Chapter 41: Vascular Disorders Nursing Care

Peripheral artery disease emerges as a primary focus, characterized by atherosclerotic narrowing of extremity arteries that produces intermittent claudication, diminished pulses, and potential progression to critical limb ischemia requiring antiplatelet therapy, supervised exercise programs, and surgical interventions including angioplasty, stenting, or bypass procedures. Acute arterial ischemia presents as a vascular emergency manifesting the classic six Ps symptom complex, demanding immediate anticoagulation and revascularization strategies. The chapter explores specialized arterial conditions including thromboangiitis obliterans, a tobacco-related inflammatory disorder predominantly affecting young males, and Raynaud's phenomenon, a vasospastic condition triggered by cold exposure that responds to calcium channel blockers and lifestyle modifications. Aortic pathology receives extensive coverage, encompassing both aneurysmal disease requiring surveillance protocols and size-based surgical criteria for open repair versus endovascular techniques, and aortic dissection as a life-threatening emergency necessitating aggressive blood pressure control and emergent surgical intervention. Venous disorders including deep vein thrombosis, pulmonary embolism, varicose veins, and chronic venous insufficiency are analyzed through their underlying pathophysiology, risk stratification, anticoagulation protocols, and compression therapy applications. Throughout these conditions, nursing care priorities emphasize perfusion assessment, pain management, wound prevention strategies, medication administration including anticoagulants and antiplatelet agents, patient education regarding lifestyle modifications, and postoperative monitoring for complications such as bleeding, infection, and graft patency in surgical cases.