- Acute Pain related to Vascular system blockage and Peripheral vascular disease as evidenced by Expression of pain, cramping, or aching when walking and Burning pain in the feet (in severe cases)
- Chronic Pain related to Plaque buildup in the blood vessels of the extremities (atherosclerosis) and Severe claudication in the extremities as evidenced by Paraesthesia and Intermittent claudication
- Ineffective Peripheral Tissue Perfusion related to Atherosclerotic plaque buildup and reduced blood flow as evidenced by Absent/weak peripheral pulses and decreased blood pressure in extremities
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling (such as a prick, burn, or ache) Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns | Acute Pain related to Vascular system blockage and Peripheral vascular disease as evidenced by Expression of pain, cramping, or aching when walking and Burning pain in the feet (in severe cases) | Patient will verbalize reduced pain with walking. Patient will increase physical activity without experiencing pain. | 1. Administer medications as indicated. Cilostazol is a vasodilator that can help treat claudication. It may take up to 12 weeks to take effect. 2. Encourage exercise. Despite walking causing PVD pain, it is the best treatment for reducing disease severity. Patients should be instructed to walk until reaching their pain tolerance, pausing, and restarting once the pain is relieved. Walking sessions should last 30-45 minutes, 3-4 times per week. 3. Educate on lifestyle modifications. Treating PVD and corresponding pain requires lifestyle modifications of maintaining a healthy weight, exercising, and managing chronic conditions. 4. Instruct the patient to avoid massaging affected extremities. Massaging the affected extremities may feel good, but can dislodge an embolus. Speak with your doctor first before attempting. | Patient verbalized reduced pain with walking. Patient increased physical activity without experiencing pain. |
| Subjective data: -Reported decreased burning, tingling, and numbness in the extremities Objective data: -Burning pain -Paresthesias -Intermittent claudication -Altered mobility | Chronic Pain related to Plaque buildup in the blood vessels of the extremities (atherosclerosis) and Severe claudication in the extremities as evidenced by Paraesthesia and Intermittent claudication | Patient will report decreased burning, tingling, and numbness in the extremities. Patient will utilize nonpharmacological methods to reduce pain. | 1. Exercise first. In early PVD, exercise therapy is recommended for intermittent claudication. Collaborate with PT and OT to develop exercise regimens and safety modifications to reduce pain. 2. Consider psychological techniques. Biofeedback, mirror therapy, imagery, and meditation may be beneficial in conjunction with medications and other treatments for chronic pain. 3. Discuss spinal cord stimulation. Patients with severe ischemic pain from PVD who have not responded to other analgesics may find relief in a spinal cord stimulator, which is an implanted device that sends pulses of electricity to the nerves to mask pain. 4. Support the patient in coping with the chronic pain. Living with chronic pain can be difficult as it affects sleep quality, appetite, social interactions, and mood. Note that both mental and physical health are closely connected. Inquire about the patient’s emotional status and refer to mental health support services as necessary. 5. Prepare for surgical interventions. Revascularization treatments are utilized to restore blood flow to a blocked artery or vein and can aid in relieving pain in PVD. | Patient reported decreased burning, tingling, and numbness in the extremities. Patient utilized nonpharmacological methods to reduce pain. |
| Subjective data: Chest Pain Dyspnea Sense of impending doom Objective data: -Arrhythmias -Capillary refill >3 seconds -Altered respiratory rate -Use of accessory muscles to breathe -Abnormal arterial blood gases -Unstable blood pressure -Tachycardia or bradycardia -Cyanosis | Ineffective Peripheral Tissue Perfusion related to Atherosclerotic plaque buildup and reduced blood flow as evidenced by Absent/weak peripheral pulses and decreased blood pressure in extremities | Patient will demonstrate adequate tissue perfusion with 3+ peripheral pulses. Patient will verbalize their medication regimen to manage PVD. | 1. Manage chronic conditions. Patients with PVD often have atherosclerosis, diabetes, hypertension, or other chronic conditions that affect blood vessels. Ensure patients are receiving and adhering to their treatment plan in order to prevent worsening complications. 2. Avoid long periods of sitting. Ambulation is crucial in the treatment of PVD and patients should avoid sitting for long periods to increase venous return. 3. Consider the use of statins. Statin medications used for hyperlipidemia improve atherosclerotic disease. This coupled with lifestyle changes can improve PVD. 4. Prepare the patient for surgical intervention if indicated. Surgical intervention is usually reserved for severe cases. Prepare the patient preoperatively for revascularization procedures such as balloon angioplasty, stent placement, or bypass grafting. | Patient demonstrated adequate tissue perfusion with 3+ peripheral pulses. Patient verbalized their medication regimen to manage PVD. |