vascular disorders peripheral arterial disease of the lower extremities
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Vascular Disorders Peripheral Arterial Disease of the Lower Extremities. Aortoiliac, femoral, popliteal, tibial, or peroneal arteries Classic symptom: Intermittent Claudication Ischemic muscle ache precipitated by a consistent level of exercise Paresthesia – numbness / tingling in toes & feet

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vascular disorders peripheral arterial disease of the lower extremities
Vascular DisordersPeripheral Arterial Disease of the Lower Extremities
  • Aortoiliac, femoral, popliteal, tibial, or peroneal arteries
  • Classic symptom: Intermittent Claudication
    • Ischemic muscle ache precipitated by a consistent level of exercise
    • Paresthesia – numbness / tingling in toes & feet
    • Trophic changes: reactive hyperemia

dependent rubor

    • Rest pain – nocturnal
peripheral arterial disease of the lower extremities
Peripheral Arterial Disease of the Lower Extremities
  • Diagnostics:
    • Non-invasive: Doppler Studies
    • Invasive: Angiography
peripheral arterial disease of the lower extremities1
Peripheral Arterial Disease of the Lower Extremities
  • Treatment:
    • Risk Factor Modification –
      • HTN – Stepped Approach to Control
      • Smoking - Cessation
      • Treatment of hyperlipidemia - Nutrition
      • Exercise – slow progressive walking
    • Medication –
      • Antiplatelet Therapy – Plavix / ASA
      • < blood viscosity / >erythrocyte flexibility – Trental
      • < platelet aggregation & promote vasodilation - Pletal
p eripheral arterial disease of the lower extremities
Peripheral Arterial Disease of the Lower Extremities
  • Critical Limb Ischemia
    • Interventional Radiology
      • Percutaneous transluminal balloon angioplasty
      • Atherectomy
    • Surgical Revascularization
      • Endarterectomy
      • Graft angioplasty
      • Peripheral artery bypass surgery
    • End-stage surgery - amputation
vascular disorders peripheral arterial disease of the lower extremities1
Vascular DisordersPeripheral Arterial Disease of the Lower Extremities
  • Nursing Diagnoses
    • Ineffective tissue perfusion
    • Impaired skin integrity
    • Acute pain
    • Activity intolerance
    • Ineffective therapeutic management
peripheral arterial disease of the lower extremities2
Peripheral Arterial Disease of the Lower Extremities
  • Assess: Peripheral pulses, pallor, blanching, hyperemia, warmth, capillary refill, ability to bear weight and walk, pain, risk factors
  • Nsg Action: Medication administration, prepare for tests, treatment, surgery, prevent injury, skin care, community referrals
  • Pt/Family Education: Skin care, Medications, risk factor modification, exercise
peripheral vascular disease thromboangiitis obliterans buerger s disease
Peripheral Vascular DiseaseThromboangiitis ObliteransBuerger’s Disease
  • Nonathersclerotic, segmental inflammation of arteries, veins & nerves of upper and lower extremities
    • More common in men 25-40 years of age
    • Correlates with cigarette smoking
    • Rest pain, ischemic ulcerations
    • Tx: smoking cessation / medications –

anti-platelets, vasodilators

    • Surgical: Amputation
peripheral vascular disease raynaud s phenomenon
Peripheral Vascular DiseaseRaynaud’s Phenomenon
  • Episodic vasospastic disorder of small cutaneous arteries in fingers & toes
    • Cause: Exaggerated SNS stimulation
    • Occurs in women 15 -40 years of age
    • May occur with collagen diseases: RA, scleroderma, systemic lupus erythematosus
    • Vasospasm Phase: Blanching of hands & fingers with throbbing, aching pain, numbness, tingling
    • Hyperemic Phase: swelling
    • Tx: Smoking Cessation, no meds with vasoconstrictive effect; avoid cold; avoid constrictive clothes; Give Calcium-channel blockers
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