Peripheral Vascular Disease Pathophysiology
Peripheral Vascular Disease (PVD) is a systemic condition characterized by the narrowing or blockage of blood vessels that supply the extremities, primarily the legs and arms. This happens as a result of atherosclerosis, or buildup of plaque, which leads to reduced blood flow and oxygen delivery to tissues. When this happens, it causes pain and discomfort while walking.
If PVD goes untreated, it can progress to limb ischemia.
Peripheral Vascular Disease Causes
- Atherosclerosis
- Diabetes
- Hypertension
- Smoking
- Hyperlipidemia
- Sedentary lifestyle
Peripheral Vascular Disease Symptoms
- Leg pain
- Cramping during activity (intermittent claudication)
- Cold extremities
- Weakened pulses
- Non-healing wounds
- Skin discoloration
Subjective Data (Client may report)
- Complaints of leg pain or cramping, especially during physical activity
- Sensation of cold or numbness in the extremities
- Changes in skin color or texture
- History of smoking
Objective Data
- Diminished or absent pulses in the affected limbs
- Cool or pale skin in the extremities, numbness or tingling
- Intermittent pain (claudication), which may feel like cramps, muscle fatigue or heaviness (usually in the legs)
- Worsening pain during exercise (usually in the legs)
- Easing of pain during rest (usually in the legs)
- Non-healing wounds or ulcers, particularly on the feet
- Evidence of atherosclerotic plaques on imaging studies
Peripheral Vascular Disease Risk Factors
- Smoking or tobacco use
- High blood pressure (hypertension)
- Diabetes mellitus
- History of stroke or heart attack
- Hyperlipidemia or elevated cholesterol levels
- Sedentary lifestyle
- Obesity
- Family history
Peripheral Vascular Disease Nursing Assessment
Cardiac Function
Assess heart rate, rhythm, and blood pressure regularly. Monitor for signs of heart failure or decreased cardiac output, such as dyspnea, edema, and fatigue.
Respiratory Function
Monitor respiratory rate and effort. Watch for signs of shortness of breath or decreased oxygen saturation, which may indicate impaired gas exchange.
Neurologic Function
Conduct regular neurological assessments to identify any changes in mental status, motor function, or reflexes.
Sensory Function
Assess sensory perception in the extremities, checking for loss of sensation or abnormal sensations.
Peripheral Vascular Disease Labs
Essential labs to consider for PVD management include lipid profiles, fasting blood glucose levels, and complete blood count. These can help in identifying and managing underlying risk factors.
Peripheral Vascular Disease Nursing Interventions
- Encourage smoking cessation and provide resources for tobacco cessation programs.
- Promote regular physical activity tailored to the client’s abilities.
- Monitor and manage wounds or ulcers to prevent infection and promote healing.
- Administer medications as prescribed, such as antiplatelets, lipid-lowering agents, and antihypertensives.
- Educate the client on foot care, including daily inspection and appropriate footwear.
Peripheral Vascular Disease Goals and Outcomes
- Improve peripheral blood flow and oxygen delivery to affected limbs.
- Alleviate pain and symptoms of intermittent claudication.
- Prevent complications, such as non-healing ulcers or infections.
- Reduce risk factors through lifestyle modifications and medication adherence.
