RAYNAUD’S

DISEASE
AND
BUERGER’S
DISEASE

BY: JOY-RENA S. OCHONDRA

BSN II- A
RAYNAUD’S DISEASE

 MANIFEST AS A RECURRENT VASOSPASM OF THE FINGER

AND TOES AND USUALLY OCCURS IN THE RESPONSE TO
STRESS OR COLD EXPOSURE.

 CHARACTERIZED BY PALLOR, CYANOTIC, SUFFUSION AND A

SENSE OF FULLNESS.
CLASSIFICATION/ TYPES:
RAYNAUD’S DISEASE:

1. PRIMARY RAYNAUD’S- CHARACTERIZED BY THE

OCCURRENCE OF THE VASOSPASM ALONE,
WITH NO ASSOCIATED WITH ANOTHER ILLNESS.

2. SECONDARY RAYNAUD’S- DESIGNATION USUALLY

USED IN THE CONTEXT OF VASOSPASM ASSOCIATED
WITH ANOTHER ILLNESS.
ETIOLOGY

 UNKNOWN
POSSIBLE CAUSE FOR
SECONDARY RAYNAUD

HEMATOLOGIC
COLLAGEN VASCULAR (AUTOIMMUNE)
MEDICATION INDUCED
PROGNOSIS

VERY GOOD WITH NO MORTALITY AND

MORBIDITY. IN VERY RARE CASES, HOWEVER
ISCHEMIA OF AFFECTED BODY PART CAN RESULT
TO NECROSIS BECAUSE OF NOT EFFECTIVE
MANEUVERS TO RESTORE BLOOD FLOW.
DIAGNOSTIC TEST

CONDUCTING MEDICAL EXAMINATION

SYMPTOMS

COLD FINGER OR TOES

COLOR CHANGES IN YOUR SKIN IN RESPONSE TO COLD
AND STRESS
NUMB, PRICKLY FEELING OR STINGING PAIN UPON
WARMING OR STRESS RELIEF.
TREATMENT

DRESSING FOR THE COLD AND WEARING GLOVES OR

HEAVY SOCKS USUALLY EFFECTIVE TO:
* REDUCE THE NUMBER AND SEVERITY OF
ATTACKS.
* PREVENT TISSUE DAMAGE.
NURSING DIAGNOSIS

INEFFECTIVE PERIPHERAL TISSUE PERFUSION

RELATED TO LACK OF BLOOD SUPPLY TO
EXTREMITIES.
DEFICIENT KNOWLEDGE REGARDING SELF-CARE
ACTIVITIES.
ANXIETY RELATED TO DISEASE PROCESS.
NURSING INTERVENTION

 ASSESS THE PATIENT FOR THE BLOOD CIRCULATION, COLOR AND

SENSATION AT THE EXTREMITIES.
 APPLY WARM COMPRESS AT THE AFFECTED AREA.
 ADMINISTER THE MEDICATION AS PRESCRIBED BY DOCTOR SUCH
AS VASODILATOR, CALCIUM CHANNEL BLOCKERS AND ALPHA
BLOCKERS.
 MONITOR THE BLOOD CIRCULATION TO THE EXTREMITIES EVERY
TWO HOURLY (CIRCULATION CHART)
 ENCOURAGE PATIENT TO PERFORM EXTREMITIES EXERCISES
WHILE SITTING OR DURING WORK.
THROMBOANGIITIS OBLITERANS
(BUERGER’S DISEASE)

INFLAMMATORY CONDITION OF MEDIUM-SIZED

AND SMALL ARTERIES IN THE LEGS AND ARMS.
DUE TO THE INFLAMMATION, A THROMBUS
FORMS EASILY AND FIBROSIS LEADS TO VASCULAR
OCCLUSION .
ETIOLOGY

BUERGER’S DISEASE IS ASSOCIATED WITH

HEAVY USE OF TABACCO AND THE
PROGRESSION OF THE DISEASE IS CLOSELY
LIKED TO CONTINUED USE.
SYMPTOMS

PAIN THAT MAY COME AND GO IN THE LEGS AND FEET

OR ARMS AND HANDS (CLAUDICATION).
INFLAMMATION ALONG THE VEIN JUST BELOW THE SKIN
SURFACE.
FINGERS AND TOES THAT TURN PALE WHEN EXPOSED TO
COLD (RAYMAUND’S DISEASE)
PAINFUL OPEN SORE ON YOUR FINGERS AND TOES.
DIAGNOSTIC TEST

BLOOD TEST
ALLEN’S TEST
ANIOGRAM
TREATMENT

QUIT TOBACCO PRODUCTS

MEDICATION TO DILATE BLOOD VESSELS
SPINAL CORD STIMULATION
SURGERY (SYMPATHECTOMY)
NURSING DIAGNOSIS

INEFFECTIVE PERIPHERAL TISSUE PERFUSION RELATED

TO IMPAIRED CIRCULATION.
PAIN RELATED TO DIMINISHED OXYGEN FLOW TO THE
AFFECTED EXTREMITY.
FEAR AND ANXIETY RELATED TO ACTUAL OR POTENTIAL
SERIOUS COMPLICATIONS.
NURSING INTERVENTION

 PATIENT TEACHING, INSRUCT THE PATIENT TO DO THE FOLLOWING

SEVERAL TIMES A DAY.
*LIE FLAT ON A BED WITH BOTH LEGS ELEVATED ABOVE THE
LEVEL OF THE HEART FOR TWO TO THREE MINUTES.
*NEXT SIT ON THE EDGE OF THE BED WITH THE LEGS
DEPENDENT FOR THREE MINUTES.
*THEN EXERCISE THE FEET AND TOES BY MOVING THEM UP,
DOWN, INWARD, THEN OUTWARD.
*LASTLY, RETURN TO THE FIRST POSITION AND HOLD FOR FIVE
MINUTES.
NURSING INTERVENTION

 PROVIDE FOR ULCER DEBRIDEMENT AND HEALING

 PROVIDE ADDITIONAL INTERVENTION TO PROMOTE VENOUS RETURN AND
HEALING, MAXIMIZE COMFORT AND PROVIDE CLIENT EDUCATION FOR
MEASURES TO PREVENT VENOUS STASIS ULCER.
 ADMINISTER MEDICATIONS WHICH MAY INCLUDE ANTIBIOTICS.
 ENCOURAGE THE PATIENT TO MAKE THE LIFESTYLE CHANGES NECESSITATED BY
THE ONSET OF A CHRONIC DISEASE, INCLUDING PAIN MANAGEMENT AND
MODIFICATIONS IN DIET, ACTIVITY AND HYGIENE (SKIN CARE).
 ASSISTS THE PATIENT IN DEVELOPING AND IMPLEMENTING A PLAN TO STOP
USING TOBACCO.
 ASSESSING FOR SIGNS OF ULCER FORMATION AND GANGRENE.
NURSING INTERVENTION

ASSESSING FOR PAIN

OBTAINING BLOOD PRESSURE
FOOT CARE
PROTECT FROM TRAUMA TO AVOID SOURCE IF
INFECTION
ENOUGH REST
 PATHOPHYSIOLOGY
(RAYNAUD’S DISEASE)

PREDISPOSING FACTORS: PRECIPITATING FACTORS:

*GENDER: WOMEN ARE *SMOKING
MOSTLY AFFECTED *WORKING W/ VIBRATING MACHINERY
*AGE: BETWEEN 15 & 40 Y/O *EMOTIONAL DISTRESS
*EXPOSURE TO THE COLD

COLD EXPOSURE

SMALL ARTERIES AT FINGERS & TOES

VASOSPASM
BECOME PALE, LESS BLOOD FLOW
& LOW O2 SUPPLY

WARM UP
(ARTERIES DILATE)

BLOOD FLOW INCREASE, HIGH O2

SUPPLY

AFFECTED AREA IS WARM &

THROBBING PAIN
 PATHOPHYSIOLOGY
(BUERGER’S DISEASE)

PREDISPOSING FACTORS: PRECIPITATING FACTORS:

* GENDER: MALE *LIFESYTLE (CIGARETTE SMOKING,
*AGE: 20-60 Y/O ETIOLOGY CHEWING OF TOBACCO, SEDENTARY
*HISTORY (HPN,HYPERLIPIDEMIA) UNKNOWN LIFESTYLE)
*GENETICS *ENVIRONMENT: EXPOSURE TO COLD,
STRESSFULL ENVIRONMENT

PLAQUES/DEPOSITS OF NICOTINE
ON THE VEINS OR
 HYPERSENSITIVITY REACTION TO TOBACCO
PRODUCTS OR AUTOIMMUNE ELEMENTS

INFLAMMATION OF THE SMALL & MEDIUM-

SIZED ARTERIES & VEINS OF THE EXTREMITIES

THICKENED ARTERY & INFLAMMATORY FACTORS (NEUTROPHILS,

LYMPHOCYTES & OTHERS) MIGRATES TO
VEINS OF THE THE INFLAMED ARTERY OR VEIN

PLATELETS DEPOSITS ON THE MICRO ABSCESS FORMATION

THICKENED ARTERY AND

FIBRINOID OCCLUSION LUMINAL THROMBOTIC

IMPAIRED BLOOD
 ISCHEMIA

INJURY

NECROSIS
EARLY S/SX: ADVANCE/LATE S/SX:
*CLAUDICATION TYPE *THROMBOPHLEBITIS
OF PAIN W/TRAUMA
*COLOR CHANGES *ULCERATION
(PALLOR) *GANGRENE
*TEMPERATURE *PULSATION OF THE POSTERIOR
CHANGES TIBIAL
*COLD SENSITIVITY & DORSALIS PEDIS ARTERIES ARE
(REYNAUD’S PHENOMENA) WEAK
*ULCERATION OR ABSENT.
*GANGRENE *COLOR CHANGES (CYANOTIC)
JOCHONDRA