RAYNAUD’S

DISEASE
WHAT IS RAYNAUD’S DISEASE??
 Raynaud's is a rare disorder that affects the
arteries.
 Raynaud's is also called a
disease, syndrome, or phenomenon.
 Vasospasm, which is a narrowing of the
blood vessels.
 Vasospasm of the arteries reduces blood
flow to the fingers and toes.
 Also may occur at the tip of ears and nose.
RAYNAUD’S DISEASE
RAYNAUD’S DISEASE
CLASSIFICATION
 Primary Raynaud’s / Raynaud’s disease the
causes is not known.(idiopathic)

 Secondary Raynaud’s / Raynaud’s

phenomenon where the causes are known.
ETIOLOGY OF PRIMARY RAYNAUD’S

 Cold temperature
 Stress

 Blood vessels in spasm

ETIOLOGY OF SECONDARY RAYNAUD’S

 Scleroderma
 Lupus.
 Rheumatoid arthritis
 Sjogren's syndrome
 Diseases of the arteries.
 Carpal tunnel syndrome
 Repetitive actions
 Hand and foot injuries
 Exposure to certain chemicals
 Medicines
 Smoking
RISK FACTORS….

 PRIMARY RAYNAUD’S
 Gender
 Age
 Family history
 Living area climate
 SECONDARY RAYNAUDS’S
 Age
 Certain disease and condition
 Work place
 Injury of hand and leg
 Repetitive action
 Living climate
 Smoking
 Medicines
PATHOPHYSIOLOGY
Become
Small arteries at
Expose to cold / pale, less blood
fingers and toes
triggering factor flow and low O2
vasospasm
supply

Blood flow
Warm up
increase, high O2
(arteries dilate)
supply

Affected area is
Color change to
warm and
bright red
throbbing pain
CLINICAL MANIFESTATION
$ During the Raynaud’s attack, arteries
become narrow and no blood supply to the
area, this will cause :
# Turn pale or white and then blue
# Feel numb, cold, or painful
# Turn red, throb, tingle, burn, or feel numb
as
blood flows back to the affected area
INVESTIGATION
 Cold Stimulation Test
 Nailfold Capillaroscopy

 Antinuclear antibody (ANA)

 Erythrocyte sedimentation rate (ESR or "sed

rate")
 C-reactive protein (CRP) tests
TREATMENT

 Medical treatment
@ Calcium channel blockers -- Norvasc
@ Alpha blockers -- Prazosin
@ Vasodilators -- Losartan (Cozaar)
 Surgical treatment
@ Nerve surgery--- sympathectomy
@ Chemical injection
@ Amputation.
COMPLICATION
Complete lost of blood to the digits will cause:
 deformities of fingers and toes
 gangrene
 ulcer
HEALTH EDUCATION

 Stop smoking
 Exercise

 Control stress

 Avoid caffeine

 Take care of feet and hand

 Dress warmly outdoors

NURSING CARE PLAN
NURSING CARE PLAN 1
NURSING DIAGNOSIS: Ineffective peripheral
tissue perfusion
related to lack of blood
supply to
extremities.

GOAL: Increased arterial blood supply to

extremities.
 NURSING RATIONALE
INTERVENTION
Assess the patient for the blood For further investigation and treatment.
circulation,colour and sensation at the
extremities.
Apply warm compress at the affected To promote good blood circulation
area

Administer the medication as prescribed To vasodilate the blood vessel and

by doctor such as vasodilator, calcium increase blood supply to the extremities
channel blockers and alpha blockers

Monitor the blood circulation to the To observe for any further complication
extremities every two hourly (circulation
chart)
Encourage patient to perform extremities Muscular exercises promotes blood flow
exercises while sitting or during work and the development of collateral
circulation
EVALUATION : Patients extremities are warm
to touch, improve in colour
and no complain of numbness
.
NURSING CARE PLAN 2

NURSING DIAGNOSIS : Anxiety related to

disease process.

GOAL : To reduce the anxiety level of patient

 NURSING RATIONALE
INTERVENTION
Asses the patient’s anxiety level by For further investigation
observing clients behavior e.g crying
facial expression and anxious.

Reinforce doctor’s explainations to To increase the understanding of patient

patient by using the non medical term about the disease.

Provide moral and emotional support to To provide patient psychological comfort

patient

Encourage diversional theraphy e.g To deviate client’s mind away from the
watching tv, listening songs disease and to avoid patient get mentally
stress
EVALUATION : Patient’s anxiety level
decrease and client is more
clear about the disease.
NURSING CARE PLAN 3

NURSING DIAGNOSIS : Deficient knowledge

regarding self-care
activities.

GOAL : The patient will able to carry out daily

activity by understanding the
health education given by nurse
based on the disease.
 NURSING RATIONALE
INTERVENTION
Assess client knowledge level For the nurses to give adequate health
education to the client

Encourage patient to perform extremities To promote the blood flow to the affected
exercises. area

Advise patient to place the fingers or toe The warm water will vasodilate and
under the warm water during the attack. encourage the blood flow.

Advise patient to stop smoking Reducing the risk factor may reduce
symptoms or slow the disease
progression

Advise patient not to wear tight wrist Constrictive clothing and accessories
band or watch and clothings impede circulation.
EVALUATION : Client is able to carry out the
daily activities by implementing
the health education
given.
CONCLUSION
 Raynaud's sometimes is called a disease,
syndrome, or phenomenon.
 Is a narrowing of the blood vessels.

 Vasospasm of the arteries reduces blood flow to

the fingers and toes.
 In people who have Raynaud's, the disorder
usually affects the fingers.
 In about 40 percent of people who have
Raynaud's, it affects the toes. Rarely, the
disorder affects the nose, ears, nipples, and lips.
 Has two type of raynaud that is primary and
secondary raynaud disease
 In both types of Raynaud's, even mild or brief
changes in temperature can cause
Raynaud's attacks.
 People with severe Raynaud's can develop
skin sores or gangrene from prolonged or
repeated Raynaud's attacks.
 It can be treated e.g. by placing the hand
under warm water to vasodilate
REFERRENCES

 http://www.mayoclinic.com/health/raynauds-
disease/DS00433/DSECTION
 http://www.nlm.nih.gov/medlineplus/ency/arti
cle/000412.htm
 http://www.faqs.org/health/topics/77/Raynaud
-s-disease.html
 http://www.medic8.com/healthguide/articles/r
aynauds.html
 http://www.nhlbi.nih.gov/health/dci/Diseases/ray
naud/ray_diagnosis.html

 http://www.medicalnewstoday.com/articles/1767
13.php -raynaud disease

 http://agedcareact.wordpress.com/2007/11/13/w
hat-is-raynauds-disease/ - raynaud disease

 http://bodyandhealth.canada.com/channel_cond
ition_info_details.asp?disease_id=110&channel
_id=2022&relation_id=16665 –raynaud disease

 http://edition.cnn.com/HEALTH/library/raynauds-
disease/DS00433.html -raynaud disease
 Brunner & Suddarth’s textbook of medical –
surgical nursing, 12th edition.

 Pearson International edition medical –

surgical nursing, 4th edition.

 Joyce.M & Jane Hokanson Hawks medical –

surgical nursing, 8th edition.
THANK YOU