Content Reviewers:Lisa Miklush, PhD, RNC, CNS, Jodi Berndt, PhD, RN, CCRN-K, PCCN-K, CNE, CHSE, Gabrielle Proper, RN, BScN, MN, Robyn Hughes, MScBMC
Contributors:Ursula Florjanczyk, MScBMC, Jennifer Montague, PhD, Jerry Ferro, Maria Emfietzoglou, MD
Cardiovascular disorders are disorders of the blood, the blood vessels, and the heart, affecting the body’s ability to carry oxygen and nutrients from the heart to the tissues and remove waste products, such as carbon dioxide from the tissues. Some of these disorders are anemia, venous disorders, and atherosclerosis.
Anemia is a disorder of the red blood cells, or RBCs, that decrease their ability to carry oxygen. This usually develops when there’s low iron or deficiency of certain B vitamins, which leads to decreased production of RBCs.
Anemia also occurs when the person is losing blood due to a disorder, such as ulcers and cancers of the gastrointestinal system.
A biological female can also develop anemia due to heavy menstruations. Other causes include decreased production of RBCs from the bone marrow, inherited disorders that cause abnormal shapes in some RBCs, and hemolytic disorders that cause excessive destruction of RBCs.
Clients with anemia will become tired easily and can have difficulty breathing, and their skin and mucous membrane becomes more pale.
Okay, moving onto venous disorders. Normally, the veins move the blood towards the heart and they have one-way valves to prevent backflow.
In venous disorders, veins lose their elasticity and the valves are not working properly, allowing blood to leak backward and pool in the lower legs.
This makes individuals prone to varicose veins, which is when the veins in the lower legs become enlarged from this additional blood, and they start becoming tortuous, or twisted.
Although there are probably a lot of factors that play into the development of varicose veins in the legs, biological females tend to be more at risk than biological males; people that stand or cross their knees for long periods of time and those who are obese are also at greater risk. Clients with varicose veins often complain of pain in the legs, swelling, and a sensation of heavy legs.
Now, varicose veins can progress to phlebitis, where the stagnant blood in the lower extremities starts to cause an inflammatory reaction in the veins.
This will cause the skin over the vein to become red, warm, and painful. Over time, this pooling of blood can also cause inflammation of the surrounding tissues and potentially even ulcers, called venous stasis ulcers, most often in the ankles.
Venous ulcers cause darkening of the skin as well as itchiness and pain. There can also be a lot of swelling as some of this blood starts to leak out of the veins and into the surrounding tissues of the ankles and the lower legs.
This will cause the skin to become more fragile, or easy to break down, and can lead to an open sore. Pooling of blood can also predispose to the formation of blood clots in the veins.
Thrombophlebitis occurs when a blood clot forms in a vein and causes inflammation. This most often occurs in superficial leg veins, where it’s called superficial thrombophlebitis, and deep leg veins, where it’s called deep vein thrombosis, or DVT.
An individual with DVT will often complain of swelling, redness, and pain in the lower leg. The bad news is that it can lead to life threatening conditions, such as pulmonary embolism, where a broken off piece of the clot, called an embolus, travels to the lungs and causes respiratory problems, like difficulty breathing, chest pain, and coughing.
Alright, generally, venous disorders can affect mobility and clients with these problems might need assistance with daily activities.
As a nursing assistant, you may be asked to assist these clients and help with prescribed leg exercises. Also, for clients at risk for DVTs, you may be asked to apply antiembolic stockings and sequential compression devices, or SCDs.
These both work by exerting pressure on the veins of the lower legs, promoting blood return to the heart instead of pooling in the legs and decreasing the risk for blood clots.
These clients are often prescribed anticoagulant medications to prevent blood clots. It’s important to remember that these medications can affect the ability of the blood to form clots, so in the event of trauma or surgery, there’s an increased risk of bleeding.