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Peripheral Vascular Disease Overview

Oct 13, 2024

Lecture on Peripheral Vascular Disease (PVD)

Introduction

  • Speaker: Sarah from RegisteredNurseRN.com
  • Topic: Peripheral Vascular Disease (PVD)
    • Impediment of blood flow in the peripheral vascular system due to vessel damage.
    • Affects circulation in arms, hands, feet, and legs.
    • Can be arterial (Peripheral Arterial Disease, PAD) or venous.

Arterial vs. Venous System Review

  • Arterial System: Carries oxygenated blood from the heart.

    • Key Issue in PAD: Atherosclerosis - fatty plaques accumulate, limiting blood flow and causing ischemia.
    • Pain, ulcers, and potentially necrosis or amputation.
  • Venous System: Carries deoxygenated blood back to the heart.

    • Key Issues in Venous Disease: Varicose veins, Deep Vein Thrombosis (DVT).
    • Causes blood pooling, pain, skin issues, and venous stasis ulcers.

Risk Factors

Peripheral Arterial Disease (PAD)

  • Causes:
    • Smoking, uncontrolled hypertension, high cholesterol, obesity, diabetes.

Peripheral Venous Disease

  • Causes:
    • Being female, use of birth control pills, pregnancy, obesity, prolonged sitting/standing, advanced age.

Types of PVD

PAD

  • Causes and Effects: Atherosclerosis causes ischemia and tissue damage.
  • Renaud’s Disease: Vasospasm of peripheral arteries triggered by cold/stress.
    • Symptoms: White, blue, then red extremities.
  • Buerger’s Disease: Inflammation/clots in arteries and veins, leading to blockage.
    • Strongly associated with smoking.

Venous Diseases

  • Issues:
    • Veins can't return blood to the heart.
  • Conditions:
    • Varicose veins, DVT, superficial venous thrombosis, chronic venous insufficiency.

Signs and Symptoms Differentiation

Using “VESSEL”

  • V:
    • Arterial: Pain alleviated by dangling legs.
    • Venous: Pain alleviated by elevating legs.
  • E:
    • Arterial: Sharp pain, worse at night, intermittent claudication.
    • Venous: Heavy, dull, throbbing pain.
  • S:
    • Arterial: Cool, thin, dry skin, rubor when dangled, pale when elevated.
    • Venous: Warm, thick skin, brown pigmentation.
  • S: Pulse strength
    • Arterial: Weak/absent pulse.
    • Venous: Normal pulse.
  • E: Edema
    • Arterial: Uncommon.
    • Venous: Common, worsens by end of day.
  • L: Lesions/Ulcers
    • Arterial: Deep, round, punched-out ulcers.
    • Venous: Shallow, irregular ulcers.

Nursing Interventions

PAD

  • Monitor pulses, temperature, color, and sensation.
  • Prevent further damage: Avoid tight clothing, extreme cold, and smoking.
  • Positioning: Avoid knee flex and leg crossing.
  • Medication adherence: Cholesterol-lowering, anticoagulants.
  • Skin care: Inspect daily, avoid heating pads.
  • Diagnoses: Ankle Brachial Index for blood flow assessment.

Treatments for PAD

  • Angioplasty, stents, artery bypass, or atherectomy.
  • Possible amputation if severe.

Venous Disease Management

  • Focus on blood return, skin care, and clot prevention.
  • Monitor for clots and prescribe anticoagulants.
  • Use compression stockings, elevate extremities.
  • Wound care with Unaboots for venous ulcers.

Conclusion

  • The importance of recognizing symptoms and appropriate nursing interventions for both PAD and venous diseases to ensure effective patient care.