Low Na Diet Complementary and Integrative Therapies interactions Surgical

Low na diet complementary and integrative therapies

This preview shows page 43 - 58 out of 64 pages.

Low Na+ Diet Complementary and Integrative Therapies – interactions Surgical Intervention isease/diagnosis-treatment/drc-20350563
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Surgical Management – I.R.: PAD Percutaneous transluminal angioplasty (PTA[PCTA]): Stents: >
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Surgical Management - I.R.: PAD Atherectomy: Cryoplasty:
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Surgical Therapy: PAD Bypass Endarterectomy Patch graph angioplasty Amputation
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Post-Bypass Nursing Care: PAD Check operative extremity perfusion Q15 min x 1hr, then Q1hr : Color, temp, cap refill, peripheral pulses, sensation, movement. Loss of palpable pulse or change in Doppler sound notify HCP immediately . Always compare assessment findings to baseline and opposite limb ABI measurements are not recommended - increases risk of graft thrombus Avoid knee-flexed position x during exercise Control edema – may require elevation and graduated compression Pain Management
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Nursing Management: PAD Diagnoses: Ineffective peripheral tissue perfusion Acute/Chronic pain Activity intolerance Ineffective health management Impaired tissue integrity?
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Nursing Management: PAD Planning/Outcomes: Maintain adequate tissue perfusion Pain relief Increased activity tolerance Maintain healthy tissue Increase knowledge of disease management
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Nursing Management: PAD Interventions: Identify s/s impaired healing (assess) Notify HCP Keep environment and extremities warm Risk factor reduction Foot and Leg Care Daily inspection/washing Clean cotton, well fitted socks File toenails Avoid crossing legs extreme temps prolonged standing
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Nursing Management: PAD Interventions (cont): Ambulate/reposition frequently Improve overall health management Nutrition Self-care/disease management Comorbidity management Antihypertensives Controlled blood glucose Long-term prescription therapy Antiplatlet - Clopidigrel (Plavix) Statin Pain management – Cilostazal (Pletal ) Evaluation : Pt verbalizes, demonstrates, & understands complex care required for PAD management
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ACUTE ARTERIAL ISCHEMI C DISORDE RS Acute Arterial Ischemia - Buerger’s Disease - Raunaud’s Syndrome
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Acute Arterial Ischemic Disorders
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Acute Arterial Ischemia Sudden interruption in the arterial blood supply to tissue Causes: Embolism, thrombosis, trauma/dissection Increased risk of arterial occlusion: Hypovolemia Hyper-viscosity Hypercoagulability
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Clinical Manifestations – A.A.I. Notify MD if suspected Early intervention to prevent loss of limb Without immediate intervention ischemia may cause tissue necrosis and gangrene within hours. 1)P ain 2)P allor 3)P aresthesia 4)P aralysis 5)P oikilothermia 6)P ulselessness
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Collaborative Care: A.A.I IV therapy with heparin – sliding scale Diagnostic imaging to evaluate perfusion Revascularization: Remove thrombus to restore blood flow - Surgical thrombectomy (recommended procedure) Converted to long-term prophylaxis with warfarin
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Clinical Manifestations – Buerger’s Thromboangiitis obliterans Nonatherosclerotic, inflammatory vascular disorder Often mistaken for PAD or autoimmune dz.
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