Cardiovascular Disorder Case Studies NR 283 QUESTIONS
AND CORRECT DETAILED ANSWERS
1. A client presents to the hospital with reports of severe pain to
... [Show More] the left lower extremity only. The
patient reports the pain started a day or so ago and has steadily increased to unbearable.
What manifestations stand out?
- severe pain to LLE (left lower extremity)
- pain is sudden/ acute because it started a day or so ago
What could they indicate? Why? How do you know?
- Indicates peripheral vascular problem
- Why and how kind of go hand in hand there is no indication at this point that the patient has a
musculoskeletal issue therefore the next most common thing to affect the lower extremities is
peripheral vascular disease.
The triage nurse assesses the left lower extremities. The left leg is dusky, cold to touch, the pedal pulse is
weak, and the capillary refill is 6 seconds. The patient’s hair distribution is normal and when compared
to the right leg, there is no edema noted.
What do you suspect is causing the patients symptoms?
Acute occlusion of the artery (remember that peripheral vascular disease is an umbrella term that
encompasses arterial disease and venous disease. This is an arterial problem)
Which manifestations support your assumption? Why?
- Dusky (in darker skinned people pallor may appear more as a dusky color; dusky means ashen or
grey; in lighter skinned people they will appear more pale)
- Cold to the touch
- Weak pulse in foot (pedal pulse is on the top of the foot)
- The capillary refill is > 3 seconds
- Lack of edema (remember when the vessel has decreased flow the hydrostatic pressure is low
and therefore NOT pushing out in to the interstitial space)
- All of the aforementioned symptoms indicate arterial problem rather than venous problem.
Which manifestations do not support your assumption? Why not?
- Normal hair distribution indicates that this isn’t a chronic issue for the patient and is something
sudden
Is this systemic or localized? Why?
- Localized because ONLY one leg is affected; had it been both legs it would be due to systemic
diseas [Show Less]