Editing Medical-Surgical Nursing (section)

=== Peripheral Vascular Disease ===

Peripheral arterial disease produces intermittent claudication, pain relieved by dangling the legs, diminished or absent pulses, cool and shiny hairless skin, thick nails, pallor on elevation, dependent rubor, and painful ulcers on the toes or lateral malleolus. Venous insufficiency produces aching heaviness relieved by elevation, warm skin, brown hemosiderin staining, edema, and shallow weeping ulcers near the medial malleolus.

Nursing application: elevate legs for venous disease and avoid elevation for arterial disease. Compression stockings help venous disease and are dangerous in significant arterial disease. Never apply heat directly to an ischemic or neuropathic extremity.

Deep vein thrombosis presents with unilateral calf or thigh swelling, warmth, redness, and tenderness. Do not massage the extremity. Anticoagulation is the treatment; the feared complication is pulmonary embolism.