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 toes.
 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
Become
Small arteries at
Expose to cold / pale, less blood
fingers and toes
triggering factor flow and low O2
vasospasm
supply
Blood flow
Warm up
increase, high O2
(arteries dilate)
supply
Affected area is
Color change to
warm and
bright red
throbbing pain

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 RATIONALE
INTERVENTION
Assess the patient for the blood For further investigation and treatment.
circulation,colour and sensation at the
extremities.
Apply warm compress at the affected To promote good blood circulation
area
Administer the medication as prescribed To vasodilate the blood vessel and
by doctor such as vasodilator, calcium increase blood supply to the extremities
channel blockers and alpha blockers
Monitor the blood circulation to the To observe for any further complication
extremities every two hourly (circulation
chart)
Encourage patient to perform extremities Muscular exercises promotes blood flow
exercises while sitting or during work 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 RATIONALE
INTERVENTION
Asses the patient’s anxiety level by For further investigation
observing clients behavior e.g crying
facial expression and anxious.
Reinforce doctor’s explainations to To increase the understanding of patient
patient by using the non medical term about the disease.
Provide moral and emotional support to To provide patient psychological comfort
patient
Encourage diversional theraphy e.g To deviate client’s mind away from the
watching tv, listening songs 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 RATIONALE
INTERVENTION
Assess client knowledge level For the nurses to give adequate health
education to the client
Encourage patient to perform extremities To promote the blood flow to the affected
exercises. area
Advise patient to place the fingers or toe The warm water will vasodilate and
under the warm water during the attack. 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 Constrictive clothing and accessories
band or watch and clothings 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/arti
cle/000412.htm
 http://www.faqs.org/health/topics/77/Raynaud
-s-disease.html
 http://www.medic8.com/healthguide/articles/r
aynauds.html

31.  http://www.nhlbi.nih.gov/health/dci/Diseases/ray
naud/ray_diagnosis.html
 http://www.medicalnewstoday.com/articles/1767
13.php -raynaud disease
 http://agedcareact.wordpress.com/2007/11/13/w
hat-is-raynauds-disease/ - raynaud disease
 http://bodyandhealth.canada.com/channel_cond
ition_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, 12th edition.
 Pearson International edition medical –
surgical nursing, 4th edition.
 Joyce.M & Jane Hokanson Hawks medical –
surgical nursing, 8th edition.

33. THANK YOU