6. ANEURYSM PATHOPHYSIOLOGY Damage to the intima and media weakness outpouching Dissecting aneurysm tear in the intima and media with dissection of blood through the layers
57. Buerger’s Disease Also known as Thromboangiitisobliterans Usually a disease of heavy cigarette smoker/tobacco user men, 25-40y/o Inflammatory arterial disorder that causes thrombus formation often extends to adjacent veins & nerves
58. Affects medium-sized arteries (usually plantar & digital vessels in the foot or lower legs) unknown pathogenesis but it had been suggested that: tobacco may trigger an immune response or unmask a clotting defect; -> these 2 can incite an inflammatory reaction of the vessel wall
70. Return to normal color Note: although all of the fingers are affected symmetrically, only 1-2digits may be involved Severe cases: arthritis may arise (due to nutritional impairment) Brittle nails Thickening of the skin of fingertips Ulceration & superficial gangrene of fingers (rare occasions)
78. Care Plan for Clients with Altered Cardiovascular Oxygenation Goals: Relief of pain & symptoms Prevention of further cardiac damage Nursing Interventions: Pain control Proper medications Decrease client’s anxiety Health teachings (meds, activities, diet, exercise, etc) Assessment: Hx of symptoms (pain, esp. chest pain; palpitations; dyspnea) v/s Nursing Dx: ineffective tissue perfusion (cardiopulmonary) Impaired gas exchange Anxiety due to fear of death (clients with MI or Angina)