PVD: ARTERIAL DISORDER BUERGER’S DISEASEDefinitionDiffuse inflammation of arteries and veins with clot formation.EtiologyunknownRisk factors:cigarette smoking, genetic, malesClinical manifestationsintermittent claudication, edema ulceration, and gangrene
PVD: ARTERIAL DISORDER RAYNAUD’S DISEASE (PHENOMENA)Definitionvasospasm causing ischemiaEtiologyunknown; related to release of serotonin, hypersensitivity to cold Riskcigarette smoking, congenital, womenClinical manifestationsnumbness of fingertips, pallor, delayed capillary refill, cyanosis, ulceration**See comparison of Raynaud’s and Beurger’s diseases (p.993 Table 32-5)
PVD: ARTERIAL DISORDERS: ARTERIAL OCCLUSIONArterial thrombusBlood clot adhering to the wall of an arteryCan occur at the area of a blood vessel where there is inflammation and blood pooling (aneurysm formation)Leads to tissue ischemia and eventually necrosis if not treatedArterial EmbolismSudden obstruction from debrisDevelop in the left side of the heartMIValvular heart diseaseA-fibInfectious heart diseaseLeft Heart failureCould be a broken piece of a thrombus (thromboembolism)
PVD: ARTERIAL DISORDERS: ARTERIAL OCCLUSION MANIFESTATIONSClinical ManifestationsPainPallor or mottlingParesthesiaCool/cold skinPulselessnessPossible paralysis, weakness or muscle spasmsPossible line of demarcation, with pallor cyanosis and cooler skin distal to the blockage (especially with arterial embolism)
NURSING CARE FOR PERIPHERAL ARTERIAL DISORDERSAssessment, physical examIneffective tissue perfusion, pain, Impaired skin integrity, Activity intolerance, AnxietyAny other Nursing Dx?OutcomesImproved blood flowPain reliefNo evidence of skin ulcerationsNo complications Pulmonary EmbolismInterventions?
PVD: VENOUS DISORDERSImpairment of venous systemVenous system brief reviewLow pressure systemBlood return depends on skeletal muscle, abdominal and thoracic muscle contraction to return blood to heartValves present to prevent retrograde blood flowTwo primary typesOcclusive disordersVenous thrombosisDeep Vein Thrombosis (DVT)Ineffective venous blood flowVenous insufficiency
PVD: VENOUS DISORDERS: VENOUS INSUFFICIENCYInadequate blood return to the heart over a prolonged period of timeCausesDVTVaricositiesLeg traumaUnknown causesPathophysiologyValves responsible for venous blood flowValves become incompetent/damagedBlood flow impededInvolves one or more veinsO2 and nutrient deprivation
PVD: VENOUS DISORDERS: VENOUS THROMBUS/DEEP VEIN THROMBOSISThrombus development on walls of veinsCan be superficial veins or deep veins
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