Raynaud’s phenomenon

1. Raynaud’s phenomenon
By Master Student
Haider Mohammed

2. Raynaud’s phenomenon is a form of
intermittent arteriolar vasoconstriction that
results in coldness, pain, and pallorof the
fingertips or toes. There are two forms of
this disorder:

3. 1- Primary or idiopathic Raynaud’s
(Raynaud’s disease) occurs in
the absence of an underlying disease.
2- Secondary Raynaud’s
(Raynaud’s syndrome) occurs in association
with an underlying disease, usually a
connective tissue disorder, such as systemic
lupus erythematosus, rheumatoid arthritis, or
scleroderma; trauma; or obstructive arterial
lesions.

6. Raynaud’s phenomenon is most common
in women between 16 and 40 years of
age, and it occurs more frequently
in cold climates and during the winter.
Male : female = 1:5

7. - Immunologic disorders
- Scleroderma
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Obstructive arterial disease
- Diseases of arteries
- Some Drugs

8. 1- pallor brought on by sudden
vasoconstriction.
2- become bluish (cyanotic) because of
pooling of deoxygenated blood during
vasospasm.
3- a red color (rubor) is produced when
oxygenated blood returns to the digits after
the vasospasm stops.
4- Numbness, tingling

9. 5- burning pain occur as the color
changes.
The manifestations tend to be bilateral and
symmetric and may involve toes and
fingers.

10. 1- Primary
- Age
- Gender
- Family history
- Climate
2- Secondary
- Associated diseases
- Certain occupations
- Exposure to certain substances

11. serious complications such as gangrene
and amputation, but these complications
are uncommon unless the patient has
another underlying disease causing arterial
occlusions.

12. 1- Physical exam for Fingers & toes
2- Imaging studies, including thermography (IRT)
and arteriography
3- CBC (FBC)
4- RFT/BUN/ S.Creatinine - To evaluate for
possible renal impairment or dehydration
5- ANA (ANF) - May be positive in autoimmune
disorders and should be obtained in patients with
features of these disorders
6- Serum CPK- Elevated in muscle damage

14. 1- Calcium channel blockers (nifedipine
[Procardia], amlodipine [Norvasc]) may be
effective in relieving symptoms.
2- Sympathectomy (interrupting the
sympathetic nerves by removing the
sympathetic ganglia) may help some patients.
3- Avoid some medications cause narrowing
blood vessels (amphetamines, drugs of
cancer)

15. 1- Acute pain related to tissue ischemia
secondary to vasospasm.
2- Ineffective peripheral tissueperfusion
related to lack of supplies to extremities
secondary to vasospasm
3- Anxiety related to disease process

16. 1- The nurse teach patient Avoiding the
particular stimuli (cold, tobacco) that provoke
vasoconstriction is a primary factor in
controlling Raynaud’s phenomenon.
2- Instruct the patient about the should wear
layers of clothing or gloves when going
outside.
3- Patients should be cautioned to handle
sharp objects carefully to avoid injuring their
fingers.

17. 4-Assess vital signs, noting tachycardia,
hypertension, and increased respiration
5- Given medications for pain such as
analgesics as prescribe to relieve pain.
6- Asses the patient for the blood circulation,
color and sensation at the extremities every
2hrs
7- apply warm compress at the affected area
8- provide moral and emotional support to
patient to relief the anxiety level