Ms. Marisa A. Climaco Dra. Ma. Cristina F. Lachica, M.D.

It is a recurring progressive inflammation and thrombosis of small and medium arteries and veins of lower and upper extremities.

Current (or recent) history of tobacco use

Age Race
Sex

Autoimmune Diseases

History of Raynauds Disease

Parasthesia Pain , Burning or tingling , Numbing Claudication

Raynaud's phenomenon

Ulcer Pulses are impaired or absent in one or more pedal arteries Critical Limb Ischemia

 Blood tests The Allen's test

 Doppler ultrasound exam of an arm or leg Angiogram

Skin Biopsy

 Smoking cessation Therapeutic angiogenesis

Spinal cord stimulator implantation

Surgical sympathectomy

Amputation

 Lower the extremities below the level of the heart Encourage moderate amount of walking or graded extremities exercises if no contraindications exist.

 Maintain warm temperature and avoid chilling. Discourage use of tobacco products. Counsel in ways to avoid emotional upsets; stress management. Encourage avoidance of constrictive clothing and accesories. Encourage avoidance of crossing legs.

Promote increased circulation. Administer Analgesic agents as prescribed, with appropriate nursing considerations.

 Instruct in ways to avoid trauma to extremities. Encourage wearing protective shoes and padding for pressure areas, wear new shoes for short period of time and inspect feet for signs of injury. Encourage meticulous hygiene; bathing with neutral soaps, applying lotions and carefully trimming nails. Cation to avoid scratching or vigorous rubbing.

 Include family / significant others in teaching program. Provide written instructions about foot care, leg care, and exercise program. Assist to obtain properly fitting clothing , shoes , and stockings. Refer to self-help groups indicated, such as smoking cessation clinics or stress management , weight management , and exercise program.