Question

Chronic Venous Insufficiency (CVI) What is CVI and how is it different from peripheral arterial disease (PAD)? What are the risk factors for developing CVI What is ambulatory venous hypertension? What is hemosiderin? Describe the clinical manifestations, including wounds that can occur with CVI How are wounds with CVI different from those associated with PAD? Describe 3 nursing interventions

Answer 1

Chronic venous insufficiency: This is a condition which occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return o heart from the legs. CVI causes blood to “pool” in these veins and this pooling is called stasis.

Peripheral arterial disease: Is an abnormal narrowing of arteries other than those that supply the heart or brain. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved.

Risk factors for CVI

1. Age over 50 - As we grow older, the walls of our veins tend to weaken this prevents them from efficiently transporting blood back to the heart

2. Being a women - Women tend to report higher incidence of varicose veins and venous insufficiency. Although the exact mechanisms underlying this effect are unclear.

3. Being overweight or obese - Being above a healthy body weight places more stress on your vascular system. Your veins need to work harder to pump blood, making it more likely for blood to pool in the extremities.

4. Family history - Genetic risk factors may make you more likely to develop varicose veins

5. Smoking - In  addition to affecting the lungs, smoking reducing the health of veins. The weakening of vein walls makes smokers have a significant higher risk of venous insufficiency.

6. Inactivity- e need to maintain minimum level of movement to keep our blood pumping effectively. People with a sedentary lifestyle are more likely to develop venous insufficiency

7. Pregnancy - pregnant woman often develop varicose veins in the legs and groin area. Risk of venous insufficiency rises with each additional pregnancy a women undergoes

8. Long periods of sitting or standing - people who work in industries that require lengthy period of sitting or standing are at increased risk of varicose veins

Ambulatory venous hypertension - AVP (ambulatory venous pressure) monitoring is the criterion standard in assessing the hemodynamics of CVI, and AVH (ambulatory venous hypertension) is the term used when the hemodynamic pressures of CVI is higher then normal value.

Hemosiderin - it is an iron storage complex. The breakdown of heme gives rise to biliverdin and iron. The body then traps the released iron and stores it as hemosiderin in tissue. Hemosiderin is also generated from the abnormal metabolic pathways of ferritin.

Wound in PAD : characterized by a punched-out look is usually round in shape, with a well defined, even wound margin. These are often between or on the tip of the toes, on the outer ankle, or where there is pressure from walking or footwear. The wound themselves are characteristically deep often extending down to the underlying tendons, and will frequently display no signs of new tissue growth. The base of the wound typically does not bleed.

Wounds in CVI : scaling and erythema of lower extremities occur, hemosiderin staining may occur, causing presence of brownish or yellow patches underneath skin , venous ulcers will present with shallow but large wounds with irregular margins that typically develop on the lower leg or ankle.

nursing interventions:

1. Use of antithrombotic socks

2. Having an active lifestyle , stretching from time to time.

3. And quitting smoking habit.