Ward Class

An Online Resource Site For Student Nurses

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Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

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The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.




Cardiovascular Disorders: Buerger's Disease


  • also called thromboangiitis obliterans, an acute inflammatory disorder affecting medium/smaller arteries and veins of the arms and legs
  • results in occlusion of a blood vessel with subsequent collateral circulation
  • the classic patient with Buerger's disease is a male patient between ages 20 and 40 who smokes heavily
  • also found in women and people over the age of 50
  • common in Southeast Asia, India, and the Middle East
  • caused by cigarette smoking and tobacco use
Assessment Findings
  • intermittent claudication (leg pain during activity such as walking)
  • sensitivity to cold (skin becomes white->blue->red)
  • decreased or absent peripheral pulses (posterior tibial and dorsalis pedis)
  • swelling of feet and hands
  • open sores and gangrene (advanced)
  • elevated serum sodium
  • diagnostic tests:
    • oscillometry may reveal decrease in pulse volume
    • Doppler ultrasound reveals blood flow through affected vessels
    • angiography reveals location and extent of obstructive process
Medical Management
  1. cessation of smoking
  2. calcium-channel blockers and thrombolytics to improve circulation
  3. oral antibiotics-->for ulcers
  4. pain medications
Surgical Management
  • surgical sympathectomy (nerves in affected area are severed to control pain)
  • amputation of affected extremity if infection or gangrene occurs
Nursing Management
  • for clients who will undergo surgery
    1. prepare client for surgery
    2. provide client teaching and discharge planning concerning:
      • drug regimen (vasodilators, anticoagulants, analgesics) including dosage, frequency, and side effects
      • need to avoid trauma to affected extremity
      • need to maintain warmth, especially in cold weather
      • importance of cessation of smoking
Prognosis

Death from Buerger's disease is rare but for patients who continue smoking, 1 or more amputations are required in a span of 7 years.

Prevention

The best way to prevent Buerger's disease is to cease smoking or tobacco use.

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