Disorders of the Veins and Arteries sample essay

Disorders of the Veins and Arteries sample essay

Assignment: Disorders of the Veins and Arteries
Advanced practice nurses often treat patients with vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT). While the symptoms of both disorders are noticeable, these symptoms are sometimes mistaken for signs of other conditions, making the disorders difficult to diagnose. Nurses must examine all symptoms and rule out other potential disorders before diagnosing and prescribing treatment for patients. In this Assignment, you explore the epidemiology, pathophysiology, and clinical presentation of CVI and DVT.

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To Prepare

Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis Disorders of the Veins and Arteries sample essay.
To Complete

Write a 2- to 3-page paper that addresses the following:

Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.
Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your Disorders of the Veins and Arteries sample essay paper.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting Disorders of the Veins and Arteries sample essay.

Introduction

The circulatory system constitutes of three main blood vessels including arteries, veins, and lymphatic. According to Bergan and Bunke, ( (2014), blood in the peripheral veins tends to be passive and under low pressure and since its pumping mechanism relies on muscle contraction in the legs and arms. However, physiological changes in the body lead to hypertension and trigger thrombi formation resulting in diseases of the veins. Notably, the clinical manifestations of common venous diseases may be misdiagnosed for other disorders. This paper provides a review of the pathophysiology of common vein diseases before concluding with mind maps highlighting the epidemiology, pathophysiology, clinical presentation, and treatment of Deep Vein Thrombosis(DVT)  and Chronic  Veins Insufficiency(CVI) Disorders of the Veins and Arteries sample essay.

Pathophysiology of Deep vein insufficiency

Deep vein insufficiency emanates from venous stasis. According to Eberhardt and Raffetto (2014),  the main factors resulting in venous stasis include a dysfunction in the venous valve, inflammation of the venous walls, dysfunctional pump mechanism, and venous hypertension. Notably, venous stasis results in an increase in blood viscosity and subsequent venous hypertension, factors which stimulate the release of vasoactive substances triggering the expression of adhesion molecules and inflammatory mediators. In this regard, the underlying cascade of events results in inflammation and subsequent rapture of peripheral veins walls, a condition imminent in CVI Disorders of the Veins and Arteries sample essay.

Pathophysiology of Deep Vein Thrombosis

Considering that the venous valves are vascular, the formation of microthrombi in the calf veins predisposes the development of DVT. Notably, venous stasis resulting from calf veins microthrombi obstruction and subsequent, endothelial hypoxemia stimulates the release of adhesion molecule and leukocytes (Huether and McCance, 2015). The leukocytes transfer the vasoactive molecules to the endothelial cells where they combine with activated Factor VII and through a cascade of events results to coagulation with the resultant formation of a thrombus. Di Nisio, Van and Büller (2016)) pinpoints that the main components of resultant venous thrombin are fibrin and erythrocytes. In this regard, clot formation results in the destruction of the peripheral veins, a condition imminent in Deep vein thrombosis Disorders of the Veins and Arteries sample essay.

Comparison of the pathophysiology of DVI and DVT

The pathophysiology of DVI and DVT harbor some similarities in the development of the underlying disorder. Notably, the development of both diseases involves three steps including venous stasis, coagulation activation, and subsequent endothelial damage in peripheral veins (Eberhardt and Raffetto, 2014). In this regard, there is a correlation between venous stasis, hemodynamic alterations, and hypertension in both disorders and their subsequent stimulation in the release of blood coagulation factors. Further, blood coagulation results in endometrial cells damage, a clinical manifestation evident in both DVI and DVT. Lastly, the mechanism of origin of venous stasis exhibit similarities with valve incompetence in peripheral veins of the body muscles is common in the progression of venous both venous diseases Disorders of the Veins and Arteries sample essay.

Differences between venous thrombosis and arterial thrombosis

The pathophysiology of venous and arterial thrombosis display notable differences. Di Nisio, Van and Büller (2016), asserts that despite thrombi formation, being a common manifestation in both disorders, their pathophysiology and outcome differs. Notably, arterial stasis results from plaque formation in the deep arteries and affects the valves in the left chambers of the heart. In contrast, venous stasis emanates from a variety of factors (both intrinsic and extrinsic) such as tissue damage and biochemical imbalance with its associated alterations affecting the soleus sinusoid and cusps valves in the extreme parts of the body Disorders of the Veins and Arteries sample essay. Additionally, the inflammatory response in arterial thrombosis results to coagulation involving the platelets while venous associated coagulation constitutes mainly fibrin and erythrocytes ( Di Nisio, Van  & Büller (2016). Finally, chronic inflammation in arterial thrombosis results in the acute coronary syndrome and ischemic stroke, while on the other hand, the pathogenesis of untreated venous thrombosis results to pulmonary embolism and deep vein thrombosis.

Pregnancy as a patient factor

Previous studies reveal that pregnancy is a risk factor in the development of DVI and DVT. According to (Khan, Vaillancourt, and Bourjeily (2017), the incidence of DVT among pregnant women is approximately 1.1 per 1000 deliveries. Further, risk increases during the last trimester and six weeks after parturition. In this regard, considering misdiagnosis of DVT and CVI may lead to the development asserts that there is a need for nurses and medical practitioners to undertake precautions in the diagnosis of the clinical manifestations of the diseases for effective treatment Disorders of the Veins and Arteries sample essay

Pathophysiology of DVT in pregnancy

Pregnancy results in anatomical and physiological changes in the body. According to Khan, Vaillancourt, and Bourjeily (2017), increased cardiac output resulting to peripheral vasodilation is a common event in pregnancy. Notably, the anatomical and physiological alterations associated with pregnancy result in venous stasis and hypercoagulability in the peripheral veins located in the legs and arms. In this regard, the body increases the production of procoagulant peptides and subsequently, decreases the release of the anticoagulant substances and as such, there is a formation of fibrin-rich thrombi, which initiates vascular damage of the endothelial cells in the peripheral veins located in legs and arms. Further, Khan, Vaillancourt, and Bourjeily (2017), asserts that vascular damage occurs in the pelvis during parturition

Diagnosis of DVT and CVI in pregnancy

Clinical diagnosis of DVT and DVI  should be accompanied with further laboratory tests to prevent misdiagnosis of the underlying disorder. Notably, a consideration of the physiological alterations associated with pregnancy should facilitate the decision-making process during the diagnosis of the disorders clinical manifestation. As such, the first criteria entail a physical examination of symptoms such as pain, tenderness, and swelling of the extremities in the patient with regard to the patient’s medical history (Khan, Vaillancourt, & Bourjeily 2017). However, since the clinical manifestations of DVT and pulmonary embolism in pregnancy are similar, I would recommend the patient to undergo an ultrasound scan analysis of the proximal venous system to confirm if the underlying condition is DVT Disorders of the Veins and Arteries sample essay.

Treatment

Considering that physiological changes in pregnancy result to hypercoagulation, administration of anticoagulants would be the first drugs of choice. In this regard, I would prescribe the patient to take low molecular weight heparin, which suppresses the release of clotting factors in the body. According to Khan, Vaillancourt, and Bourjeily (2017), LMWH has a safety profile since it does not cross the placental barrier and it reduces the risk of hemorrhage. Additionally, it does not affect the breast milk and it can be administered even after parturition.

Conclusion

Despite the fact that Diseases of the veins are common, their clinical manifestations tend to be misdiagnosed for other diseases. In this regard, there is a need for nurses and other medications to understand their pathophysiology for easy their treatment. Notably, understanding of the pathophysiology and clinical manifestations of these disorders will go a long way in facilitating the appropriate treatment for the underlying condition. Further, an understanding of the patient condition such as pregnancy will facilitate the adoption of a treatment option, which bests suits the patients Disorders of the Veins and Arteries sample essay.

Mind Map for Chronic Vein Insufficiency

Mind Map For Deep Vein Thrombosis

References

Bergan, J. J., & Bunke, N. (Eds.). (2014). The vein book. Oxford University Press.

Di Nisio, M., van Es, N., & Büller, H. R. (2016). Deep vein thrombosis and pulmonary embolism. The Lancet, 388(10063), 3060-3073.

Eberhardt, R. T., & Raffetto, J. D. (2014). Chronic venous insufficiency. Circulation, 130(4), 333-346

Huether, S. E., & McCance, K. L. (2015). Understanding Pathophysiology-E-Book. Elsevier Health Sciences.

Khan, F., Vaillancourt, C., & Bourjeily, G. (2017). Diagnosis and management of deep vein thrombosis in pregnancy. BMJ: British Medical Journal (Online), 357 Disorders of the Veins and Arteries sample essay.

Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis.

To Complete

Write a 3 page paper that addresses the following:

Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.
Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

Please references should be within the last five years. All in text quotation should have paragraph number or page number. paper should have introduction and summary Disorders of the Veins and Arteries sample essay. Thank you

Disease of Arteries and veins

One of the conditions affecting the veins is deep venous thrombosis which affects 40% of women and 17 % of men globally and leads to pulmonary embolism, a life threatening condition. Valves are major anatomical and physiological components of the veins and chronic venous insufficiency results from impairment of the valves (Huether, & McCance, 2015). The discussion below will present a comparison of the pathophysiology of deep venous thrombosis, chronic venous insufficiency and arterial thrombosis. Finally, the essay will discuss how gender affects the pathophysiology, diagnosis and treatment of the above specified conditions and mind maps summarizing the conditions.

Pathophysiology

The predisposing factors to the development of the deep venous thrombosis include: female gender, pregnancy, overweight, cancer, immobility, post -partum period and surgical procedures. The predisposing factors in the development of chronic venous insufficiency include: long standing periods and deep venous thrombosis.  Chronic venous insufficiency basically refers to the impairment in the functioning of the valves that facilitate the uni-directional flow of blood through the veins to the heart. In contrast, deep venous thrombosis refers to a condition in which there is formation of a blood clot in the deep veins of the extremities. Chronic venous insufficiency affects both the deep and the superficial veins while the deep venous thrombosis affects the deep veins of the lower extremities in most of the cases. Deep venous thrombosis eventually leads to pulmonary thrombosis as a complication, whereas chronic venous insufficiency leads to ulceration and bacterial eczema following the effect the sequel of the condition on the walls of the affected veins. Deep venous thrombosis presents with tenderness and swelling of the affected lower limb whereas chronic venous insufficiency presents with hyperpigmentation, ulceration and varicose veins on the limb where the valves of the veins function insufficiently. Both the deep venous thrombosis and the chronic venous insufficiency are characterized by the occurrence of blood stasis in the affected veins. In addition, deep venous and chronic venous insufficiency present with pain and swelling of the affected extremities (Gloviczki, & Lawrence, 2017) Disorders of the Veins and Arteries sample essay.

Arterial thrombosis affects the arteries whereas deep venous thrombosis affects veins. In addition, arterial thrombosis affects any of the arteries whereas deep venous thrombosis affects the deep veins of the lower extremities in most cases and specifically is associated with the femoral vein, the popliteal vein or the ilio-femoral vein. The deep venous thrombosis is cause by injury to the endothelial lining of the veins which activates the coagulation pathway that involves conversion of prothrombin to thrombin and fibrinogen to fibrin. Finally a plug that consists of platelets, fibrin and red blood cells is formed (Gujja, Wiley, & Krishnan, 2014). In addition, blood stasis also causes the development of the deep venous thrombosis. Blood stasis is formed as result immobility.  Finally, a state hypercoagulability also leads to frequent and easy activation of the coagulation path way leading to a formation of the blood clot. On the other hand, arterial thrombosis is caused by the presence of thrombus, emboli, air emboli or cancer thrombi. Furthermore, deep venous thrombosis leads to the pulmonary thrombosis as a complication due to the mobility of the thrombi from the extremities, through the inferior vena cava to the heart and eventually to the lungs through the pulmonary artery. In contrast, arterial thrombosis leads to insufficient oxygen supply to the tissues that are supplied within blood by the affected artery. Subsequently, the body forms new collateral arteries to increase blood and oxygen supply to the affected tissues (Martinod, Witsch, Farley, Gallant, Remold‐O’Donnell, & Wagner, 2016).

Effect of Gender on DVT and DCI

Notably, the prevalence of the above mentioned conditions is higher among the women as compared to men.  In addition, pregnancy, post-partum period and the female gender are risk factors for the development of the deep venous thrombosis. During pregnancy the production of the clotting factors increases and thus, their concentration in the blood of the pregnant patient. Therefore, a state of hypercoagulability is created. Subsequently, following an injury to the endothelial lining of the blood vessel, the coagulation cascade is easily activated. In addition, reduced mobility is common among the pregnant women. Immobility contributes to the pathophysiological development of deep venous thrombosis and chronic venous insufficiency Disorders of the Veins and Arteries sample essay. Prolonged immobility reduces the contractility of the cuff muscles.  Therefore the propulsive force and effect of the muscles to the venous return through the major veins is affected. The diagnosis of deep venous thrombosis and chronic venous insufficiency should be guided by biographic data, medical and obstetric history of the patient. In cases of female patients, the clinician should be keen to take the obstetric history so as to elicit pregnancy and post -partum period as risks towards to the development of DVT and CVI. The treatment of DVT and CVI is universal regardless of the gender, and therefore anticoagulants and surgery are the treatment approaches (Aggarwal, Fullam, Brownstein, Maynard, Ansell, Varga, & Rickles, 2015).

                  Mind Map

  In conclusion, DVT and CVI are the most common conditions affecting the blood vessels. The two conditions differ widely in terms of the pathophysiology. However the conditions hare similarities. Gender affects the pathophysiology, prevalence and the diagnosis of DVT and CVI.

References

Aggarwal, A., Fullam, L., Brownstein, A. P., Maynard, G. A., Ansell, J., Varga, E. A., … & Rickles, F. R. (2015). Deep vein thrombosis (DVT) and pulmonary embolism (PE): awareness and prophylaxis practices reported by patients with cancer. Cancer investigation, 33(9), 405-410.

Gloviczki, P., & Lawrence, P. F. (2017). Iliac vein stenting and contralateral deep vein thrombosis. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5(1), 5-6.

Gujja, K., Wiley, J., & Krishnan, P. (2014). Chronic Venous Insufficiency. Interventional cardiology clinics, 3(4), 5 Disorders of the Veins and Arteries sample essay93-605.

Huether, S. E., & McCance, K. L. (2015). Understanding Pathophysiology-E-Book. Elsevier Health Sciences.

Martinod, K., Witsch, T., Farley, K., Gallant, M., Remold‐O’Donnell, E., & Wagner, D. D. (2016). Neutrophil elastase‐deficient mice form neutrophil extracellular traps in an experimental model of deep vein thrombosis. Journal of Thrombosis and Haemostasis, 14(3), 551-558 Disorders of the Veins and Arteries sample essay.

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