ANEURYSM AMPUTATION (for severely

Localized, irreversible dilation of artery infected or non healing ulcerations and

due to alteration on the wall gangrene

TYPES OF ANEURYSM NURSING INTERVENTION

1. Fusiform aneurysm Patient teaching

a. Both side of wall is dilated Reduce emotional stress
2. Saccular aneurysm
Avoid exposure to cold
a. One side of arterial wall is
dilated Encourage to stop smoking
3. Dissecting Aneurysm
a. There is separation between SUPERFICIAL THROMBOPHLEBITIS
TUNICA MEDIA and TUNICA
INTIMA Venous thrombosis and inflammation in
a superficial vein
ABDOMINAL AORTIC ANEURYSM
Most common type “AAA” SIGNS AND SYMPTOMS

SIGNS AND SYMPTOMS OF “AAA” Pain in the calf of leg

Tenderness
Pulsatile mass over abdomen Palpable induration
Low back pain, lower abdominal pain
Collapse and shock due to hemorrhage COLLABORATIVE MANAGEMENT

MANAGEMENT Bed rest with leg elevation

Administration of antihypertensive Local moist heat on the leg
drugs Patient teaching
Surgery if aneurysm is greater than 4 Avoid prolong sitting or standing
cm Elevate legs when sitting
Avoid crossing of legs at knee
RAYNAUDS DISEASE Daily exercise

Intermittent vasospasm of arteries in CAUSE

the digits result of exposure to cold and Vessel wall injury
emotional distress Venous statis

MEDICAL MANAGEMENT SIGNS AND SYMPTOMS

Calf pain
Medication : CALCIUM CHANNEL Tenderness
BLOCKER Edema
VASODILATOR
ANTI INFLAMMATORY MEDICAL MANAGEMENT
ANALGESICS Thrombolytic
Anticoagulant
Surgery: SYMPATHECTOMY (to relieve Surgery
vasospastic symptoms) Thrombolectomy
Umbrella filter
NURSING INTERVENTION RISK FACTORS
Bed rest 5-7 days Blood loss from surgery or injury
Monitor calf pain Chronic infections
Assess presence edema Poor or inadequate diets that are low in
iron, vitamins and minerals
BUERGERS DISEASE
SIGNS AND SYMPTOMS
Thromboangitis Obliterans
It involves fibrosis of nerves Coldness in the hands and feet
Diffuse inflammation of the small and Chest pain
medium arteries Dizziness

SIGNS AND SYMPTOMS DIAGNOSIS

Intermittent claudication Medical history (signs and symptoms)

Physical exam
MANAGEMENT Blood test
Eliminate smoking
Medication: CCB, antiplatelet DIAGNOSTIC TEST AND PROCEDURE
Surgery
Sympathectomy COMPLETE BLOOD COUNT (CBC)
Amputation of ulcerated fingers and
toes 1. THE HEMOGLOBIN LEVEL – hemoglobin
is the iron rich protein in RBC that
HEMATOLOGIC BLOOD DISORDER carries oxygen. Normal range of
RED BLOOD CELL DISORDERS hemoglobin is 11-15 g/dL (low lvl means
anemia)
ANEMIA 2. THE HEMATORCIT LEVEL – measures
A condition in which the hemoglobin how much of blood is made up of RBC.
concentration is lower than normal. Reflects the Normal range is 32-43 %
presence of fewer than normal erythrocytes 3. THE NUMBER OF RBC – few RBC means
person has anemia seen with either a
CLASSIFICATION OF ANEMIA low hemoglobin or low hematocrit lvl.
4. THE NUMBER OF WHITE BLOOD CEELS
HYPOPROLIFERATIVE ANEMIA – involved in fighting infection
Defective RBC production 5. THE NUMBER OF PLATELETS – small cell
Ex. Iron deficiency, vitamin b12 fragments that are involved in blood
and folate deficiency clotting
6. RBC SIZE – cell volume measures the
Hemolytic anemia- destruction of RBC average size (volume) of RBC, in iron-
Ex. Sickle cell anemia, deficiency anemia RBC usually smaller
thalassemia, drug induced anemia than normal (MICROCYTOSIS)
7. HEMOGLOBIN ELECTROPHORESIS –
Bleeding- loss of RBC evaluates the different types of
Ex. Trauma, nose bleeding, hemoglobin in blood, used to diagnose
menorrhagia types of anemia caused by abnormal
hemoglobin
 8. RETICULOCYTE COUNT – young RBC,
measures the number of new RBC in
blood, used to determine whether your
bone marrow is producing RBC at
proper rate
POLYCYTHEMIA VERA – proliferative disorder in
which the myeloid stem cells seem to have
escaped normal control mechanisms
SIGNS AND SYMPTOMS

TREATMENT Splenomegaly
Elevated BP and uric acid
Blood Transfusion Ruddy complexion
Changes in diet
COMPLICATION
Dietary supplement
Thromboses ( brain attack, stroke)
MYELODYSPLASTIC SYNDROME (MDS)
MI
Bleeding
Group of diseases in which bone
marrow does not make enough healthy blood
MEDICAL MANAGEMENT
cells
PHLEBOTOMY – removing enough
RISK FACTORS
blood to diminish blood viscosity and to deplete
iron stores
Being male or white
Being older than 60 years old
WBC DISORDER
Being exposed to heave metals
(mercury, lead)
NEUTROPENIA – decrease production
and increase destruction of neutrophil
SIGNS AND SYMPTOMS
CAUSES
Shortness of breath
Weakness or feeling tired
Infections
Fever
Medications
Disease in bone marrow
DIAGNOSTIC TEST
TREATMENT
Physical Exam
CBC
Chemotherapy
Peripheral blood smear – checked for
Radiation therapy
changes in number, type, shape, and size of
blood cell or too much iron the RBC
PLATELET and COAGULATION DISORDER
Cytogenic analysis – test which cells in
THROMBOCYTOPENIA – low platelet level
sample of blood or bone marrow, look for
certain changes in chromosomes
CAUSES
Bone Marrow Aspiration and biopsy –
Decreased production of platelet
removal of bone marrow, blood, and a small
(infection, alcohol)
piece of bone, (hipbone or breastbone)
 Increased destruction of platelets
(malignant lymphoma)
Increased platelet consumption (DIC)
SIGNS AND SYMPTOMS
Bleeding and petechiae- when platelet
count drops to less than 20,000/mm3
Gingival bleeding
Excessive menstrual bleeding
MEDICAL MANAGEMENT
Bone marrow aspiration and biopsy
Excessive platelet destruction –
destroyed platelet transfused
PLATELET AND COAGULATION DISORDER
HEMOPHILIA – rare inherited bleeding
disorder in which the blood does not clot
normally
HEMOPHILIA CAN BE DUE TO
Low level of one of the clotting factors
Clotting factor that is completely
missing (when missing it can take long time for
your blood to clot after and injury or accident)
WHAT IS CLOTTING FACTOR?
Proteins in blood that work in platelets
a type of small blood cell to help the blood to
clot, when blood vessels are damaged, clotting
factors help the platelets stick together to plug
cuts and breaks the site of injury
TYPES OF HEMOPHILIA
HEMOPHILIA A – clotting factor VIII is low or
missing about 9 or 10 have Hemo A.
HEMOPHILIA B – Clotting factor IX is low or
missing
Also can be acquired when antibodies
to these clotting factors form and block their
function
CAUSES OF HEMOPHILIA
An inherited disorder, caused by a
defect in genes, these genes are located on X
chromosomes, which determine whether a
baby is a boy or a girl.
Woman is a “Carrier” she can pass the
defective gene on to her children
Son = 50% will have hemophilia
Daughter – 50% will be a carrier
INHERITANCE OF HEMOPHILIA
Man who has hemophilia cannot pass
the disorder on to his sons, all of his daughters,
however will be carriers
SIGNS AND SYMPTOMS
Major s/s are bleeding and bruising
Male w/ severe hemophilia, will bleed
heavily after circumcision
Most common s/s in older children and
adults are bleeding in joints (hemarthrosis)
CLASSIFICATION
Mild Hemophilia - >5-30%
Moderate hemophilia – 1-5% normal
factor
Sever Hemophilia – less than 1%
DIAGNOSIS
Blood test used to determine
How long it takes for blood to
clot
Whether blood has low lvls of
any of clotting factors
TREATMENT
REPLACEMENT THERAPY
To prevent bleeding /to stop bleeding