Thromboangiitis Obliterans (Buerger's Disease)

  1. General information
    1. 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.
    2. Most often affects men ages 25-40
    3. Disease is idiopathic; high incidence among smokers.
  2. Medical management: see Arteriosclerosis Obliterans, above; only really effective treatment is cessation of smoking.
  3. Assessment findings
    1. Intermittent claudication, sensitivity to cold (skin of extremity may at first be white, changing to blue, then red)
    2. Decreased or absent peripheral pulses (posterior tibial and dorsalis pedis), trophic changes, ulceration and gangrene (advanced)
    3. Diagnostic tests: same as in Arteriosclerosis Obliterans except no elevation in serum triglycerides
  4. Nursing interventions
    1. Prepare client for surgery.
    2. Provide client teaching and discharge planning concerning
      1. Drug regimen (vasodilators, anticoagulants, analgesics) to include names, dosages, frequency, and side effects
      2. Need to avoid trauma to the affected extremity
      3. Need to maintain warmth, especially in cold weather
      4. Importance of stopping smoking.

Saturday, May 24, 2008 | Labels: |

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