Updates and Advances in Cardiovascular Nursing: Peripheral Arterial Disease

This article focuses on peripheral arterial disease (PAD) of the lower extremities. There is a higher incidence of myocardial infarction, stroke, and cardiovascular death, resulting in higher rates of all-cause mortality compared with patients without PAD. Thus, the presence of PAD is a marker for systemic atherosclerotic disease and can lead to the early detection and treatment of coronary artery disease or cerebrovascular disease. This article reviews the latest information about the prevalence, symptoms, classification, diagnosis, and treatment of PAD. Monitoring and detection of PAD are also discussed, including implications for nursing care.

A Multifaceted Hypnosis Smoking-Cessation Program: Enhancing Motivation and Goal Attainment

Smoking cessation remains a major health priority. Despite public campaigns against smoking and widespread availability of smoking-cessation treatments, many people continue to smoke. The authors argue that the "problem of motivation," that is, suboptimal or fluctuating motivation to resist smoking urges and to comply with the demands of treatment, commonly undermines treatment seeking and adherence, appreciably reducing the success rates of smoking-cessation programs. The authors describe the history of the Winning Edge smoking-cessation program and discuss ways to enhance motivation before, during, and after formal treatment. They illustrate how hypnotic suggestions, administered in the context of their program, can promote cognitive, behavioral, and emotional commitment to treatment and enhance motivation to live a smoke-free life.

Medical management of claudication

Peripheral artery disease (PAD) is common and associated with significant morbidity and mortality. Optimal medical management of PAD is required for each patient, irrespective of the decision regarding lower extremity revascularization. The goals include reducing cardiovascular morbidity and mortality and improving quality of life. The approach should consist of aggressive and individualized risk factor modification including smoking cessation, antiplatelet therapy, a statin, and an angiotensin-converting enzyme inhibitor. Exercise is critical for cardiovascular health and highly effective for improving claudication symptoms. Cilostazol may be considered for symptomatic treatment in certain patients.