A patient’s Case Study

What other assessments should be included for this patient?

Other assessments that should be included for the patient include:

  1. Checking for stiffness of the toes and clicking and popping noises.
  2. Inquire about the pace of development of the toe swellings, noting whether it was gradual, sudden, persistent or worsens over time.
  3. Assess if the swellings are accompanied with sudden chest pain or pressure, palpitation, or high fever.
  4. Inquire about any current or recent medication usage by the patient such as example anti-inflammatories such as steroids, antidepressants, diabetic drugs, or blood pressure medication.
  5. Examine the toe and whole feet for any skin infection in that area that would be causing the area to swell.
  6. Inquire about the patient’s history of heart problems such as congestive heart failure and hypertensive heart disease can also lead to swollen

From the readings, what is the most probable cause of the edema?

Being that the patient is a truck driver; the most likely cause of the edema in the two toes could be sitting or staying in one position for too long.This couldbe attributed to his lifestyle as a truck driver which involves prolonged hours of driving. Sitting or staying in one position for longs hours usually leads to the tiny vessels in the body to leak fluids which build up in surrounding tissues, in this case, the patient’s two toes on his right foot, resulting in the swelling. This explains why the patient does not recall injuring his foot.
What are two known nursing diagnoses?

The patient can be diagnosed with arthritis, especially psoriatic arthritis, or Gout or inflamed bunion.

What would be included in the nursing care plan?

The nursing care plan would include the patient understanding measures to prevent and lessen fluid volume excess.

What interventions might be included in the plan of care for this patient?

  1. Regular exercise such as walking, swimming, cycling which improve circulation and help pump fluid back into the bloodstream back to the heart.
  2. Measures to reduce salt intake and increase water intake. Low salt diet reduces water retention which usually leads to swollen lower extremities. More water intake will dilute the sodium levels, flushing salt out of the system.
  3. The patient should avoid long periods of sitting or standing; this assists in getting the excess fluids back up the leg into circulation again.
  4. Encourage weight loss which will help reduce the pressure on the foot and help relieve the swollen toes.
  5. The patient should always elevate their feet when they are sitted

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