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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

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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

Peripheral Arterial Disease


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 disease clinical manifestations

Peripheral DiseaseClinical Manifestations


Peripheral vascular disease treatment

Peripheral Vascular DiseaseTreatment


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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