Raynaud’s

raynauds disease

1. Raynaud’s disease

2. What is raynaud’s disease?? Raynaud's is a rare disorder that affects the arteries. Raynaud's is also called a disease, syndrome, or phenomenon. Vasospasm, which is a narrowing of the blood vessels. Vasospasm of the arteries reduces blood flow to the fingers and to es. Also may occur at the tip of ears and nose.

3. Raynaud’s disease

4. Raynaud’s disease

5. classification Primary Raynaud’s / Raynaud’s disease the causes is not known.(idiopathic) Secondary Raynaud’s / Raynaud’s phenomenon where the causes are known.

6. Etiology OF PRIMARY RAYNAUD’S Cold temperature Stress Blood vessels in spasm

7. ETIOLOGY OF SECONDARY RAYNAUD’S  Scleroderma  Lupus.   Rheumatoid arthritis  Sjogren's syndrome  Diseases of the arteries.  Carpal tunnel syndrome

8.  Repetitive actions  Hand and foot injuries  Exposure to certain chemicals  Medicines  Smoking

9. RISK FACTORS…. PRIMARY RAYNAUD’S  Gender  Age  Family history  Living area climate

10. SECONDARY RAYNAUDS’S  Age  Certain disease and condition  Work place  Injury of hand and leg  Repetitive action  Living climate  Smoking  Medicines

11. pathophysiology

12. Clinical manifestation $ During the Raynaud’s attack, arteries become narrow and no blood supply to the area, this will cause : # Turn pale or white and then blue # Feel numb, cold, or painful # Turn red, throb, tingle, burn, or feel numb as blood flows back to the affected area

13. investigation Cold Stimulation Test Nailfold Capillaroscopy Antinuclear antibody (ANA) Erythrocyte sedimentation rate (ESR or " sed rate") C-reactive protein (CRP) tests

14. treatment Medical treatment @ Calcium channel blockers -- Norvasc @ Alpha blockers -- Prazosin @ Vasodilators -- Losartan ( Cozaar )

15. Surgical treatment @ Nerve surgery--- sympathectomy @ Chemical injection @ Amputation.

16. complication Complete lost of blood to the digits will cause: deformities of fingers and toes gangrene ulcer

17. Health education Stop smoking Exercise Control stress Avoid caffeine Take care of feet and hand Dress warmly outdoors

18. Nursing care plan

19. Nursing care plan 1 NURSING DIAGNOSIS: Ineffective peripheral tissue perfusion related to lack of blood supply to extremities. GOAL: Increased arterial blood supply to extremities.

20. NURSING INTERVENTION RATIONALE Assess the patient for the blood circulation,colour and sensation at the extremities. For further investigation and treatment. Apply warm compress at the affected area To promote good blood circulation Administer the medication as prescribed by doctor such as vasodilator, calcium channel blockers and alpha blockers To vasodilate the blood vessel and increase blood supply to the extremities Monitor the blood circulation to the extremities every two hourly (circulation chart) To observe for any further complication Encourage patient to perform extremities exercises while sitting or during work Muscular exercises promotes blood flow and the development of collateral circulation

21. EVALUATION : Patients extremities are warm to touch, improve in colour and no complain of numbness .

22. Nursing care plan 2 NURSING DIAGNOSIS : Anxiety related to disease process. GOAL : To reduce the anxiety level of patient

23. NURSING INTERVENTION RATIONALE Asses the patient’s anxiety level by observing clients behavior e.g crying facial expression and anxious. For further investigation Reinforce doctor’s explainations to patient by using the non medical term To increase the understanding of patient about the disease. Provide moral and emotional support to patient To provide patient psychological comfort Encourage diversional theraphy e.g watching tv , listening songs To deviate client’s mind away from the disease and to avoid patient get mentally stress

24. EVALUATION : Patient’s anxiety level decrease and client is more clear about the disease.

25. Nursing care plan 3 NURSING DIAGNOSIS : Deficient knowledge regarding self-care activities. GOAL : The patient will able to carry out daily activity by understanding the health education given by nurse based on the disease.

26. NURSING INTERVENTION RATIONALE Assess client knowledge level Fo r the nurses to give adequate health education to the client Encourage patient to perform extremities exercises. To promote the blood flow to the affected area Advise patient to place the fingers or toe under the warm water during the attack. The warm water will vasodilate and encourage the blood flow. Advise patient to stop smoking Reducing the risk factor may reduce symptoms or slow the disease progression Advise patient not to wear tight wrist band or watch and clothings Constrictive clothing and accessories impede circulation.

27. EVALUATION : Client is able to carry out the daily activities by implementing the health education given .

28. Conclusion Raynaud's sometimes is called a disease, syndrome, or phenomenon. Is a narrowing of the blood vessels. Vasospasm of the arteries reduces blood flow to the fingers and toes. In people who have Raynaud's , the disorder usually affects the fingers. In about 40 percent of people who have Raynaud's , it affects the toes. Rarely, the disorder affects the nose, ears, nipples, and lips.

29. Has two type of raynaud that is primary and secondary raynaud disease In both types of Raynaud's , even mild or brief changes in temperature can cause Raynaud's attacks. People with severe Raynaud's can develop skin sores or gangrene from prolonged or repeated Raynaud's attacks. It can be treated e.g. by placing the hand under warm water to vasodilate

30. referrences http://www.mayoclinic.com/health/raynauds-disease/DS00433/DSECTION http://www.nlm.nih.gov/medlineplus/ency/article/000412.htm http://www.faqs.org/health/topics/77/Raynaud-s-disease.html http://www.medic8.com/healthguide/articles/raynauds.html

31. http://www.nhlbi.nih.gov/health/dci/Diseases/raynaud/ray_diagnosis.html http://www.medicalnewstoday.com/articles/176713.php -raynaud disease http://agedcareact.wordpress.com/2007/11/13/what-is-raynauds-disease/ - raynaud disease http://bodyandhealth.canada.com/channel_condition_info_details.asp?disease_id=110&channel_id=2022&relation_id=16665 –raynaud disease http://edition.cnn.com/HEALTH/library/raynauds-disease/DS00433.html -raynaud disease

32. Brunner & Suddarth’s textbook of medical – surgical nursing, 12 th edition. Pearson International edition medical – surgical nursing, 4 th edition. Joyce.M & Jane Hokanson Hawks medical – surgical nursing, 8 th edition.

33. Thank you