3.
Raynaud’s DISEASE
.Pathophysiology & TYPES ( Concept Map Form)
Raynaud's phenomenon (RP) is a condition resulting in a particular series of
discolorations of the fingers and/or the toes after exposure to changes in
temperature (cold or hot) or emotional events.
Skin discoloration occurs because an abnormal spasm of the blood vessels
causes a diminished blood supply to the local tissues
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Initially, the digit(s) involved turn white because of the diminished blood
supply.
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The digit(s) then turn blue because of prolonged lack of oxygen.
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Finally, the blood vessels reopen, causing a local "flushing" phenomenon,
which turns the digit(s) red. This three-phase color sequence (white to blue to
red), most often upon exposure to cold temperature, is characteristic of RP.
ADDITIONAL INFO:
Raynaud's disease is a rare disorder of the blood vessels, usually in the
fingers and toes. People with this disorder have attacks that cause the blood
vessels to narrow. When this happens, blood can't get to the surface of the
skin and the affected areas turn white and blue. When the blood flow returns,
the skin turns red and throbs or tingles. In severe cases, loss of blood flow
can cause sores or tissue death. Cold weather and stress can trigger attacks.
II. Risk factors
The risk factors for primary Raynaud's (Raynaud's disease) and secondary Raynaud's
(Raynaud's phenomenon) are different.
The risk factors for primary Raynaud's include:
• Gender. About 80 percent of people who have primary Raynaud's are women.
• Age. Primary Raynaud's usually develops before the age of 30.
• Family history. Primary Raynaud's may occur in members of the same family.
• Living in a cold climate. Cold temperatures can trigger Raynaud's attacks.
The risk factors for secondary Raynaud's include:
• Age. Secondary Raynaud's usually develops after the age of 30.
• Certain diseases and conditions. For examples, diseases that directly damage the
arteries or damage the nerves that control the arteries in the hands and feet may
cause secondary Raynaud's.
• Injuries to the hands or feet.
• Exposure to certain workplace chemicals, such as vinyl chloride (used in the
plastics industry).
• Repetitive actions with the hands, such as typing or using vibrating tools.(piano)
• Certain medicines, such as migraine, cancer, cold/allergy, or blood pressure
medicines.
• Smoking.
• Living in a cold climate.
III. Sign and Symptoms
What Are the Signs and Symptoms of Raynaud's?
People who have primary Raynaud's (Raynaud's disease) or secondary Raynaud's
(Raynaud's phenomenon) can have attacks in response to cold temperatures or emotional
stress.
Raynaud's attacks usually affect the fingers and toes. Rarely, the attacks affect the nose,
ears, nipples, or lips.
During a Raynaud's attack, the arteries become very narrow for a brief period. As a result,
little or no blood flows to affected body parts. This may cause these areas to:
• Turn pale or white and then blue
*Coldness, numbness, tingling in one or more digits; pain (usually precipitated by
exposure to cold, emotional upsets, tobacco use)
*Intermittent color changes (pallor, cyanosis, rubor); small ulcerations and gangrene at
tips of digits (advanced).. Turn red, throb, tingle, burn, or feel numb as blood flow returns
to the affected areas
IV. Nursing Diagnosis ( at least 2)
1. knowledge deficit
2. alteration in comfort
V. Nursing Intervention/ Action
• Provide client teaching concerning
1. Importance of stopping smoking, Limit your use of caffeine and alcohol.
2. Need to maintain warmth, especially in cold weather,
Discuss ways of avoiding exposure to cold:
*wear adequate clothing to promote warmth
* wear socks and gloves
*need to use gloves when handling cold objects/opening freezer or refrigerator
door
Avoid that will cause vasoconstriction such as birth control pills, ergotamine.
Suggest anti inflammatory analgesics to promote comfort with doctor advise
SUGGEST: You can help stop a Raynaud's attack once it starts. Warm up your
hands, feet, or other affected areas right away. For example, place your
hands under your armpits, run warm water over your fingers and toes, or
massage your hands and feet.
IV. Drugs
If lifestyle changes don’t control Raynaud’s, you may need medicines or
surgery. Your health care provider may prescribe medications to relax the
walls of the blood vessels , these include topical nitroglycerin, calcium
channel blockers, sildenafil (Viagra), and ace inhibitors
Medicines are used to improve blood flow to the fingers and toes.
Examples of medicines used to treat Raynaud’s include calcium channel blockers, alpha
blockers, prescription skin creams, and ACE inhibitors (used less often)
