Which rationale explains the use of ramipril in a patient with symptomatic peripheral artery disease

The vasospasm-induced color changes (from white to blue to red) of fingers, toes, ears, and nose are the usual characteristics of Raynaud's disorder. Decreased perfusion leads to pallor (white), followed by cyanotic (bluish purple) digits that further turn red when blood flow is restored. In the later phases of the disease, the patient may complain about numbness and coldness along with throbbing, tingling, and swelling. Chronic ischemic pain and ulceration may indicate peripheral arterial disease, whereas hypertension, hyperglycemia, and inflamed arteries may indicate one or more cardiovascular disorders. Further diagnostic tests are desirable to confirm the diagnosis.

An absence of hair on the legs and feet, thickened, brittle nails, and cool feet indicates PAD. Long-term use of heparin causes osteoporosis as a side effect. Bluish fingers and toes, pallor, pain, and numbness are symptoms of Raynaud's phenomenon. The main difference between arterial and venous disease is the difference in skin temperature; in PAD, the skin temperature is cool, whereas, in venous disease, the temperature is warm.

Decreased pulse rate; cool, pale, and mottled extremities; and pain in extremities are symptoms of graft occlusion after aortic aneurysm surgery. Immediate treatment is needed for this condition. Redness, swelling, and drainage at surgical site, elevated body temperature, and increased white blood cells count are symptoms of infection. Tachycardia, an altered level of consciousness, clammy skin, abdominal tenderness, and decreased urine output are symptoms of aneurysm rupture. Bluish fingers and toes, pallor, pain, and numbness are symptoms of Raynaud's phenomenon.

Dilation of the aorta indicates aortic aneurysms. Diaphoresis, weakness, periumbilical pain, tachycardia, pallor, pulsating abdominal mass, and hypotension are the symptoms of aneurysm rupture. Marfan's syndrome is a genetic disorder, and it affects the body's connective tissue. Dizziness, depression, fatigue, and erectile dysfunction are adverse effects of metoprolol. Tenderness, itching, redness, warmth, pain, and inflammation of the leg vein are the symptoms of superficial vein thrombosis.

Metoprolol is recommended after aortic dissection repair to decrease myocardial contractility. It may cause side effects of depression, fatigue, and erectile dysfunction. Blue color of fingers and toes, pallor, rubor, throbbing, and aching pain due to exposure to cold are symptoms of Raynaud's phenomenon. Decreased ankle-brachial index, decreased Doppler pressures, cool feet, brittle nails, and atherosclerosis are symptoms of peripheral artery disease. Antibiotics change the normal flora of the intestine and decrease the body's ability to synthesize biotin as a side effect.

In general, aortic surgery patients have a bowel preparation (e.g., laxatives, enema) and skin cleansing with an antimicrobial agent the day before surgery, have nothing by mouth (NPO) after midnight the day of surgery, and receive IV antibiotics immediately before the incision is made. If appropriate, a preoperative visit to the intensive care unit (ICU) may be helpful to the patient and caregiver. On the day of the surgery, the patients may receive medication including essential medications (e.g., antihypertensives), preoperative antibiotic, and a beta blocker if the patient has a history of cardiovascular disease (CVD).

The presence of an itchy, reddened, painful, and warm lower extremity characterizes a superficial vein thrombosis. A patient with superficial vein thrombosis may also have an elevated body temperature. Altered bowel elimination, abdominal and chest pain are symptoms of an aortic aneurysm. Bluish fingers and toes, pallor, rubor, throbbing, and aching pain due to exposure to cold are symptoms of Raynaud's phenomenon. Atherosclerosis, arterial stenosis, and decreased Doppler pressures are symptoms of peripheral artery disease.

The home care plan for a patient receiving anticoagulant therapy must include information regarding the possible adverse effects of the drug. Cold, blue, and painful feet may be indicative of severe lower extremity VTE, which, if untreated, may cause arterial occlusion and gangrene, and possibly lead to amputation. Garlic and other supplements, such as ginger and vitamins, can increase the risk of severe bleeding and hence should be avoided when a patient is on anticoagulant therapy. Dietary products are not prohibited unless the patient is allergic to them. For maximum benefits, sequential compression devices should be worn all the time, except during bathing, assessment, and ambulation.

Venous thromboembolism is a condition associated with both deep vein thrombosis (DVT) and pulmonary embolism (PE) in a patient. Hormone therapy decreases clotting factors (such as fibrinogen, protein S, protein C, tissue factor pathway inhibitor [TFPI], and antithrombin), which increases the risk of venous thromboembolism. Therefore, patient A is at a high risk for developing venous thromboembolism. Patient B, with hyperuricemia (excess uric acid in the blood), is at a high risk for developing peripheral artery disease. Nadroparin is an anticoagulant. Patient C, who is receiving anticoagulant therapy as well as aspirin, has a higher risk of bleeding. Patient D, with high C-reactive protein levels, is at a high risk for peripheral artery disease.

Sets with similar terms

Why are ACE inhibitors used for PAD?

Which drug is likely to be prescribed for a patient with peripheral arterial disease and hypertension?

How does hypertension lead to peripheral artery disease?

What is the management of peripheral arterial disease?