UNIT 4 NURSING CARE OF CLIENTS WHO HAVE
CARDIOVASCULAR DISORDERS
SECTION: VASCULAR DISORDERS
CHAPTER 30 Peripheral Vascular
Diseases
Peripheral
... [Show More] vascular diseases include peripheral
arterial disease (PaD) and peripheral venous
disorders, both of which interfere with normal
blood flow. PaD affects arteries (blood vessels
that carry blood away from the heart), and
peripheral venous disease affects veins (blood
vessels that carry blood toward the heart).
Peripheral arterial disease
● PAD results from atherosclerosis that usually occurs
in the arteries of the lower extremities and is
characterized by inadequate flow of blood.
● Atherosclerosis is caused by a gradual thickening of the
intima and media of the arteries, ultimately resulting in
the progressive narrowing of the vessel lumen. Plaques
can form on the walls of the arteries, making them
rough and fragile.
● Progressive stiffening of the arteries and narrowing of
the lumen decreases the blood supply to affected tissues
and increases resistance to blood flow.
● Atherosclerosis is a type of arteriosclerosis, which
means “hardening of the arteries” and alludes to the
loss of elasticity of arteries over time due to thickening
of their walls.
● PAD is classified as inflow (distal aorta and iliac
arteries) or outflow (femoral, popliteal, and tibial
arteries) and can range from mild to severe. Tissue
damage occurs below the arterial obstruction.
● Buerger’s disease, subclavian steal syndrome, thoracic
outlet syndrome, Raynaud’s disease, and popliteal
entrapment are examples of PAD.
DATA COLLECTION
risK FacTOrs
● Hypertension
● Hyperlipidemia
● Diabetes mellitus
● Cigarette smoking
● Obesity
● Sedentary lifestyle
● Familial predisposition
● Female clients
● Older adult clients
eXPecTeD FiNDiNGs
● Burning, cramping, and pain in the legs during exercise
(intermittent claudication)
● Numbness or burning pain, primarily in the feet
when in bed
● Pain that is relieved by placing legs at rest in a
dependent position
PHYSICAL FINDINGS
● Bruit over femoral and aortic arteries
● Decreased capillary refill of toes (greater than
3 seconds)
● Decreased or nonpalpable pulses
● Loss of hair on lower calf, ankle, and foot
● Dry, scaly, shiny, skin
● Thick toenails
● Cold and cyanotic extremity
● Pallor of extremity with elevation
● Dependent rubor (redness) of the extremity (30.1)
● Muscle atrophy
● Ulcers and possible gangrene of toes [Show Less]