1. The client/caregiver can define peripheral vascular disease.
   1. It is diminished blood supply to or from the lower extremities.
   2. It can involve either the veins or the arteries.
2. The client/caregiver can recognize the signs and symptoms.
   1. Arterial insufficiency
      1. Sharp pain that increases after exercise
      2. Cool, pale skin
      3. Absent or diminished pulse in legs and feet
      4. Reddish-blue color of skin
      5. Delayed healing
      6. Decreased capillary filling time
   2. Venous insufficiency
      1. Aching, cramping-type pain
      2. Edema
      3. Mottled and pigmented skin
      4. Ulcers close to the ankle
3. Client/caregiver can list measures for the management of a disease.
   1. Prevent decreased circulation
      1. Avoid smoking.
      2. Avoid constrictive clothing.
      3. Never cross legs.
      4. Avoid letting lower extremities be exposed to extreme temperatures.
      5. Avoid long periods of sitting or standing.
      6. Eat a diet low in cholesterol, fats, and sodium (nutrition guides for specific diets).
   2. Promote increased circulation
      • Prop legs in elevated position; hold legs at approximately 45 degrees for 1 minute to drain
        blood.
      • Sit with legs dangled on the side of the bed. Stretch feet downward, holding for 30
        seconds, and then stretch feet inward, outward, and upward, holding each position for 30
        seconds.
      • Lie flat on the back with legs straight for 1 minute.
   3. Prevent injury to lower extremities
      1. Never go barefooted.
      2. Cut toenails carefully straight across after soaking them for 10 minutes.
      3. Wear well-fitting shoes with hose or stockings.
      4. Avoid scratching lower extremities.
      5. See a podiatrist for corns, calluses, ingrown toenails, and so forth.
      6. Avoid the use of hot water bottles or heating pad.
      7. Wash feet carefully and pat dry. Observe for any redness or open areas.
      8. Wear clean cotton socks.
   4. Take medications as ordered.
   5. Obtain laboratory tests as ordered and attend follow-up appointments with a physician.
4. The client/caregiver is aware of possible complications.
   1. Ulcers
   2. Cellulitis
   3. Gangrene
   4. Thrombophlebitis
   5. Embolism
      1. Walking as ordered by a physician.
      2. Wear a support hose.
      3. Perform Buerger-Allen exercises.

Resources

American Heart Association
www.americanheart.org

National Institutes of Health
www.nih.gov

American Dietetic Association
www.eatright.org

Support groups for weight reduction or cessation of smoking

Stress management

Exercise classes at local YMCA

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com