Help, first term nursing student!?

Question

If the nursing diagnosis is "Impaired walking r/t poor circulation" Give me some interventions.
Thanks.

Answer 1

Brandi!:

What you are describing was called "hardening of the arteries" by my grandparents. After medical school, I call it arteriovascular disease or intermittant claudication, although other causes of poor circulation may cause impaired walking.

If a vascular problem, a person who walks half a block (or less) gets crampy pain in their muscles below the vascular problem. If calves ache with such little activity, then the blockage or narrowing of the arteries is in the thighs (femoral artery).

Your intervention for claudication symptoms would be "STOP SMOKING", take statins (not proven to work but most physicians agree that reducing the cholesterol may reduce or stop the progression of the disease), and drugs like PLETAL can help. Anything that makes the blood less viscous can improve symptoms; pletal, coumadin, or aspirin are some of those drugs. Pletal works by making the RBC membrane a little more flexible - or so the literature says.

Nursing interventions? Drink more water - a dehydrated person has slightly thicker blood (more viscous) and optimal water will improve circulation. Exercise as much as they can - walk them to the point of mild pain, have them rest, and then walk them again. Repetition can help - one of my patients who couldn't walk a block quit smoking, increased exercise endurance slowly, took pletal and an aspirin daily, and in two years the hair began to grow on their lower leg, the vascular disease skin changes were disappearing, and most importantly, they were walking two miles every morning without pain!

Heating pads & warm soaks can help, but if arterial inflow is poor, dilating the "downstream" tissue of feet and ankles won't help that much or that quickly. But it will feel good! As will massage of the effected areas. Take care on applying pressure to painful limbs - bruising is a concern, but a good masseuse understands.

Other circulation problems are Congestive Heart Failure or Coronary Artery Disease. Both of those will reduce walking because of shortness of breath and possibly chest pain, not because of leg or foot cramping.

You can write me an email if you'd like interventions for either of those disease states, I'll tell you what we have nurses do for our patients.

Good luck in your studies, we doctors need enthusiastic nurses who know their stuff - it helps our patients and makes our job easier!

Answer 2

1. Provide loose garments or clothing. R: Tight garments can restrict flow of circulating blood.

2. Assist/Encourage regular ambulation or encourage passive exercises if unable to walk.

3. Keep the limbs warm :
a. providing a warm environment.
b. providing warm-keeping clothings.
c. warm compression if no contraindications.

4. Elevate and straighten legs when sleeping with pillow support under.

5. Advice to avoid prolonged fixed position.
6. Apply light massage on the limbs if no contraindication.
7. Administer prescribed drugs to improve the circulation or to treat underlying causes that affect the circulation.
8. Encourage activities that promote circulation.
9. Encourage foods and drinks that will enhance circulation.
10. etc....

Answer 3

Hi i have found this for you, hope it helps you out good luck w,w...http://allnurses.com/forums/f50/interventions-212888.html