Peripheral Vascular Disease (arterial) Created by: Elizabeth, Tara, Jaelyn, Andrew and Danny

Peripheral Vascular Disease (PVD)/ Diagnosis PVD is circulation disorder within the blood vessels. Typically occur in peripheral vessels, vessels away from the heart.(Healthline, 2016). Usually affects upper and lower extremities, the head and stomach.

Types of PVD Arterial Venous Leg ulcerations Venous Thromboembolism Arteriosclerosis Peripheral arterial occlusive disease Aneurysm Arterial embolism Arterial thrombosis Leg ulcerations Venous Thromboembolism Varicose Veins Chronic venous insufficiency/ postthrombotic syndrome

Signs and Symptoms Venous Arterial Diminished or absent pulse Pain-Intermittent claudication, constant Cool-to-cold temperature Nails thickened and ridged Skin- dependent Rubor Observable within 20 seconds to 2 mins after placed in dependent position Pulse is present Pain- Aching, cramping Skin- pigmentation in gaiter area (medial and lateral malleolus) Thickened and tough, may be reddish- blue (associated with dermatitis)

Risk factors occurs most often in men and is a common cause of disability (Brunner,2013) High levels of homocysteine Optimal (< 12 mcmol/L) Borderline ( 12-15 mcmol/L) High risk ( >15 mcmol/L) Smoking Diabetes Obesity (BMI over 30) High blood pressure High Cholesterol

Treatments Lifestyle Physical activity Walking Medication Invasive (surgical) Femoropopliteal bypass graft Percutaneous transluminal angioplasty or stent placement Atherectomy Lifestyle Diet Low cholesterol choices Cessation of smoking Physical activity Walking Leg excercises Medication Antiplatelet therapy- Asprin or clopidogrel

Collaborative Care Physical therapy Walking aids Cardiovascular Surgeons Depending on severity Nutritionist/ Dietician Community Resources

What the Prognosis? Early Detection Most cases respond to lifestyle treatments Increase effectiveness of treatment Contact physician if symptoms worsens, if you begin to experience: Fever, chill, weakness, or other signs of infection Leg becomes swollen, warm to touch or red You develop chest pain accompanied by leg pain New ulcers develop and do not heal (healthline, 2016)

Community Resources Abbot Vascular’s Peripheral Artery Disease (PAD) Awareness Program Stay in Circulation Diabetes Institute Weight Loss program

Psychosocial Implications Caregiver strain from caring for non-compliant spouse has cause tension on the marriage Patient’s loss of independence from needing help of children to get around Depression from loss of independence

Nursing Diagnosis Actual Diagnosis Risk Diagnosis Activity intolerance R/T compromised oxygen transport system secondary to peripheral arterial disease as AMB patient having severe pain in his leg when walking. Goal: The client will progress activity potential by cessation of smoking, increase distance of walks as tolerated, increase skin integrity, and maintain a healthy diet Risk Diagnosis Risk for caregiver role strain R/T history of patient non-compliance with physician recommendations Goals: Care giver will not experience role strain .

Question #1 What is Peripheral Vascular Disease? Circulation disorders within the blood vessels Skin disorder Blood in stool Vision disease

Question #2 What is a risk factor of PVD?(select all that apply) Smoking Low blood pressure BMI of 36 High cholesterol Diabetes

Question #3 Why would the patient not realize they have unhealed ulcers on their feet? Too much pain medication Dementia Never takes his shoes off Decreased peripheral sensation to area

Question #4 What are types of PVD?( select all that apply) Arteriosclerosis Arterial embolism Leg ulcerations Raynaud’s phenomenon diaphoresis

References Peripheral Vascular Disease. (n.d.). Retrieved March 05, 2016, from http://www.vascularsurg.wustl.edu/en/Patient-Care/Peripheral-Vascular- Diseasehttps://www.nhlbi.nih.gov/health/health-topics/topics/pad/names Healthline.Peripheral Vascular Disease. Healthline media, 2016. Web. 02 Mar. 2016.http://www.healthline.com/health/peripheral-vascular-disease#Symptoms5 About Peripheral Artery Disease (PAD). (n.d.). Retrieved March 05, 2016, from http://www.heart.org/HEARTORG/Conditions/More/PeripheralArteryDisease/About-Peripheral- Artery-Disease-PAD_UCM_301301_Article.jsp#.VtjY9kY9lu4 Porth, Carol. (10/2014). Essentials of Pathophysiology: Concepts of Altered States. [VitalSource Bookself Online]. Retrieved from http://coursepoint.vitalsource.com/#/books/9781469898087 Hinkle, Janice L., Cheeve, K. H. (11/2013). Hinkle & Cheever. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 13th Edition. [Vital Source Bookshelf Online]. Retrieved from https://conrsepoint.vitalsource.com/#/books/9781469863801/