Angelite Nurses: Thromboangiitis Obliterans (Buerger's Disease)

Thromboangiitis Obliterans (Buerger's Disease)

General information

Acute, inflammatory disorder affecting medium/smaller arteries and veins of the lower extremities. Occurs as focal, obstructive process; results in occlusion of a vessel with subsequent development of collateral circulation.
Most often affects men ages 25-40
Disease is idiopathic; high incidence among smokers.

Medical management: see Arteriosclerosis Obliterans, above; only really effective treatment is cessation of smoking.
Assessment findings

Intermittent claudication, sensitivity to cold (skin of extremity may at first be white, changing to blue, then red)
Decreased or absent peripheral pulses (posterior tibial and dorsalis pedis), trophic changes, ulceration and gangrene (advanced)
Diagnostic tests: same as in Arteriosclerosis Obliterans except no elevation in serum triglycerides

Nursing interventions

Prepare client for surgery.
Provide client teaching and discharge planning concerning

Drug regimen (vasodilators, anticoagulants, analgesics) to include names, dosages, frequency, and side effects
Need to avoid trauma to the affected extremity
Need to maintain warmth, especially in cold weather
Importance of stopping smoking.

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