|
|
Cardiovascular 9
nursing interventions
- administer medications as ordered
- monitor peripheral pulses and blanch test
- provide comfort measures
- help client develop an exercise program
- care of the client undergoing surgery
- provide foot care
- teach client
- to change positions frequently
- to avoid crossing legs
- to avoid any constrictive clothing on legs
- to avoid trauma to lower extremities
- foot care
- to place legs in dependent position to increase blood flow
- Raynaud's phenomenon (arteriopastic disease)
- Definition: disorder of small cutaneousarteries causing vasospasm. usually affects the fingers bilaterally.
- Etiology
- unknown
- frequently occurs in women
- may be triggered by stress, cold
- Findings
- Management
- pharmacologic agents
- antihypertensive agents: reserpine (Serpasil)
- alpha-adrenergic blocking agents: phenoxybenzamine (Dibenzyline), tolazoline (Piscoline)
- vasodilators
- surgery
- sympathectomyin advanced stages
- amputation of fingers showing gangrene
- Nursing interventions
- administer medications as ordered
- care of the client undergoing surgery
- teach client
- to manage stress
- to stop smoking, avoid caffeine
- to avoid temperature extremes
- protection from cold
- medications and their side effects
- Thromboangiitis obliterans (Buerger's disease)
- Definition: blocking of the medium and small arteries, usually in the legs and feet.
- Etiology
- affects men more than women
- 25 to 40 age group who smoke
- the disease only occurs in smokers
- Findings
- intermittent claudication
- numbness and tingling of toes
- weak or absent peripheral pulses
- ischemic ulcerations may occur
- can lead to gangrene
- Management
- smoking cessation
- other treatment, see arterial occlusive disease
- analgesics
- surgery in late stages, amputation
- Nursing interventions
- assist client with smoking cessation
- see nursing interventions for arterial occlusive disease:
- administer medications as ordered
- monitor peripheral pulses and blanch test
- provide comfort measures
- help client to develop an exercise program
- care of the client undergoing surgery
- provide foot care
- teach client how stopping smoking can relieve symptoms
- Varicose veins (illustration)
- Definition: dilation of superficial veins of the legs and feet.
- Etiology
- usually found in greater saphenous vein (leg)
- incompetent valves (incompetence, vavular) in the superficial veins
- increased pressure in veins causing them to distend
- risk factors: standing for long periods, pregnancy
- Findings
- pain after period of standing
- foot and ankle swelling at end of day
- distended leg veins
- Management
- objective: to reduce pain and halt underlying condition
- medical: sclerotherapy (injection of sclerosing agent that causes vein thrombosis)
- surgical: vein ligation (Vein stripping)
- Nursing interventions
- care of the client undergoing surgery
- post-operative care includes
- application of elastic stocking or bandages
- elevation of leg
- teach client
- not to cross legs
- to elevate legs as much as possible
- to avoid prolonged sitting or standing
- Thrombophlebitis
- Definition: A clot inflames the wall of a superficial blood vessel.
- Etiology
- trauma
- intravenous catheters
- prolonged immobility
- IV drug use
- Findings
- redness
- swelling
- tenderness
- warmth
- Management
- bed rest, with elastic stockings
- elevation of affected extremity
- anticoagulants - to prevent clot formation
- analgesics - to control discomfort
- Nursing interventions
- keep leg elevated
- monitor
- for findings of pulmonary embolism (sudden pain, cyanosis, hemoptysis, shock)
- vital signs, including peripheral pulses
- for findings of vascular impairment (pallor, cyanosis, coolness)
- administer analgesics as ordered
- client teaching
- avoid tight or constricting clothing
- stop cigarette smoking
- avoid maintaining one position for long periods
|
|
