Med-Surg - Cardiovascular System, part 19: Buerger's Disease and Raynaud's

Hi, I'm Cathy, with Level Up RN. In this video, I will be covering Buerger's disease as well as Raynaud's phenomenon and Raynaud's disease. At the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key concepts I'll be covering in this video. So definitely stay tuned for that. And if you have our Level Up RN Medical-Surgical Nursing Flashcards, definitely pull those out so you can follow along with me.

First up, we have Buerger's disease, and it looks like Buerger's disease, but apparently, it's pronounced Buerger's disease. This is an inflammatory condition that impairs circulation to the extremities, so both the arms and the legs.

And the key risk factor with this condition is smoking.

So the chemicals in the tobacco cause vasculitis, which is inflammation of the vascular system, so inflammation of the small and medium arteries in the arms and legs. So this inflammation leads to scarring and occlusion of these blood vessels. So the typical patient who ends up with Buerger's disease is a male between the ages of 20 and 50 who smokes.

And signs and symptoms include claudication. So this is pain with activity, as well as numbness and tingling, decreased pedal pulses and decreased temperature in the extremities, and possible cyanosis in the extremities. So if this disease progresses far enough, then blood flow will be blocked completely to the extremities, which causes tissue death. So the patient will end up with gangrene, and these digits will fall off, or they may require an amputation. So it can be very serious.

In terms of diagnosis, we can use an arteriogram to visualize the inside of the arteries.

And then, in terms of treatment, we're definitely going to advise our patient to avoid the use of any tobacco products because that is the key risk factor with this condition. We can also use vasodilators such as nifedipine.

In terms of patient teaching. Again, they need to quit smoking and cease using any tobacco product. We also want to advise them to avoid extreme cold because that can cause vasoconstriction, which further impairs blood flow to the extremities.

Next, we have Raynaud's, which is a rare vascular disorder that causes vasospasming of the arteries in the fingers and/or toes. And this decreases the blood flow to these extremities. So we have primary and secondary Raynaud's.

Primary Raynaud's is Raynaud's disease, and the cause of this is idiopathic or unknown. This is the more common of the two types of Raynaud's, and the symptoms tend to be a little less severe than with Raynaud's phenomenon, which is secondary Raynaud's.

With Raynaud's phenomenon, we have an underlying connective tissue disease, such as lupus or scleroderma, which damages the arteries.

So in terms of signs and symptoms, upon exposure to cold or stress, the fingers will become cyanotic, cold, painful, and numb. After spasming, blood flow will return to the area and cause those fingers to turn very red in color.

Diagnosis can usually be done based on the clinical signs and symptoms. We can also run an ANA titer, so an anti-nuclear antibody titer to assess for the presence of any underlying autoimmune disorders in the patient.

Treatment includes the use of vasodilators and then for severe cases of Raynaud's, we can do a sympathectomy.

Patient teaching includes advising the patient to avoid cold and to dress warmly because that cold can trigger the vasospasming associated with Raynaud's. We also want to advise our patient to decrease caffeine intake because that causes vasoconstriction as well. They should reduce stress levels and definitely stop smoking if they smoke currently.

All right, time for a quiz. I have three questions for you. First question, what is the number one risk factor for Buerger's disease? The answer is smoking. Question number two, connective tissue disorders such as lupus can cause Raynaud's phenomenon. True or false? The answer is true. Question number three, why do patients with Raynaud's need to avoid cold? The answer is that cold will trigger a vasospasming, which decreases blood flow to the extremities.

All right, I hope this quiz has been helpful, as well as the whole video. If so, be sure to like this video and leave me a comment. Take care and good luck with studying.