PAD vs PVD Practice Questions with Answers and NCLEX® Review

It’s estimated that >200 million people have PAD worldwide, with a spectrum of symptoms from none to severe.

PVD, also known as Peripheral venous insufficiency (PVI) affects the arteries that carry blood to the limbs. PVD occurs when there is atherosclerosis (fatty deposits) in the arteries that supply blood to the feet and legs. The arteries can become hardened and narrowed, which makes it difficult for blood to flow through them.

PVD can lead to damage or loss of tissue in the legs and feet, as well as pain and decreased mobility.

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Peripheral Artery Disease (PAD) Symptoms

The most common symptom of peripheral artery disease is leg pain during exercise or when at rest (usually felt in the calves or thighs).

Other symptoms include:

• Cold hands or feet
• Tingling, numbness, or burning pain in your hands or feet
• Pain that doesn’t go away with rest (that may be worse in the morning)
• Cramping muscle pain in the calves when walking uphill or downhill
• Pain that gets worse with time
• Swelling in your feet and legs
• Feeling tired after walking short distances

Peripheral Vascular Disease (PVD) Symptoms

Peripheral vascular disease (PVD) is a condition in which the arteries and veins that carry blood to and from the arms, legs, and feet become narrowed or blocked. Some clients with PVD may only have numbness, tingling, or a “dead” feeling in their legs.

Other symptoms of PVD include:

• Weakness in the legs that can make it hard to stand up or walk
• Swelling of your legs, ankles, or feet
• Pain in the feet and ankles when walking or standing
• Tightness in the leg muscles when walking
• Leg cramps at night
• Heaviness in the legs
• Feeling cold or clammy to the touch
• Skin color changes (such as redness or blotchy spots) on the toes or feet

What Causes Peripheral Artery Disease (PAD)?

PAD is a condition that occurs when the arteries in the body are narrowed or blocked. It can be caused by atherosclerosis, in which artery walls become thickened and hardened due to plaque buildup.

Atherosclerosis can occur anywhere in the body, but it is most common in the heart and brain, where it often causes heart attacks and strokes, respectively. This can lead to blocked or narrowed arteries, which can lead to poor circulation, pain when walking, and even heart attacks.

The main risk factors for PAD include smoking, diabetes, high blood pressure, and high cholesterol levels. Other risk factors include:

• Age: PAD is more common in older people.
• Sex: Men are more likely than women to have PAD.
• Race: African-Americans are more likely than Caucasians to have PAD.
• Family history of peripheral artery disease can increase your risk of developing it yourself.

What Causes Peripheral Vascular Disease (PVD)?

The causes of PVD are varied, but they generally fall into two categories: those related to aging and those related to other health conditions.

Aging-related causes include high cholesterol levels and smoking. Other health conditions that can cause PVD include diabetes, heart failure, previous heart attack, and stroke.

The most common cause of PVD is atherosclerosis. Like PAD, this disease causes plaque buildup in arteries that carry oxygen-rich blood to the heart and brain.

Peripheral Artery Disease (PAD) Treatment

Treatment for peripheral artery disease (PAD) includes a variety of interventions, involving lifestyle changes, medications, and surgery. Some of these surgeries include amputation, atherectomy, and percutaneous transluminal angioplasty (for larger blood vessels or necrosis cases)

Peripheral Artery Disease (PAD) Nursing Interventions

Nurses can encourage clients to:

• Eat low-fat diets
• Exercise regularly
• Avoid smoking cigarettes and drinking alcohol
• Control blood pressure with medication (if necessary)
• Maintain a healthy weight
• Wear compression stockings or anti-embolic devices (during air travel and long periods of sitting.)

For improved skin integrity, increased circulation, and reduced discomfort, nursing goals for PAD clients include:

• Avoiding extreme cold and dressing loosely.
• Not smoking.
• Avoiding bending the knees or crossing legs (may restrict blood flow).
• Taking antiplatelets, anticoagulants, or cholesterol drugs, as prescribed.
• Avoiding wearing clothing or shoes that are too restrictive.
• Following a low-fat diet and including exercise.

PAD clients require regular check-ins to keep track of any changes.

Peripheral Vascular Disease (PVD) Treatment

PVD is treated by:

• Managing risk factors.
• Focusing on any underlying cause such as diabetes, hypertension or hypercholesterolemia.
• Providing care for affected areas of the body.
• Medications:
  • Antihypertensive medications to lower blood pressure.
  • Statins to lower cholesterol.
  • Antiplatelets like aspirin or clopidogrel to prevent blood clots.
  • Medications like alpha-glucosidase inhibitors to control blood sugar.
• Surgery:
  • Angioplasty or stent placement
  • Bypass surgery
  • Thrombolytic therapy at the site

Peripheral Vascular Disease (PVD) Nursing Interventions

Nurses may provide compression stockings or recommend physical therapy or exercise programs designed to increase circulation in affected areas.

Nurses can educate PVD clients about the condition and its treatment options, administer medications that help prevent clotting and reduce inflammation, and advise clients on lifestyle choices.

If blood clots get into the lungs, clients could have chest pain, dyspnea, breathing problems, low oxygen saturation, and rapid breathing. Blood clots may be treated with Warfarin, Heparin, and other blood thinners.

To help reduce the risk of developing blood clots, nursing goals for PAD clients include:

• Watching for warm, red, painful, and swollen symptoms of a dislodged clot.
• Elevating the lower extremities above the heart (to encourage blood flow after work or at the end of the day before going to sleep).
• Avoiding sitting for long periods of time.
• Avoiding standing or sitting for extended periods of time.
• Wearing compression stockings.
• Avoiding smoking.

Interventions that help reduce symptoms like pain or numbness, improve quality of life and mobility, and decrease the overall risk of complications from PVD.

PAD vs PVI Conclusion

Peripheral artery disease (PAD) and peripheral vascular disease (PVD) are two conditions that affect the blood vessels of the lower extremities, or legs. They are both considered forms of arterial insufficiency because they cause reduced blood flow to the legs.

With PAD, a client’s arteries have been damaged by atherosclerosis, which causes them to narrow and thicken. On the other hand, with PVD, this narrowing and thickening affect the veins of the lower extremity as well as the arteries, especially in clients who have diabetes or high cholesterol levels.

The most common symptom of PAD is pain in the legs when walking or exercising; this pain usually occurs after walking for about 10 minutes but can also occur at rest. Other symptoms include pain with swelling in one or both legs, cramping in one or both calves, numbness and tingling in one or both legs, and coldness in one or both feet or ankles.

Although PAD doesn’t always cause symptoms, it can lead to serious complications if left untreated. These include leg ulcers (abnormal breaks in the skin), gangrene (death of tissue due to lack of blood flow), heart attack, stroke, and claudication.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948585/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6113064/
https://healthcare.utah.edu/cardiovascular/conditions/peripheral-vascular-disease.php
http://www.nlm.nih.gov/medlineplus/peripheralarterialdisease.html