Arteriosclerosis

Concept
Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from the heart to the
rest of the body (arteries) become thick and stiff sometimes restricting blood flow to the organs and
tissues. Healthy arteries are flexible and elastic. 32% of deaths account for atherosclerosis. 13.8%
prevalence is among adults of 20 years and above.

Definition
Arteriosclerosis is a type of vascular disease where the blood vessels carrying oxygen away from the
heart (arteries) become damaged from factors such as high cholesterol, high blood pressure, diabetes
and certain genetic influences.

Types
a) Atherosclerosis: In this type, the large arteries are hardened and narrowed.
b) Moenckeberg medial calcific sclerosis: The hardening of small to medium-sized arteries.
c) Arteriolosclerosis: The calcification of small arteries.

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 Atherosclerosis

Atherosclerosis is a specific type of arteriosclerosis. Atherosclerosis is the buildup of fats,

cholesterol and other substances in and on the artery walls. This buildup is called plaque. The plaque
can cause arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot.

Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in the
body. Atherosclerosis can be treated. Healthy lifestyle habits can help prevent atherosclerosis.

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Risk Factor
 High cholesterol and triglyceride levels
 High blood pressure
 Smoking
 Type 1 diabetes
 Obesity
 Physical inactivity High saturated fat diet

Etiology /Causes
 High blood pressure.
 High cholesterol.
 High triglycerides, a type of fat (lipid) in the blood.
 Smoking or chewing tobacco.
 Diabetes.
 Insulin resistance.
 Obesity.
 Inflammation from an unknown cause or from diseases such as arthritis, lupus, psoriasis or
inflammatory bowel disease.
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Clinical Manifestation
● Confusion or difficulty talking or understanding others.
● Dizziness, loss of balance or lack of coordination.
● Severe headache.
● Weakness or numbness in the face, arm or leg, usually on one side of the body.
Vision problems in one or both eyes.

Diagnostic Evaluation
 Ankle-brachial index: This test compares the blood pressure between your ankle and
arm using a blood pressure cuff and ultrasound.
 Cardiac imaging tests: These tests include X-ray, CT, MRI, PET and Doppler
ultrasound scans that assess the health of your heart and blood vessels.
 Cerebral angiography: This minimally invasive test allows your doctor to see how
blood circulates through your blood vessels.
 Coronary calcium scan: This is a CT test that shows calcium deposits in the coronary
arteries and scores your risk of heart disease.
 Heart function tests: These tests include electrocardiogram and echocardiogram,
 Stress tests: These tests include stress electrocardiogram and echocardiogram to evaluate
how your heart functions when it is working hard.

Medical Management
For patients who are diagnosed with forms of arteriosclerosis such as coronary artery disease,
peripheral artery disease and carotid artery disease, there are several treatment options available
Treatment options are divided into two categories:
 Medical therapy involves the use of medications such as aspirin, beta blockers and
cholesterol lowering drugs.
 Revascularization therapy procedures include coronary stenting and coronary bypass surgery.

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Nursing Management

A. Nursing Assessment:

● Assess patient's and family's knowledge of disease.

● Obtain a baseline 12 lead ECG.
● Identify patient's and family's level of anxiety.
● Gather inf. About the patient's cardiac risk factors.
● Evaluate patient's Medical history for such conditions as heart failure, previous MI or
obstructive lung disease that may influence choice of drug therapy.
● Discuss with patient current activity level.
● Discuss patient's beliefs about modifications of risk factors and willingness to change.

B. Nursing Diagnosis:
 Ineffective Tissue Perfusion related to decreased arterial blood flow and narrowing of the
arteries.
 Risk for Impaired Skin Integrity related to compromised circulation and reduced tissue
perfusion.
 Imbalanced Nutrition: Less Than Body Requirements related to dietary restrictions and
decreased appetite.
 Ineffective Self-Health Management related to insufficient knowledge of risk factors and
lifestyle modifications.
 Risk for Activity Intolerance related to reduced oxygen supply to tissues and decreased
cardiovascular endurance.
 Risk for Impaired Gas Exchange related to compromised blood flow to the pulmonary
system.
 Anxiety related to the fear of complications and uncertainty about the disease
progression.
 Deficient Knowledge regarding arteriosclerosis, risk factors, and self-care measures.
 Risk for Falls related to impaired peripheral circulation and decreased balance.
 Ineffective Coping related to the emotional impact of arteriosclerosis and the need for
lifestyle modifications.
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 C. Nursing Care Plan & Goals:
 Improving tissue perfusion.
 Improve skin integrity.
 Improve nutritional balance.
 Maintain healthy lifestyle.
 Reduce anxiety.
 Improve disease knowledge.
D. Nursing Interventions

Promote Tissue Perfusion:

 Encourage regular physical activity within the patient’s capabilities to improve blood
flow and promote collateral circulation.
 Assist with positioning to optimize blood flow to affected areas (e.g., elevating legs for
peripheral artery disease).
 Provide warm compresses or heating pads to promote vasodilation and enhance tissue
perfusion.
 Educate the patient on the importance of maintaining healthy blood pressure and
cholesterol levels to support adequate perfusion.

Monitor and Manage Skin Integrity:

 Perform regular skin assessments to identify areas of compromised circulation and potential
skin breakdown.
 Promote proper hygiene and skin care, ensuring adequate hydration and moisturization.
 Implement measures to prevent pressure ulcers, such as repositioning, using specialized
cushions or mattresses, and providing skin protection.

Optimize Nutrition:

 Collaborate with a nutritionist to develop a heart-healthy diet plan tailored Educate the
patient on the importance of a balanced diet low in saturated fats, cholesterol, and sodium.
 Educate the patient on the importance of a balanced diet low in saturated fats, cholesterol,
and sodium.
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  Provide support and resources for the patient and family to make dietary changes, such as
meal planning and healthy cooking techniques.
 Monitor and assess the patient’s nutritional status regularly and make appropriate referrals if
needed.

Promote Self-Health Management:

 Provide education on modifiable risk factors, such as smoking cessation, regular exercise,
and stress management techniques.
 Collaborate with the patient to set achievable goals and develop a personalized plan for risk
factor modification.
 Teach the patient how to monitor blood pressure and cholesterol levels at home, and provide
guidance on medication adherence.
 Offer resources and referrals to support smoking cessation programs, exercise programs, and
stress reduction strategies.

Enhance Activity Tolerance:

 Collaborate with physical therapists to develop an individualized exercise program that is

safe and appropriate for the patient’s condition.
 Encourage gradual increase in physical activity, focusing on aerobic exercises and strength
training within the patient’s capabilities.
 Monitor vital signs and symptoms during exercise to ensure safety and make adjustments as
necessary.
 Educate the patient on energy conservation techniques to optimize activity tolerance and
prevent fatigue.

Manage Gas Exchange:

 Monitor respiratory status regularly, including respiratory rate, oxygen saturation levels, and
signs of respiratory distress.
 Encourage deep breathing exercises and use of incentive spirometry to promote optimal lung
function.
 Collaborate with respiratory therapists to develop a respiratory care plan, including
techniques for effective coughing and airway clearance.
 Provide education on the importance of maintaining a smoke-free environment and avoiding
exposure to respiratory irritants.

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Decrease Anxiety:

 Establish a therapeutic nurse-patient relationship to provide emotional support and

reassurance.
 Teach relaxation techniques, such as deep breathing exercises and guided imagery, to
help manage anxiety.
 Encourage the patient to express their concerns and provide accurate information about
arteriosclerosis and its management.
 Collaborate with the healthcare team to identify additional resources, such as counseling
or support groups, to address anxiety.
E. Evaluation
 Improved tissue perfusion.
 Improved skin integrity.
 Improved nutritional balance.
 Maintained healthy lifestyle.
 Reduced anxiety.
 Improved disease knowledge.

Prevention
The best treatment for arteriosclerosis-related diseases is prevention. To help keep plaque from
accumulating in your arteries:
 Control your blood pressure
 Manage risk factors like diabetes
 Exercise regularly
 Don’t smoke
 Maintain a healthy diet
If you are worried about your risk for developing arteriosclerosis, talk to your doctor about a lifestyle
plan that is best for you and any recommended preventive medicationard.

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Complications
The complications of atherosclerosis depend on which arteries are narrowed or blocked. For
example:
 Coronary artery disease: When atherosclerosis narrows the arteries close to your heart, you
may develop coronary artery disease, which can cause chest pain (angina), a heart attack or
heart failure.
 Carotid artery disease: When atherosclerosis narrows the arteries close to your brain, you
may develop carotid artery disease. This can cause a transient ischemic attack (TIA) or
stroke.
 Peripheral artery disease: When atherosclerosis narrows the arteries in your arms or legs,
you may develop blood flow problems in your arms and legs called peripheral artery disease.
This can make you less sensitive to heat and cold, increasing your risk of burns or frostbite.
Rarely, a lack of blood flow to the arms or legs can cause tissue death (gangrene).
 Aneurysms: Atherosclerosis can also cause aneurysms, a serious complication that can occur
anywhere in the body. Most people with aneurysms have no symptoms. Pain and throbbing in
the area of an aneurysm may occur and is a medical emergency. If an aneurysm bursts, it can
cause life-threatening bleeding inside the body.
 Chronic kidney disease: Atherosclerosis can cause the arteries leading to the kidneys to
narrow. Narrowing of these arteries prevents enough oxygen-rich blood from reaching the
kidneys. The kidneys need enough blood flow to help filter waste products and remove
excess fluids.