UNIT 4 NURSING CARE OF CLIENTS WHO HAVE CARDIOVASCULAR DISORDERS SECTION: VASCULAR DISORDERS CHAPTER 30 Peripheral Vascular Diseases Peripheral vascular
... [Show More] diseases include peripheral arterial dise ase (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]