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.