Lecture Notes: Peripheral Arterial Disease vs. Peripheral Venous Disease

Overview

In this lecture, Sarah from RegisteredNurseArianne.com discusses the differences between peripheral arterial disease (PAD) and peripheral venous disease (PVD). These differences are crucial for exams and nursing practice.

Mnemonic: VESSEL

To remember the differences, use the mnemonic VESSEL:

V - Various Positions that Alleviate Pain

• Arterial Disease:
  • Pain alleviated by dangling legs (dependent position).
  • Pain worsened by elevating legs.
  • Issue: Blood flow to extremity is compromised.
• Venous Disease:
  • Pain alleviated by elevating legs.
  • Pain worsened by sitting or standing for long periods.
  • Issue: Blood return to heart is compromised.

E - Explanation of Pain

• Arterial Disease:
  • Sharp pain, worse at night.
  • Characterized by intermittent claudication (cramping during activity).
  • Pain relieved by rest.
• Venous Disease:
  • Heavy, dull, throbbing, aching pain.
  • Pain worsened by prolonged standing or sitting with legs down.
  • Alleviated by leg elevation.

S - Skin of Lower Extremity

• Arterial Disease:
  • Cool to the touch, thin, dry, scaly skin.
  • Hairless, thick toenails.
  • Color changes: Rubor when dangled, pale when elevated.
• Venous Disease:
  • Warm to the touch, thick, tough skin.
  • Swollen with edema, brownish color.

S - Strength of Pulse in Lower Extremity

• Arterial Disease:
  • Poor or absent pulses.
  • Use Doppler for pulse assessment.
• Venous Disease:
  • Present and normal pulse.

E - Edema

• Arterial Disease:
  • Edema is not common.
• Venous Disease:
  • Common, worse at the end of the day.

L - Lesions (Ulcers)

• Arterial Ulcers:
  • Location: Ends of toes, dorsum of feet, lateral malleolus.
  • Appearance: Little drainage, pale/light pink, or necrotic.
  • Deep "punched out" look with noticeable margins.
• Venous Ulcers:
  • Location: Medial lower legs, medial malleolus.
  • Appearance: Swollen, tight, edematous with drainage.
  • Pink to deep red base, irregular and shallow edges.

Conclusion

Understanding the differences between PAD and PVD is essential for effective patient assessment and care. Use the VESSEL mnemonic to remember the key differences in symptoms and presentation.