CHAPTER 1 Cardiovascular System^47
- Check oxygen saturation (pulse oximetry).
- Record fluid intake and output.
- Weigh the patient daily. Call physician if patient gains 2 lbs daily.
- Call physician if BUN and creatinine increase.
- Record characteristics of sputum.
- Explain to the patient:
- Call the physician, nurse practitioner, or physician assistant if the patient
detects fluid overload: weight gain, shortness of breath, fatigue, chest pains. - Call 911 if in respiratory distress.
- Decrease sodium in diet.
- Sleep with head elevated i.e. three pillows, or blocks under head of bed
frame.
- Call the physician, nurse practitioner, or physician assistant if the patient
Raynaud’s Disease
WHAT WENT WRONG?
Blood flow to the extremities decreases as peripheral arteries narrow from
vasospasm when exposed to cold or emotional stress. This results in the fingers,
toes, nose, and ears blanching to a pale shade and/or turning blue and red as blood
flow decreases. It usually occurs bilaterally, often sparing the thumbs, and begins
to resolve with warming of affected areas. Raynaud’s is a benign condition usually
controlled by avoidance of underlying factors, i.e., cold and stress. Secondary
Raynaud’s can be seen with other disorders, mostly inflammatory and/or connec-
tive tissue diseases. This is more common in older men, usually involves the
hands, and can have other complications.
PROGNOSIS
Prognosis for primary Raynaud’s is good. Symptoms may be controlled by avoid-
ance or by medications. In secondary Raynaud’s, long-term ischemic complica-
tions may develop, such as loss of fat pads of fingers, gangrene due to diminished
sensation, and propensity to develop frostbite.
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