| If your patient is receiving drug therapy, monitor the | | | | monitor his PTT, and adjust the infusion rate, as |
| effects of the prescribed drugs. Assess the | | | | needed. |
| neurovascular status of his legs and report any | | | | Some More Facts |
| deterioration in circulation. | | | | Teach your patient how to promote circulation. Help |
| Place lamb's wool between the patient's toes to | | | | him devise a progressive exercise program to |
| prevent pressure necrosis. If he has ulcers, provide | | | | develop collateral circulation and enhance venous |
| wound care as needed. Assess the ulcer for signs | | | | return. Instruct him to stop exercising if he feels pain. |
| and symptoms of infection. Cover the ulcer with a | | | | Also, tell him to inspect his feet daily for color |
| dry sterile dressing, topical antibiotic, or other wound | | | | changes, mottling, scabs, skin texture changes, skin |
| care product, as ordered. | | | | breakdown, and hair growth changes. |
| If your patient has had surgery for peripheral | | | | Advise the patient to change positions frequently to |
| vascular disease, check his leg for color, temperature, | | | | avoid blood pooling in the feet. Teach him how to |
| sensation, movement, and pulses during the | | | | promote perfusion by keeping his legs and feet |
| immediate postoperative period. Report any loss of | | | | warm and by avoiding vasoconstrictive substances, |
| pulse immediately. Observe the incision site for | | | | such as caffeine and nicotine. Tell him that wearing |
| redness, swelling, and drainage. | | | | tight, restrictive clothing on the legs can hinder blood |
| Turn and reposition your patient every 2 hours. Tell | | | | flow. |
| him to not cross his legs and to avoid severe hip or | | | | If the physician has prescribed an anticoagulant, |
| knee flexion. To aid circulation, add a footboard | | | | review its therapeutic effect, dosage, and adverse |
| to the bed, use a sheepskin under his legs, or place | | | | effects with your patient. Tell him that he'll have to |
| him on an air, pressure, or other special mattress. | | | | undergo frequent blood tests that monitor the drug's |
| If the patient has undergone percutaneous trans | | | | effectiveness. |
| luminal angioplasty or another form of surgical | | | | If your patient will have a home care nurse, tell him |
| catheterization, assess the site for bleeding, edema, | | | | that she'll assess his legs and feet and evaluate any |
| ecchymosis, and hematoma. Monitor his peripheral | | | | changes. She'll also evaluate wounds and incisions, |
| pulses every 15 to 30 minutes for the first hour, | | | | provide wound care, and assess susceptible areas for |
| every hour for the next 4 hours, and then once | | | | infection. She'll reinforce proper foot care and teach |
| every 4 hours after that. Assess his leg for sudden | | | | him to perform self-care. And she may observe him |
| changes in color and temperature. Also, monitor him | | | | as he sits and rests so that she can recommend |
| for muscle cramping, pain at rest, and changes in | | | | better positions for sitting and for elevating his legs. |
| motor and sensory function. Administer heparin, | | | | |