Nursing

1. ATHEROSCLEROSIS
Ms. Towar Shilshi
Asst. Prof
JINS

2. INTRODUCTION
Atherosclerosis occurs when the blood vessels that carry oxygen
and nutrients from the heart to whole body becomes stiff and thick.
Usually arteries are flexible and elastic but over time, the wall of
arteries can harden, a condition commonly called hardening of the
arteries.

3. DEFINITION
It is defined as accumulation of fat in the wall of blood vessels
(artery or veins) or hardening of blood vessels due to increase level of
cholesterol in blood or serum.

4. ETIOLOGY / RISK FACTORS
Genetic.
Environment.
Smoking.
Elevated serum cholesterol.
Diabetes.
Obesity.
Physical inactivity.

5. PATHOPHYSIOLOGY
Due to etiologic and risk factors
Inflammation in intima layer in vessel
Continued exposure to source of intima injury results in continued lipid
deposit and proliferation of smooth muscle cells.
Formation of plaque (artheromas)
Narrowing and obstruction blood flow

6. CLINICAL MANIFESTATION
1) Brain ( Cerebral arteriosclerosis)
Transient ischemic attacks (TIA)
2) Heart (CAD)
Angina pectoris, MI, Heart failure.
3) GI Tract (Aortic aneurysm, mesenteric ischemia)
Abdominal , weight loss, lower back pain.
4) Kidneys (Renal artery stenosis)
Renal insufficiency, hypertension.
5) Extremities (Lower extremities arterial occlusive disease).
Pain in muscles, pain at rest.
Necrosis
Cyanosis

7. DIAGNOSTIC EVALUATION
• History collection.
• CT
• ECG
• MRA (Magnetic Resonance Angiography)
• Arteriography.
• MRI
• ECG

8. COMPLICATIONS
• Stable and unstable angina.
• Heart failure.
• MI
• Renal failure.
• Aneurysm.

9. MEDICAL MANAGEMENT
• Anticoagulant or antiplatelet therapy
• Heparin , streptokinase.
• Lipid lowering agent
• Nicotinic acid (niacin)
• Fibric acids.
• Fenofibrate (reduce synthesis of cholesterol)
• Co – Enzyme reductase
• Lovastatin
• Atorvastin
• Simvastin
(They decrease triglycerides, level of serum also decreased
synthesis of cholesterol).

10. SURGICAL MANAGEMENT
PTCA ( Percuteneous Transluminal Coronary Angioplasty)
CABG (Coronary artery bypass grafting).

11. NURSING DIAGNOSIS
1. Ineffective tissue perfusion related to obstruction in the blood flow
2. Deficient knowledge related to treatment modalities.
3. Anxiety related to changes in health status.
4. Risk for decreased cardiac output related to increases vascular
resistance

12. NURSING MANAGEMENT
Provide instructions on ways the client can reduce intake of saturated
fat and cholesterol
Reduce intake of meat fat
Use vegetable oil rather than coconut oil or palm oil in cooking or
food preparation.
Use cooking methods such as boiling, steaming etc.
Administer lipid lowering agents as prescribed.
Encourage to do exercises.

13. THANK YOU