Beruflich Dokumente
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VASCULAR
DISEASE
Prepared by: Rachelle Ann R. Recio
II-Nur7, RLE 1
HOMANS’ SIGN
physical examination technique taught in many
healthcare profession curriculums, typically as a
component of lower extremity vascular assessment.
John Homans
Use to assess Deep vein thrombosis
DVT
is a blood clot occurring in a deep vein.
occurs when a blood clot (thrombus) forms in one or more of the
deep veins in your body, usually in your legs. Deep vein
thrombosis can cause leg pain or swelling, but may occur without
any symptoms.
Deep vein thrombosis can also happen if you don't move for a long
time, such as after surgery, following an accident, or when you are
confined to a hospital or nursing home bed.
Serious condition because blood clots in your veins can break
loose, travel through your bloodstream and lodge in your lungs,
blocking blood flow (pulmonary embolism)
ANATOMY
Pelvis
Thigh
Calf
DEEP VEINS (popliteal vein)
ASSESS FOR SIGNS OF DVT BY THE
HOMAN’S SIGN
1.encourage and assist client to perform active foot and leg exercises every
1 - 2 hours while awake
2.instruct client to avoid positions that compromise blood flow (e.g. pillows
under knees, crossing legs, sitting for long periods)
3.elevate foot of bed for 20-minute intervals several times a shift unless
contraindicated
4.consult physician about an order for antiembolism stockings or an
intermittent pneumatic compression device
5.maintain a minimum fluid intake of 2500 ml/day unless contraindicated to
prevent increased blood viscosity
6.administer anticoagulants (e.g. low- or adjusted-dose heparin, warfarin,
low-molecular-weight heparin) if ordered
7.progress activity as allowed.
If signs and symptoms of a deep vein thrombus
occur:
1.maintain client on bed rest until activity orders are received
2.elevate foot of bed 15 - 20º above heart level if ordered
3.discourage positions that compromise blood flow (e.g.
pillows under knees, crossing legs, sitting for long periods)
4.prepare client for diagnostic studies (e.g. venography, duplex
ultrasound, impedance plethysmography) if indicated
5.administer anticoagulants (e.g. continuous intravenous
heparin, low-molecular-weight heparin, warfarin) as ordered
6.prepare client for injection of a thrombolytic agent (e.g.
streptokinase) if planned.
VASCULAR
DISEASES
VASCULAR DISEASE
any condition that affects your circulatory system.
form of cardiovascular disease primarily affecting the
blood vessels.
This ranges from diseases of your arteries, veins and
lymph vessels to blood disorders that affect circulation
CONDITIONS
UNDER
VASCULAR
DISEASE
PERIPHERAL ARTERY
DISEASE:
Atherosclerosis
the build-up of fat and cholesterol deposits,
called plaque, on the inside walls.
hardening and narrowing of the arteries
no symptoms until middle or older age. causes pain on
walking and poor wound healing. Severe disease may
lead to amputations.
Ischemia
when blood flow to your heart
muscle is decreased by a partial or
complete blockage of your heart's
arteries (coronary arteries). The
decrease in blood flow reduces your
heart's oxygen supply.
A sudden, severe blockage of a
coronary artery may lead to a heart
attack
may also cause serious abnormal
heart rhythms.
ANEURYSM
abnormal bulge in the wall of a blood vessel.
can form in any blood vessel, but they occur most commonly in the
aorta (aortic aneurysm) which is the main blood vessel leaving the
heart:
Thoracic aortic aneurysm (part of aorta in the chest)
Abdominal aortic aneurysm - include one or more of the following:
Suprarenal aneurysm (involving the arteries above the kidneys)
Juxtarenal aneurysm (involving the main renal arteries)
Infrarenal aneurysm (involving the arteries below the kidneys)
RENAL ARTERY DISEASE
commonly caused by
atherosclerosis of the renal arteries
occurs in people with generalized vascular
disease.
can be caused by a congenital (present at
birth) abnormal development of the tissue
that makes up the renal arteries.
BUERGER'S DISEASE
most commonly affects the small and medium sized arteries, veins, and
nerves.
Cause is unknown but , there is a strong association with tobacco use or
exposure.
arteries of the arms and legs become narrowed or blocked, causing lack
of blood supply (ischemia) to the fingers, hands, toes and feet.
Pain occurs in the arms, hands, and more frequently the legs and feet,
even at rest.
With severe blockages, the tissue may die (gangrene), requiring
amputation of the fingers and toes.
PERIPHERAL VENOUS
DISEASE
*Veins are flexible, hollow tubes with flaps inside, called
valves. When your muscles contract, the valves open, and
blood moves through the veins. When your muscles relax,
the valves close, keeping blood flowing in one direction
through the veins.
If the valves inside your veins become damaged, the valves may not
close completely. This allows blood to flow in both directions. When
your muscles relax, the valves inside the damaged vein(s) will not be
able to hold the blood. This can cause pooling of blood or swelling
in the veins. The veins bulge and appear as ropes under the skin. The
blood begins to move more slowly through the veins, it may stick to
the sides of the vessel walls and blood clots can form.
VARICOSE VEINS
bulging, swollen, purple, ropy veins, seen just under
your skin, caused by damaged valves within the
veins. They are more common in women than men
and they often run in families. They can also be
caused by pregnancy, being severely overweight, or
standing for long periods of time. The symptoms
include:
Bulging, swollen, purple, ropy, veins seen under the skin
Spider veins - small red or purple bursts on your knees,
calves, or thighs, caused by swollen capillaries (small
blood vessels)
Aching, stinging, or swelling of the legs at the end of the day
VENOUS BLOOD CLOTS
Blood clots in the veins are usually caused by:
Long bedrest and/or immobility
Damage to veins from injury or infection
Damage to the valves in the vein, causing pooling near the valve
flaps
Pregnancy and hormones (such as estrogen or birth control pills)
Genetic disorders
Conditions causing slowed blood flow or thicker blood, such as
inflammatory bowel disease, congestive heart failure (CHF), or
certain tumors
DEEP VEIN THROMBOSIS
is a blood clot occurring in a deep vein.
occurs when a blood clot (thrombus) forms in one or more of the deep veins in
your body, usually in your legs. Deep vein thrombosis can cause leg pain or
swelling, but may occur without any symptoms.
Deep vein thrombosis can also happen if you don't move for a long time, such
as after surgery, following an accident, or when you are confined to a hospital
or nursing home bed.
Serious condition because blood clots in your veins can break loose, travel
through your bloodstream and lodge in your lungs, blocking blood flow
(pulmonary embolism)
PULMONARY EMBOLISM