Disorders of the Veins and Arteries
For an APR (Advanced Practice Nurse)
it is vital to advise or to make accurate diagnoses and treatment therapies
based on the clinical manifestation found in the human body and also by
breaking down the groups of symptoms for disease processes. Scientists have
outlined numerous conditions of human body’s venous system and the circulatory
system. This paper will discuss the deep vein thrombosis, pathophysiology and
how insufficiency of chronic venous causes gender influences.
Pathophysiology of Deep Vein Thrombosis
A report from CDC (Centers for Disease Control and
Prevention) presents an alarming picture as it outlines the estimation of
900,000 American suffering from VTE (Venous Thromboembolisms) which is also
known as DVT (Deep Vein Thrombosis) amongst the practioners. The report further
mentions the death of 100,000 patients out the aforementioned number each year
due to their health condition (CDC, 2017). The condition of Deep Vein
Thrombosis should not be confused with arterial thrombosis that is caused by
the atherosclerosis having been plaqued and such blockage can lead to severe
results such as stroke. On the contrary, a DVT is found in the calf and in some
cases, it is also found in the upper extremities (Huether, & McCance,
2017).
It has been found that over the time within the venous
system the platelets and clotting factors (of bifurcations of the venous
circulation) get accumulated (Patel, & Chung, & Chang, 2016). The
propagation of red blood cells, fibrin, thrombin aggregation and platelets as well
as the inflammation caused by immune response give growth to thrombus (Huether,
& McCance, 2017).
The occurrence of detachment of thrombus from the venous
vessel wall turns in to thromboembolus (Huether, & McCance, 2017). The
Virchow’s Triad is commonly known scenario in the formation of DVT condition
and this triad promotes the venous thrombosis. According to Huether &
McCance (2017), the Virchow’s triad has manifestations that include: “(1)
venous endothelial damage (e.g., trauma, intravenous medications), (2) venous
stasis (e.g., immobility, age, congestive heart failure), and (3)
hypercoagulable states (e.g., inherited disorders, malignancy, pregnancy, use
of oral contraceptives or hormone replacement therapy)”.
Further, Huether & McCance (2017) mention the patients
with DVTs registering complaints of suffering from tenderness, swelling, calf
pain and redness which is a direct result of irregularity found in blood
circulation in the body and also due to the inflammation.
The researchers report that patients, at times, have signs
of calf discomfort caused by food dorsiflexion linked with an extended knee.
Where examples are available of thrombi resolutions without any major or minor
treatment there are also situations where DVT patients suffer from
immobilization. Such condition further racks up the risks for PE in the chronic
venous insufficiency and this would make the patient feel the discomfort
(Huether, & McCance, 2017).
DVT examination can be done and accurate diagnosis can be
achieved through a number of ways such as patient history, physical
examination, blood tests, Dopler Ultrasonography and D-dimer. APNs can best
manage the condition of DVT through prevention or by using a filter that can be
placed in to the inferior vena cava. Another way to manage the DVT is
thrombolytic therapy which is also very helpful. When we talk about the
patients having VTE (Venous Thromboembolisms) condition their prevention can be
achieved by SCD (Sequential Compression Devices), anticoagulation and ensuring early
ambulation (Huether & McCance, 2012).
Pathophysiology of Chronic Venous
Insufficiency
The venous system plays a key role in the development of CVI
(Chronic Venous Insufficiency) condition in the patients. When the disruption
occurs in the valvular competence of the low-pressure venous system it effects
the reflux, distention and its return. The reports suggest that between 2 to 5
percent of the Americans have CVI (Weiss, Izaguirre Anaribe, Lanza,
&Lessnau, 2016).
It is quite possible for a person to develop venous
distention over the time due to his lifestyle such consistently crossing the
legs, standing for longer periods of time or using tight garments affecting the
blood circulation (Huether, & McCance, 2017). It has been observed and
recorded that risks of having CVI are increasing in people aged over 30, doing
heavy lifting, affected by obesity, are pregnant and have a family history in
same line of health conditions.
Epidemiology
Both CVI and DVT are seen to be prevailing in female gender
and this is due to the gender specific conditions such as obstetric or
gynecologic.
Huether & McCance (2012) argue, since females, when
compared with males, have different reproductive mechanism and they also use
tight garments and posture (such as crossing the legs at their knees) which
makes them more vulnerable to CVI. There should be more efforts made to educate
the females on the points of oral contraception, wearing garments, their diet
controls, how to posture and hormone replacement therapies to avoid the
increasing chances of CVI and DVT.
References
Centers for Disease Control and
Prevention. (2017). Venous thromboembolism (blood clots). Retrieved from https://www.cdc.gov/ncbddd/dvt/index.html
Huether, S. E., & McCance, K. L.
(2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Patel, K., & Chung, L. J., &
Chang, J. S. (2016). Deep venous thrombosis. Medscape. Retrieved from http://emedicine.medscape.com/article/1911303-overview#showall
Vascular Disease foundation. (n.d.).
Chronic venous insufficiency. Retrieved from http://www.vasculardisease.org/flyers/chronic-venous-insufficiency-flyer.pdf
Weiss, R., & Izaguirre Anaribe,
D. (2016). Venous Insufficiency. Medscape. Retrieved from http://emedicine.medscape.com/article/1085412-overview
