A 50-year-old male presents to the community clinic. He has just relocated to th
ID: 122686 • Letter: A
Question
A 50-year-old male presents to the community clinic. He has just relocated to the area and has no primary provider. He is a long distance truck driver and requires a physical examination to maintain his continued employment. Physical examination demonstrates a BMI of 33, blood pressure of 180/90 mm Hg, diminished femoral pulses and bilateral varicose veins with 1+ pitting edema in both ankles. He has a 30 year history of smoking two packs of cigarettes per day. Initial Discussion Post: What additional information is needed from the patient history and physical assessment to determine if this patient has arterial or venous insufficiency? Compare and contrast evidence based nursing interventions for the patient diagnosed with arterial insufficiency and the patient diagnosed with venous insufficiency.
Explanation / Answer
Patient history
1. 50 year old male
2. 30 year history of cigarette smoking
3. Blood pressure of 180/90 mm of Hg
4. 33 BMI
5. Diminished femoral pulse and ankle oedema
The above mentioned patient is suffered from the peripheral vascular disease because from long time he is a truck driver and chain smoker, but data that you have provided is somewhat less to identify wether he is a patient of ischemia , artery insufficiency, vein insufficiency or other type. See whenever patient is old he suffered from majority of disease and in that if he is a smoker or hard worker like driver then this is aid in the disease.
Following additional data require to know his current status
1. Sugar test
2. Ischemia test
3. Physical examination of leg like wound, any hard mass etc
4. If pain in feet or leg then severity of pain
5. If wound is there then wound history and it's healing consequences
6. Personnel interview about family history and past diseases or any major or Minor accident
Nursing intervention for both artery and venous insufficiency
As we know that disease in any condition is not good for health and day to day work. Above mentioned patient is suffered from PVD which affect his lower extremities due to which there is a irregular supply of blood to heart.
As we know that artery has more important than veins because any issue in arterial flow may be sudden death of patient.
Whenever patient diagnosed with arterial insufficiency , we have to examine patient throughlly to identify cause of disease. We also teach him that now from onwards you take extra care of because if atherosclerosis or any thrombus to the artery. Venous insufficiency also examine carefully because ones physical state of patient is change means his body is prone to any type of disease.
Such patient is carefully examine for patient physical state like any wound in leg or not if wound is there then severity of pain.
If patient is arterial insufficiency then extra care is provided to stop the severity of disease to upper side.
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