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Peripheral Arterial Disease Case Study

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Thank you for your detailed illustration of peripheral arterial disease (PAD). The point of view that I will be sharing with you is the postoperative intervention and rehabilitation of PAD in the acute care setting. Mahameed (2009) describes the indication for invasive revascularization surgery in individuals who failed conservative claudication therapies; acute or critical limb ischemia and lifestyle-limiting claudication.

The surgical procedures that are most commonly performed are carotid endarterectomy and lower extremities bypass grafting. Postoperatively, the vascular surgeon refers these patients to physical therapy for early ambulation training. As a physical therapist, thorough physical assessment including vital signs is necessary; especially blood pressure determination to assure that the bypass graft is getting enough perfusion. Low BP reading can result in low blood flow to the graft site; conversely, high BP can damage the graft due to elevated pressure.

Equally important, assessing the skin color, temperature and the pulse of the surgical limb by using a Doppler ultrasound and report findings to the bedside nurse …show more content…

Hence, a physical therapist must assure proper fall prevention teaching and strategies are implemented such as using an appropriate assistive device for ambulation. In addition to ambulation, supervised LE range of motion exercises (ROM) and gentle strengthening activities must be performed. These patients are prone to develop hip/knee flexion contractures due to immobility, post-operative pain, and fear of moving the surgical part. Nicolai, Teijink, & Prins (2010, p. 353) acknowledges the importance of supervised exercise therapy (SET) for patients with intermittent claudication (IC) vs. solely walking information alone in improving ambulation distance; the researchers found that SET is an effective treatment for IC and should be given as first-line

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There were several factors which may have contributed to this scenario. The patient’s comorbidities which include the ischaemic stroke which happened 2 years ago might have caused his fall. A Grade A recommendation and Level 1+ evidence were given by the National Stroke Foundation (2010) that patients are advised to undergo intensive rehabilitation for the first six months post-stroke. Given the fact that he had only received four months of inpatient rehabilitation, his functional status might not have been maximised. In addition, a Grade A recommendation and Level 1+ evidence were given for multi-disciplinary intervention in inpatient rehabilitation (MOH, 2008).

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These interventions included educating patients consistently about the important of getting assistance to get out of bed and go bathroom, providing information to increase patient knowledge about fall precaution, the reason why he or she was risk for falls and what specific actions they should avoid. The most important that, the nurse should to let the patient know that calling for help is not a bother to the nurse. They also found out that fall risk assessment, fall prevention, closer supervision of patient and hourly rounding were not performed or done as its policies. The findings in case reviews suggested that despite use of multiple fall prevention intervention, all falls are not preventable, but they also highlighted the need for consistent implementation of fall prevention intervention. In current evidence based fall prevention intervention recommendation, they mentioned a multicomponent approach to fall prevention can reduce fall rates by 30% (Miake-Lye et al., 2013).

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Unfortunately, not only is a surgeon tasked with the successful graft of the patient’s artery, he or she, must simultaneously monitor the patient’s vitals to make sure the patient doesn’t

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In order to have an effective falls prevention program a multifactorial approach will yield better results. Clinical practice guidelines from the United States and Canada both recommend patient education as a part of falls prevention (NGC, 2012). Patients have benefited significantly from patient education program because falls have been reduced based on the delivery methods that were used. For patients with no cognitive impairment the resources used were used included written education regarding falls data and causes of falls, self-assessment of risk, problem area identification, development of preventive strategies and behaviors, goal setting and review along with video/DVD material highlighting these same points and then

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According to research studies, Peripheral artery disease (PAD) had been commonly underdiagnosed, undertreated, and poorly understood. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894725/]. Study result demonstrates that underdiagnosis of PAD in primary care practice may have been the reason for ineffective secondary prevention of the high ischemic cardiovascular risk associated with PAD. The symptoms of Peripheral arterial disease can be mistaken for symptoms of other medical conditions, such as hip pain (a symptom of PAD), is commonly mistaken for arthritis.

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For example, a weight attached to the wrist by a strap increases resistance to arm movements during needlework or other activities (Pendleton & Schultz-Krohn, 2017). It is important to design interventions that target the client’s prior performance patterns and emotional and social needs. In one study, 29 Swedish older adults who suffered a hip fracture reported a significant decline in their ability to perform hobbies and engage in social activities after their hip fracture and that these activities were more important to them than self-care activities (Pendleton & Schultz-Krohn, 2017). As a result, the occupational therapist can play a key role in the client’s psychosocial adjustment to physical limitations and in maximizing the client’s return to participation in meaningful activities (Pendleton & Schultz-Krohn,

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On Friday January 12, 2018 I was privileged to observe with Kathy Schwartz, PT at Warm Springs Outpatient Physical Therapy Center off Sonterra Blvd in San Antonio, TX. I began my visit at 8:30 am where I was introduced to all the staff and oriented to the facility. Following this, I received a brief background on the patients I would be seeing during my visit. Which included: two patients with Parkinson’s disease (PD), one patient with complex regional pain syndrome and one patient with a total hip replacement. The first patient I encountered at 9:15 am was a 65-year-old female presenting with balance and gait disturbances.

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