Peripheral Arterial Disease (PAD) and Peripheral Bypass Graft

Overview

• Presenter: Cathy from Level Up RN
• Focus: Peripheral Arterial Disease, Peripheral Bypass Graft, Quiz on Key Concepts
• Materials: Level Up RN medical-surgical nursing flashcards

Peripheral Arterial Disease (PAD)

• Definition: Inadequate blood flow to extremities due to atherosclerosis.
  • Differentiation: Compared to peripheral venous disease, PAD involves difficulty in blood reaching the extremities, whereas peripheral venous disease involves blood return to the heart.

Causes

• Atherosclerosis
  • Partially or totally occludes blood vessels
  • Impairs blood flow and deprives extremities of oxygen and nutrients

Risk Factors

• Hypertension
• Diabetes
• Smoking
• Obesity
• Hyperlipidemia

Signs and Symptoms

• Intermittent Claudication
  • Leg pain that worsens with exertion, improves when legs are dangling
• Physical Signs
  • Delayed capillary refill
  • Decreased pedal pulses
  • Hair loss on calves
  • Cool, shiny skin
  • Pallor upon elevation, dependent rubor

Complications

• Wounds on feet (usually dry, necrotic, with eschar)
• Delayed wound healing due to lack of oxygen and nutrients

Diagnosis

• Ankle Brachial Index (ABI)
  • Compare blood pressure in ankles to arms
• Doppler Ultrasound
  • Assess blood flow to extremities

Treatment

• Medications
  • Statins
  • Antiplatelets
• Surgical Procedures
  • Angioplasty
  • Peripheral Bypass Graft

Patient Teaching

• Exercise Tips
  • Stop and rest when experiencing pain, then resume walking
• Lifestyle Tips
  • Avoid restrictive clothing and leg crossing
  • Maintain warmth with socks
  • Avoid nicotine and caffeine

Peripheral Bypass Graft

• Purpose: Reroute blood flow around occluded artery
• Post-Surgery Monitoring
  • Pedal pulses
  • Capillary refill
  • Skin color and temperature
  • Keep legs straight for 24 hours

Complications to Monitor

• Graft Occlusion
  • Signs: Pallor, decreased pedal pulses, decreased temperature, sudden pain
• Compartment Syndrome
  • Signs: Numbness, severe pain with movement, edema, taut skin
  • Action: Immediate provider notification

Quiz Questions

1. Question: A patient with PAD will have decreased pain when their extremity is elevated. True or False?
   • Answer: False. Pain decreases when extremity is in a dependent position.
2. Question: Pallor with elevation and dependent rubor are indicative of PAD. True or False?
   • Answer: True.
3. Question: Edema, taut skin, numbness, and severe pain are indicative of what complication following a peripheral bypass graft?
   • Answer: Compartment syndrome.

Conclusion

• Reminded to review flashcards for better retention.
• Encouragement to like, comment, and subscribe for more nursing resources.