for nursing

2. BUERGER'S DISEASE
(THROMBOANGIITIS
OBLITERANS)

3. Definition
• Buerger's disease is a type of vasculitis in which there is
inflammation of the small and medium sized arteries and
veins of the hands or feet.
• Buerger's disease also called thromboangiitis obliterans.

4. Incidence:
Is often seen in men, directly relates to smoking,
who are heavy cigarette smokers.

5. THE CAUSE OF BUERGER'S DISEASE
• Smoking and the use of chewing tobacco.
• It is theorized that tobacco triggers an autoimmune
reaction, in which the body's immune system mistakes
healthy tissues as potentially dangerous invades into
the body and attacks them.
(This causes inflammation and the development of clots
in the arteries and veins of the hands and feet that are
characteristic of Buerger's disease.)

6. PATHOPHYSIOLOGY
Due to etiological factors
interferes with circulation leading to
ischemia of cells and tissues.
During ischemia, cells are unable to
reproduce normally recover effectively
from injury,and fight infection.
Buerger's disease

7. SYMPTOMS OF BUERGER'S DISEASE
• Pain in the hands and feet (claudication type pain) and
the development of sores or lesions that do not heal.
• If Buerger's disease is left untreated, gangrene (tissue
death) can occur.
• Intermittent leg pains
• Leg numbness
• Leg tingling/burning/
Leg paresthesias
• Changes in color
• Weak/ decreased pulsation in
Dorsalis pedis, posterior tibial

8. DIAGNOSIS
• Medical history
• Tobacco use history
• Physical examination
• Diagnosis of Buerger's disease is based on medical history
and examination combined with ruling out a variety of
other diseases and conditions, such as Raynaud's
phenomenon and other types of vasculitis.
• CBC
• A test called an angiogram may be performed to assist in
diagnosis of Buerger's disease.
(An angiogram is an imaging test that creates a picture of the
arteries and can reveal the artery damage and blockages in
the hands and feet that are typical of Buerger's disease)

9. Management:
Buerger's disease can often be successfully
before the development of complications.
• Treatment involves quitting smoking.
• Low cholesterol diet
• Low salt diet
• Physical exercise
• Control weight
• Surgical- Sympathectomy [Transection
nerve, ganglion]
• Amputation
treated
of

10. • Analgesics
• Vasodilators
• Wound care for early healing

11. Complications
medical complications related to• Review possible
Buerger's disease:
• Leg blood clots
• blocked leg arteries
• Finger ulcers
• Toe ulcers
• Toe gangrene
• Foot gangrene
• Edema of legs
• Changes in nails and
skin
• Disability

12. NURSING MANAGEMENT
• Assessing & monitoring anti coagulant therapy
• Providing comfort
• Applying elastic compression stocking
• Positioning the body & encouraging exercise
• Identify risk factors predisposing patient to DVT,
reevaluate status frequently
• Implement ordered prophylactic regimen Non-
pharmacological & pharmacological
• Assess all of the patients extremities on a regular basis
• Encourage early ambulation & active leg exercise every
hour the patient is awake .
• Monitor for low grade fever to detect thrombophlebitis
• Encourage fluid intake.
• Use of knee gatch (or) pillows under the knees.

13. knee gatch

14. NURSING DIAGNOSIS
• Acute pain related to venous congestion,impaired
venous return and inflammation.
• Ineffective health maintenance related to lack of
knowledge about disorder and its treatment.
• Risk for impaired skin integrity related to peripheral
tissue perfusion.
• Risk for potential bleeding related to anticoagulant
therapy.