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Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Peripheral Artery Disease IV: Nursing Management01:26

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Atherosclerosis IV: Nursing Management01:23

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Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
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Community-based walking exercise for peripheral artery disease: An exploratory pilot study.

Ryan J Mays1, William R Hiatt2, Ivan P Casserly3

  • 1School of Physical Therapy and Rehabilitation Science, College of Health Professions and Biomedical Sciences, University of Montana, Missoula, MT, USA The International Heart Institute of Montana Foundation, Saint Patrick Hospital, Providence Medical Group, Missoula, MT, USA Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Ryan.Mays@mso.umt.edu.

Vascular Medicine (London, England)
|March 11, 2015
PubMed
Summary

A community walking program with training, monitoring, and coaching (TMC) did not significantly improve peak walking time in peripheral artery disease (PAD) patients. However, it did improve claudication onset time and patient-reported outcomes.

Keywords:
activity monitorsclaudicationenvironmental auditunsupervised exercise

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Area of Science:

  • Cardiovascular Medicine
  • Rehabilitation Science
  • Exercise Physiology

Background:

  • Supervised walking exercise is crucial for improving walking ability in peripheral artery disease (PAD) patients.
  • Community-based exercise programs for PAD often lack effectiveness.
  • Training, monitoring, and coaching (TMC) components may enhance supervised walking programs.

Purpose of the Study:

  • To evaluate the efficacy of a community-based walking exercise program incorporating TMC.
  • To assess the program's impact on exercise performance and patient-reported outcomes in PAD patients.

Main Methods:

  • A randomized controlled trial involving 25 PAD patients.
  • Intervention group: 14-week community-based walking exercise program with TMC.
  • Control group: Standard advice to walk.
  • Primary outcome: Peak walking time (PWT) via graded treadmill test.
  • Secondary outcomes: Claudication onset time (COT) and Walking Impairment Questionnaire (WIQ) scores.

Main Results:

  • No significant improvement in PWT for the intervention group compared to the control group (p=0.052).
  • Significant improvements in COT for the intervention group (+1.6 min vs. -0.6 min, p=0.045).
  • Significant improvements in WIQ scores for the intervention group (+18.3% vs. -4.6%, p=0.001).

Conclusions:

  • This pilot study's walking program with TMC did not meet its primary outcome for PWT in PAD patients.
  • The program demonstrated potential by improving secondary outcomes like COT and patient-reported walking function.
  • Further research with larger sample sizes is warranted to confirm the efficacy of community-based TMC walking programs for PAD.