RAYNAUD'S DISEASE
It is a form of intermittent arteriolar vasoconstriction that results in coldness, pain, pallor and occasionally of the fingertips. Involvement of the toes is seen occasionally.
Causes
- Unknown.
- May result of a defect in basal heat production ➡ decreases the ability of cutaneous vessels to dilate.
- May be triggered by emotional factors or by unusual sensitivity to cold.
Risk Factors
- Females-16-40 years.
- Countries with cold climates and during the winter months.
Pathophysiology
Causative factors
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Vasoconstriction
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Blood flow is stagnant
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Cyanotic (blue) color in fingers.
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If severe, fingers become dead white in colour. On rewarming fingers develop a reactive hyperemia (increased blond flow) and appears red.
Nursing Management
- Advise the patient to avoid situations that provoke vasoconstriction / exposure to cold must be minimized. The patient should remain indoors and wear protective clothing when outdoors.
- Handle sharp objects carefully to avoid injuring the digits.
- Administer vasodilators and sympatholytic agents as prescribed. Eg. reserpine or other ranwolfia derivatives caution the patient on postural hypotension (due to drugs) and this is increased by alcohol, exercise and hot weather
Surgical Treatment: Sympathectomy (removal of sympathetic ganglia or division of their branches.)
