Cardiovascular system: Blood, venous, and arterial disorders

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.

Okay, next up is atherosclerosis, which is the hardening and decreased elasticity of arteries caused by the buildup of plaques.

These plaques are called atheromatous plaques, and they consist of fat that accumulate on the inside the wall of the artery.

They’re thrombogenic, meaning they cause blood clots to form on them. The plaque and the blood clot can obstruct the blood flow, and after about 70% of the blood vessel is occluded, cell death begins in the areas that were relying on the blood flow; this is called ischemia.

If blood flow is reduced in the coronary arteries that supply the heart, a heart attack can occur. If it’s reduced in the arteries that supply the brain, a stroke can occur, while in the kidneys, it can cause renal failure.

If the obstruction is in the arteries that supply the legs, it can lead to peripheral vascular disease and ischemia, which is characterized by cramping during exercise.

Other symptoms include leg or foot wounds or ulcers that don’t heal up normally as well as color changes of the skin. The foot usually turns pale white when it’s raised and red when it’s lowered.

But the complications of atherosclerosis don’t stop there! The buildup of plaque also weakens the artery walls, which means it can lead to an aneurysm, especially in the abdominal aorta, which is the major artery in the abdomen.

In addition, occasionally some of the plaque can also break off from the main plaque and become an embolus, floating around in the bloodstream until it gets stuck in another blood vessel, which could cause problems in the organ supplied by the vessel.

Alright, now there are a few things the client can do to prevent atherosclerosis. Maintaining a normal blood pressure, not smoking, and avoiding excessive sugary and fatty foods and drinks all reduce the risk for atherosclerosis.

Some medical conditions, like hypertension, diabetes, and obesity, will also increase the risk. There are other risk factors that may be out of your control though.

You’re more likely to get atherosclerosis as you get older. Biological males and people who have a family history with atherosclerosis are also more prone to the disease.Alright, now when assisting clients with anemia or vascular diseases, there are a few things you should report to the nurse right away.

Let the nurse know if your client complains of getting tired easily with normal activity or exercise, has difficulty breathing, or if their mucous membrane becomes pale.

Next, report if the client complains of swelling, redness, pain, warmth, or numbness in the lower leg. Finally, let the nurse know if you notice the lower extremities are pale, cold, swollen, or if you see any abnormalities on the skin, like ulcers.

All right, as a quick recap... Common cardiovascular disorders include anemia, venous disorders, and atherosclerosis.

Anemia is a disorder of RBCs and can result from low iron and B vitamin levels as well as chronic blood loss. Venous disorders include varicose veins, phlebitis, venous stasis ulcers, and thrombophlebitis.

Atherosclerosis occurs when there’s build up of plaques inside the blood vessel and can lead to heart attacks, strokes, renal failure, peripheral vascular ischemia, aneurysms, and emboli.

When assisting with client care, remember to report any signs or symptoms of cardiovascular disease to the nurse and document the date and time of