Case
Nur 212 Peripheral Arterial Disease Case Study
- Course
- NUR 212
- Institution
- Forsyth Technical Community College
This is a comprehensive and detailed note case study on; Peripheral Arterial Disease. *Essential Study Material!!
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Peripheral Arterial Disease (PAD)JoAnn Smith, 74 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
1. Clotting
2. Pain
3. Clinical Judgment
4. Patient Education
5. Communication
6. Collaboration
© 2016 Keith Rischer/www.KeithRN.com
, Unfolding Clinical Reasoning Case Study: STUDENT
Peripheral Arterial Disease (PAD)
History of Present Problem:
JoAnn Smith is a 74-year-old woman who has a history of myocardial infarction and systolic heart failure secondary to
ischemic cardiomyopathy with a current ejection fraction (EF) of 15 percent. Over the last two weeks she has noticed
achiness in her right leg and tingling in her toes after walking short distances. When she stops walking, the pain and
tingling resolve in 10315 minutes. Now the pain/cramping in her right leg has been lasting longer3-up to 30 minutes the
last two days. Over the past month her right great toe has developed a black tip that is painless to the touch. JoAnn was
seen in the clinic today and her physician decided to directly admit her to the medical unit where you are the nurse
responsible for her care.
Personal/Social History:
JoAnn is a retired math teacher who has struggled with depression since her husband of 52 years died unexpectedly two
years ago from a myocardial infarction. She lives alone in an assisted living apartment.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
¥ 74 y.o. ¥ Possible neuropathy
¥ Hx MI, systolic HF, ischemic
cardiomyopathy, EF 15%. ¥ Indicative of alteration in perfusion to the peripheral
¥ Achiness in R leg, tingling in toes after extremities.
walking.
¥ Cramping lasts up to 30 minutes.
¥ Black tip on R great toe (painless)
RELEVANT Data from Social History: Clinical Significance:
¥ Retired ¥ Lacks support system
¥ Depression since the passing of her husband 2
years ago.
¥ Lives alone (assisted living)
What is the RELATIONSHIP of your patient9s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect)
Home Meds: Pharm. Classification: Expected Outcome:
1.
2.
1.Antipyretic/Analgesic 1. Prevention of second or
2.Adrenergic Blocker TIA.
2.Prevents stoke, heart
3. 3.Antihyperlipidemic attack, kidney issues. Lowers
4.Antihypertensive HR, BP, and decreases
4. 5.Loop Diuretic strain on the heart.
3.Lowers lipid cholesterol in
6.Nutriceutical/Electrol
5. the blood.
yte 4.Lowers BP.
7.Anticoagulant 5.Reduces extra fluid in the
6. 8.Antidiabetic/Biguanid body.
7. e 6.Prevention of hypokalemia.
8. 7.Treats and prevents blood
9.ACE
clots. Reduces risk of stroke
9. Inhibitor/Antihypertensi and heart attack.
ve 8.Regulates level of blood
glucose.
9.Treats MI, HF, HTN, CKD.
Lowers BP, increases O2 to
the heart.
© 2016 Keith Rischer/www.KeithRN.com
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