Nursing 211

N211: Health Differences Across the Lifespan I Involves and embolus, which can result from atrial fibrillation. This can occur in healthy or diseased arteries and is associated with trauma, post- operative immobilization, anemia and dehydration. Predisposing Factors for arterial disease are arteriosclerosis (95% of all cases) and advanced age. Predisposing Factors for venous disease is valvular incompetence and history of deep vein thrombosis (DVT). Associated arterial diseases are Raynaud disease (nonatherosclerotic, triggered by extreme heat or cold; Buerger disease (occlusive inflammatory disease, strongly associated with smoking) diabetes and acute occlusion (emboli/thrombi). Associated venous diseases are varicose veins, thrombophlebitis and venous stasis ulcers. 1.3 Arterial Disease Arterial Disease signs and symptoms: Smooth and shiny skin, loss of hair, thickened nails, pallor on elevation, rubor when dependent, cool temperature, decreased or absent pulses. Pain is sharp, increases with walking and elevation, intermittent claudication (classic presenting symptom occurs in skeletal muscles during exercise and is relieved by rest). Pain occurs when elevation of extremities are horizontal; may be relieved by dependent position. Ulcers are very painful, occur on lateral lower legs, toes, heels; demarcated edges, necrotic and non-edematous. 1.4 Venous Disease Venous Disease signs and symptoms: brown pigment around ankles, cyanotic when dependent, normal pulses. Persistent, aching, full feeling and dull sensation. Relieved when client is horizontal, elevate legs and use compression stockings. Ulcers are slightly painful, occur in medial legs, ankles; uneven edges, superficial and marked edema. Nursing Diagnosis • Ineffective tissue perfusion related to decreased oxygen supply • Activity intolerance related to complexity of management regimen • Impaired skin integrity related to… • Risk for infection related to… • Acute pain related to… Non-invasive treatment for arterial disease is elimination of smoking, topical antibiotic, bedrest, saline dressing and fibrinolytics agents if clots are present. Non-invasive treatment for venous disease is systemic antibiotics, snug dressing or alginate dressing if ulcerated; limb elevation, fibrinolytics agents and anticoagulants.

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