Caucasian man

Rossi, an 88-year-old Caucasian man, lives in a long-term care facility. His medical diagnoses include a myocardial infarction 15 years ago, high blood pressure (BP), high cholesterol level, chronic renal failure, peripheral arterial disease (PAD).

He has dependent rubor on his lower legs, and his feet become pale when elevated. The capillary refill is 7 seconds (normal < 3 seconds), and he is unable to differentiate sensations on his feet and lower legs.

Mr. Rossi is taking a statin for his cholesterol and an antiplatelet medication for the PAD. He also is slightly confused, with impaired recent memory. (CO5, CO7, CO8)

How does Mr. Rossi’s health history relate to his current health status?

What treatments, medical conditions and body systems are affecting Mr. Rossi’s peripheral vascular function?

What will you assess if Mr. Rossi’s PAD worsens?

How will you modify the history and physical examination depending on

Mr. Rossi’s age and present state of confusion?
How will you prioritize safety and assessment with the other care? Consider the techniques, frequency, and timing.