Soap Note: Peripheral Artery Disease

Nursing
1 min, 46 sec read Download Article

SUBJECTIVE

A patient complains of painful cramps in his legs and arms after walking; his legs become numb. He also experiences cold in his lower foot and a change of color in his legs. He experienced slow hair growth and is the reason for the visit. His legs were examined for P.A.D signs and seen to have a weak pulse. His arms and ankle systolic pressure recorded bellow 1.30. Results of ultrasound indicated that his blood vessels blocked. A treadmill tests showed he had a problem with normal walking. Magnetic resonance angiogram test indicated that his blood vessels blocked. Arteriogram test indicated the exact location of infected arteries in his ankle.

OBJECTIVE

Physical examination showed he had sung of PAD. Weak pulse was observed in his arteries. Whooshing sound heard over his arteries with a stethoscope. Ankle-brachial index test indicated high blood pressure. Doppler's ultrasound showed the patient had blocked arteries in his ankle. Angiography test indicated that his arteries were severely blocked and needed widening to improve blood flow. A blood test showed that he had high cholesterol levels in his body.

The client was provided with cholesterol-lowering drugs called statin to reduce the risk of heart attack. He was given high blood pressure medication to lower his blood pressure. The patient was given aspirin medication to prevent blood clots within his arteries and improve flow. He was also given Cilostazol drugs to increase blood flow in his ankle and arms by widening his arteries. Angioplasty surgery was done to the patient to treat peripheral artery disease causing claudication. The patient also underwent bypass surgery to allow blood flow around the blocked artery.  The patient received thrombolytic therapy. A clot-dissolving drug was injected into his vessels at the point of the clot to break it up.

PLAN

Continue OT intervention targeting lifestyle and home remedies. The patient was advised to stop smoking which contributes to damage to arteries. Increased daily exercises to condition his muscle use oxygen efficiently. Eating healthy to control blood pressure and cholesterol level. Careful foot care by washing feet daily, wearing fitting shoes and treating fungal infection.

Share this post:

Cite this Page

APA 7
MLA 9
Harvard
Chicago

GradShark (2023). SOAP NOTE: Peripheral Artery Disease. GradShark. https://gradshark.com/example/soap-note-peripheral-artery-disease

Finding it challenging to complete your essay within the given deadlines?