Question

A client complains of leg pain brought on by walking several blocks — a symptom that first arose several weeks earlier. The client's history includes diabetes mellitus and a two-pack-per-day cigarette habit for the past 42 years. The physician diagnoses intermittent claudication and orders pentoxifylline, 400 mg three times daily with meals. Which instruction concerning long-term care should the nurse provide?

1. "Practice meticulous foot care."
2. "Consider cutting down on your smoking."
3. "Reduce your level of exercise."
4. "See the physician if complications occur."

Answer 1

The nurse should instruct the client with intermittent claudication due to PAD to practice meticulous foot care, consider cutting down on smoking, maintain some level of exercise as tolerated, and see the physician if complications occur.

Step-by-step explanation:

The client diagnosed with intermittent claudication due to peripheral artery disease (PAD), which is often exacerbated by diabetes mellitus and smoking, should be given comprehensive long-term care instructions.

The most appropriate advice to offer would be:

1. "Practice meticulous foot care." Considering diabetes mellitus can impair wound healing and PAD could result in poor blood circulation in the legs, meticulous foot care is essential to prevent complications such as ulcers and infections.
2. "Consider cutting down on your smoking." Smoking is a major risk factor for PAD, and reducing or quitting can significantly improve cardiovascular health and slow the disease's progression.
3. While it might seem counterintuitive, "Reducing your level of exercise" is not advised as exercise can aid in vascular health and improve symptoms.
4. "See the physician if complications occur." Regular monitoring and prompt medical attention to any changes in symptoms are crucial in managing PAD effectively.

The combined approach of lifestyle modification (such as quitting smoking and practicing foot care) and medication adherence will be beneficial for managing PAD. Regular exercise, as tolerated, is also recommended to maintain overall vascular health.