Raynaud's Phenomenon

  1. General information
    1. Intermittent episode of arterial spasms, most frequently involving the fingers
    2. Most often affects women between the teenage years and age 40
    3. Cause unknown
    4. Predisposing factors: collagen diseases (systemic lupus erythematosus, rheumatoid arthritis), trauma (e.g., from typing, piano playing, operating a chain saw)
  2. Medical management: vasodilators, catecholamine-depleting antihypertensive drugs (reserpine, guanethidine monosulfate [Ismelin])
  3. Assessment findings
    1. Coldness, numbness, tingling in one or more digits; pain (usually precipitated by exposure to cold, emotional upsets, tobacco use)
    2. Intermittent color changes (pallor, cyanosis, rubor); small ulcerations and gangrene at tips of digits (advanced)
  4. Nursing interventions
    1. Provide client teaching concerning
      1. Importance of stopping smoking
      2. Need to maintain warmth, especially in cold weather
      3. Need to use gloves when handling cold objects/opening freezer or refrigerator door
      4. Drug regimen

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