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66 yo F (Secondary/ Hx (Diabetes mellitus, HTN, constipation, seizures,…
66 yo F
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Atherosclerosis
S/S
inadequate perfusion of tissues (slow cap refill), transient ischemic events
Dx tests
High LDL, low HDL, MRI/CT, low tissue perfusion, hs-CRP
Risk factors
HTN, diabetes, increased levels LDLs, decreased levels HDLs
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Pathophys
Injury occurs to the endothelial cells that line artery walls, these injured cells become inflamed and express adhesion molecules that bind macrophages.The macrophages are activated and release inflammatory cytokines and toxic oxygen free radicals. The radicals oxidize LDL and causes additional adhesion molecule expression, eventually leading to excessive build up of plaque.
Nsg interventions
Education about diet change, help manage HTN and DM through disease and proper medication administration
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Gangrene
S/S
swelling or blistering, discoloration, foul odor
Dx tests
Presence of bacteria/ germs, high WBC count (not in this Pt's case)
Risk factors
DM and peripheral vascular disease, severe neuropathy
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Pathophys
Severe hypoxic injury d/t atherosclerosis and subsequent bacterial invasion causing cell and tissue death and necrosis - the skin becomes very dry and shrinks, resulting in wrinkles and color changing to black
Nsg interventions
Care for tissues unaffected and prevent further perfusion through proper wound care and pt education