Vascular Diseases

Vascular System Anatomy

Disorders

Aneurysm• Is a sac formed

by dilation of an artery secondary to weakness and stretching of the arterial wall.

• The dilation may involve one or all layers of the arterial wall

Risk Factors• Atherosclerosis• Age: 50-70 years old• Hypertension• Trauma• Syphilis• Infectious process

Classification• Fusiform• Saccular• Dissecting• False

Assessment• Early stage: often asymptomatic• Deep diffuse chest pain• Hoarseness, dysphagia, dyspnea• Pallor, diaphoresis• Distended neck veins, edema or hand and arms• Feeling of “heart-beating” in the abdomen (if

abdominal aortic aneurysm)

Nursing Intervention• Monitor and improve client’s cardiopulmonary

state• Record baseline BP (lying, sitting and

standing) in both arms• Provide dependent and other collaborative

nursing interventions• Give meds: antihypertensive drugs• Prepare for UTZ• Surgery: Resection of Aneurysm and

replacement with a Teflon/Dacron graft

Buerger’s Disease (Thromboangitis Obliterans)

and Raynaud’s Disease

Buerger’s Disease Raynaud’s Disease• Vasculitis of the small and

medium size veins and arteries, usually in the lower extremities.

• More common in MEN• S&Sx: Pain; intermittent

claudication, tingling sensation, impaired pulse, hair loss in the legs

• Leg angiography reveals inflammatory lesions

• Nrsg Dx: Altered peripheral tissue perfusion

• Intervention:o Instruct the client to stop smokingo Avoid trauma to affected extremityo Maintenance of warmth during cold

weather

• Vasospastic condition of arteries of hands that occurs with exposure to cold or stress

• More common in WOMEN• S&Sx: Cyanosis of fingers

or toes after exposure to cold, numbness and tingling of digits

• Allen’s Test reveals circulatory problems

• Nrsg Dx: Altered peripheral tissue perfusion

• Intervention:o Avoid cold weathero Wear leather gloves when getting

anything from the refrigeratoro Stop smokingo Administer vasodilators as ordered

Quick RecallManifestation Condition

1. Intermittent claudication

2. Pain3. Vasospasm4. Inflamed

blood vessels

5. Intermittent color changes of the fingers

A. Buerger’s Disease

B. Raynaud’s Disease

C. BothD. Neither

Thrombophlebitis and Varicose Veins

Thrombophlebitis Varicose Veins

• Clot in the vein with inflammation of the wall of the vein

• S&Sx:o Unilateral leg edema w/ (+)

Homan’s signo Severe pain at siteo Fever, chills, swelling and

cyanosis of site

• Venography reveals a clot• N. Dx: Altered tissue

perfusion• Intervention:

o DO NOT MASSAGE THE AFFECTED LEG

o Increase fluid intakeo Monitor leg edema

• Weakening of the venous valves leading to pooling of blood

• S&Sx:o Tortuous veino Dull ache and heaviness in the legso Mild edemao Itching of the skin over the affected part

• Doppler UTZ detects the presence or absence of venous reflux

• N. Dx: Altered tissue perfusion

• Interventiono Elevate the legso Avoid crossing of legs at kneeso Avoid prolonged sitting and standingo Avoid constrictive clothingo Prepare the client for surgery

Quick RecallManifestation Disease

1. Edema2. Pain3. Homan’s

sign4. Tortuous

vein5. Intermittent

claudication

A. Thrombophlebitis

B. Varicose vein

C. BothD. Neither

End