Periferik Vasküler Hastalıklarda Hemşirelik Yaklaşımı

Emir Sultan Yavuz

doi:10.37609/akya.3245

Yazarlar

Emir Sultan Yavuz

DOI: https://doi.org/10.37609/akya.3245.c11556

Özet

Periferik Arter Hastalığı (PAH), genellikle alt ekstremite arterlerini etkileyen ve ateroskleroz kaynaklı bir damar hastalığıdır. Ancak, karotis, subklavian, mezenter ve renal arterler gibi diğer damarlar da bu hastalık kapsamına girer. PAH’nın belirtileri, damar tıkanıklığının yerine ve derecesine bağlı olarak değişir. PAH'lı hastalarda sık görülen semptomlardan biri olan klodikasyon, kas ağrıları ve kramplarla kendini gösterir. Hastalığın tanısında ayak bileği-kol indeksi (ABI), BT anjiyografi ve MR anjiyografi gibi yöntemler kullanılır. Tedavide yaşam tarzı değişiklikleri, ilaçlar ve cerrahi yöntemler yer alır. Hemşireler, hastaların tedaviye uyumunu sağlamada ve yaşam kalitesini artırmada kritik bir role sahiptir. Özellikle ilaç yönetimi, egzersiz programları ve hasta eğitimi hemşirelik bakımının önemli bileşenleridir. Sigara bırakma desteği, beslenme planları ve ağrı yönetimi gibi konularda da hemşirelerin sorumluluğu büyüktür. PAH'nın ilerlemesini yavaşlatmak ve komplikasyonları önlemek için multidisipliner bir yaklaşım gerekmektedir.

Peripheral Artery Disease (PAD) typically affects the lower extremity arteries, but other arteries such as the carotid, subclavian, mesenteric, and renal arteries can also be impacted due to atherosclerosis. The symptoms of PAD vary based on the location and severity of the arterial blockage. One of the common symptoms is claudication, which manifests as muscle pain and cramps. Diagnostic methods for PAD include the ankle-brachial index (ABI), CT angiography, and MR angiography.Treatment options range from lifestyle modifications and medications to surgical interventions. Nurses play a critical role in ensuring patient adherence to treatment and improving their quality of life. Nursing care includes medication management, exercise programs, and patient education. Additionally, nurses are responsible for supporting smoking cessation, providing nutritional guidance, and managing pain. A multidisciplinary approach is essential to slow the progression of PAD and prevent complications.

Referanslar

Aboyans, V., Ricco, J. B., Bartelink, et al. ESC Scientific Document Group (2018). 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). European heart journal, 39(9), 763–816.

Neschis DG, Golden MA. Clinical features and diagnosis of lower extremity peripheral arterial disease. 2017.

Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(12):e686-e725.

Sampson, U. K. A., Fowkes, F. G. R., Naidoo, N. G., & Criqui, M. H. (2017). Peripheral Artery Disease. In D. Prabhakaran (Eds.) et. al., Cardiovascular, Respiratory, and Related Disorders. (3rd ed.). The International Bank for Reconstruction and Development / The World Bank.

Zemaitis, M. R., Boll, J. M., & Dreyer, M. A. (2023). Peripheral Arterial Disease. In StatPearls. StatPearls Publishing.

McDermott MM, Kerwin DR, Liu K, et al. Prevalence and significance of unrecognized lower extremity peripheral arterial disease in general medicine practice. J Gen Intern Med. 2001;16(6):384-390.

Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Circulation. 2017;135(12):e791–e792]. Circulation. 2017;135(12):e726-e779.

2011 WRITING GROUP MEMBERS, 2005 WRITING COMMITTEE MEMBERS, & ACCF/AHA TASK FORCE MEMBERS (2011). 2011 ACCF/AHA Focused Update of the Guideline for the Management of patients with peripheral artery disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation, 124(18), 2020–2045.

Hur, S., Jae, H. J., Jang, Y., Min, S. K., Min, S. I., Lee, D. Y., Seo, S. G., Kim, H. C., Chung, J. W., Kim, K. G., Park, E. A., & Lee, W. (2016). Quantitative Assessment of Foot Blood Flow by Using Dynamic Volume Perfusion CT Technique: A Feasibility Study. Radiology, 279(1), 195–206.

Woolen, S. A., Shankar, P. R., Gagnier, J. J., MacEachern, M. P., Singer, L., & Davenport, M. S. (2020). Risk of Nephrogenic Systemic Fibrosis in Patients With Stage 4 or 5 Chronic Kidney Disease Receiving a Group II Gadolinium-Based Contrast Agent: A Systematic Review and Meta-analysis. JAMA internal medicine, 180(2), 223–230.

Serhal, A., Koktzoglou, I., & Edelman, R. R. (2019). Feasibility of Image Fusion for Concurrent MRI Evaluation of Vessel Lumen and Vascular Calcifications in Peripheral Arterial Disease. AJR. American journal of roentgenology, 212(4), 914–918.

Berger, J. S., & Ladapo, J. A. (2017). Underuse of Prevention and Lifestyle Counseling in Patients With Peripheral Artery Disease. Journal of the American College of Cardiology, 69(18), 2293–2300.

Sharrett, A. R., Ballantyne, C. M., Coady, S. A., Heiss, G., Sorlie, P. D., Catellier, D., Patsch, W., & Atherosclerosis Risk in Communities Study Group (2001). Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation, 104(10), 1108–1113.

Cassar, K., Bachoo, P., Ford, I., Greaves, M., & Brittenden, J. (2003). Platelet activation is increased in peripheral arterial disease. Journal of vascular surgery, 38(1), 99–103.

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr, Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Jr, Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Sr, Williamson, J. D., … Wright, J. T., Jr (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 71(19), e127–e248.

Mundi, S., Massaro, M., Scoditti, E., Carluccio, M. A., van Hinsbergh, V. W. M., Iruela-Arispe, M. L., & De Caterina, R. (2018). Endothelial permeability, LDL deposition, and cardiovascular risk factors-a review. Cardiovascular research, 114(1), 35–52.

Armstrong, E. J., Wu, J., Singh, G. D., Dawson, D. L., Pevec, W. C., Amsterdam, E. A., & Laird, J. R. (2014). Smoking cessation is associated with decreased mortality and improved amputation-free survival among patients with symptomatic peripheral artery disease. Journal of vascular surgery, 60(6), 1565–1571.

Nieves, J. A., & Kohr, L. (2010). Nursing considerations in the care of patients with pulmonary hypertension. Pediatric Critical Care Medicine, 11, S74-S78.

Archer-Chicko, C. (2011). Nursing care of patients with pulmonary arterial hypertension. Textbook of Pulmonary Vascular Disease, 1531-1558.

Ünsar, S., Özdemir, Ö. ve Yenici Bulut, E. (2019). Pulmoner Hipertansiyon ve Hemşirelik Bakımı. Kardiyovasküler Hemşirelik Dergisi, 10(21):17–24 ss