is changed.

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Approximate Pages = 8 (250 words per page double spaced)

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