Question

A nurse is caring for a patient who has a history of hypertension. The patient smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. The patient complains of calf pain during minimal exercise that decreases with rest. What do the signs/ symptoms and medical history lead the nurse to believe is the pathophysiological problem is? Describe the pathophysiology of that problem. List a nursing diagnosis is appropriate for this client.

Answer 1

On careful assessment of the signs/ symptoms and medical history leads to believe is the pathophysiological problem is ineffective tissue perfusion

The signs and symptoms with medical history leading to pathophysiological problem such as history of hypertension, smoking, low exercise, calf pain and stress. The smoking habit does lead to changes and alteration in microvasculature of different organs such as kidneys and myocardium. Tobacco smoking does cause release of catecholamines resulting in vasoconstriction. The hypertension as a concomitant condition affects the capillary rarefaction which induces a higher blood pressure in the body and as a result leads to decrease in tissue perfusion with increased risk of cardiovascular complications. The nursing intervention of this condition of ineffective tissue perfusion for cardiovascular would be a suggested treatment of nitroglycerine for angina related complaints to reduce the risk of hypertension related cardiovascular problems and enhancement of myocardial perfusion. The other therapies can be promoting the active ROM exercises, antihypertensives and Peripheral vasodilators, etc

The nursing diagnosis of this cause would be the alteration in tissue perfusion related to compromised circulation in the client leading to ineffective tissue perfusion.