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
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https://www.coursehero.com/file/60657527/STUDENT-PAD-PVD-RAPID-Reasoning-Completeddocx/
, RAPID 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 10–15 minutes. Now the pain/cramping in her right leg has been lasting longer–-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:
Last 2 weeks achiness in her rt leg /tingling Indications of lack of profusion to lower extremities and possibility of
in toes after walking short distances; diabetes.
resolving in 10-15 mins. Pain/cramping in rt
leg has increased to lasting up to 30 mins in
the last 2 days. Right great toe has developed
black tip that is painless to the touch.
RELEVANT Data from Social History: Clinical Significance:
Retired teacher, struggling with depression May not be taking appropriate care of herself, i.e. nutrition or taking her
for 2 years and lives alone in assisted living medications as prescribed. She doesn't have any sort of support system.
apartment.
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.4 F/36.9 C (oral) Provoking/Palliative:
P: 76 (reg) Quality: Denies
R: 16 (reg) Region/Radiation:
BP: 138/82 Severity:
O2 sat: 95% room air Timing:
What VS data is RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
BP is 138/82 The heart is overcompensating to try to increase blood flow to the legs.
Current Assessment:
This study source was downloaded by 100000824189183 from CourseHero.com on 04-27-2022 03:16:44 GMT -05:00
https://www.coursehero.com/file/60657527/STUDENT-PAD-PVD-RAPID-Reasoning-Completeddocx/
JoAnn Smith, 74 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
1. Clotting
2. Pain
3. Clinical Judgment
This study source was downloaded by 100000824189183 from CourseHero.com on 04-27-2022 03:16:44 GMT -05:00
https://www.coursehero.com/file/60657527/STUDENT-PAD-PVD-RAPID-Reasoning-Completeddocx/
, RAPID 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 10–15 minutes. Now the pain/cramping in her right leg has been lasting longer–-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:
Last 2 weeks achiness in her rt leg /tingling Indications of lack of profusion to lower extremities and possibility of
in toes after walking short distances; diabetes.
resolving in 10-15 mins. Pain/cramping in rt
leg has increased to lasting up to 30 mins in
the last 2 days. Right great toe has developed
black tip that is painless to the touch.
RELEVANT Data from Social History: Clinical Significance:
Retired teacher, struggling with depression May not be taking appropriate care of herself, i.e. nutrition or taking her
for 2 years and lives alone in assisted living medications as prescribed. She doesn't have any sort of support system.
apartment.
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.4 F/36.9 C (oral) Provoking/Palliative:
P: 76 (reg) Quality: Denies
R: 16 (reg) Region/Radiation:
BP: 138/82 Severity:
O2 sat: 95% room air Timing:
What VS data is RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
BP is 138/82 The heart is overcompensating to try to increase blood flow to the legs.
Current Assessment:
This study source was downloaded by 100000824189183 from CourseHero.com on 04-27-2022 03:16:44 GMT -05:00
https://www.coursehero.com/file/60657527/STUDENT-PAD-PVD-RAPID-Reasoning-Completeddocx/
