Advanced practice nurses often treat patients with vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT). While the symptoms of both disorders are noticeable, these symptoms are sometimes mistaken for signs of other conditions, making the disorders difficult to diagnose. Nurses must examine all symptoms and rule out other potential disorders before diagnosing and prescribing treatment for patients. In this Assignment, you explore the epidemiology, pathophysiology, and clinical presentation of CVI and DVT.
To Prepare
- Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.
- Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
- Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis.
To Complete
Write a 2- to 3-page paper that addresses the following:
All papers submitted include a title page, introduction, summary, and references
- Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.
- Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
- Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.
References:
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby. Chapter 23, “Structure and Function of the Cardiovascular and Lymphatic Systems”This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.Chapter 24, “Alterations of Cardiovascular Function”This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.Chapter 25, “Alterations of Cardiovascular Function in Children”This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart disease from acquired cardiovascular disorders. Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education. Chapter 11, “Cardiovascular Disorders: Vascular Disease”This chapter begins with an overview of the vascular component of the cardiovascular system and how the cardiovascular system is normally regulated. It then describes three common vascular disorders: atherosclerosis, hypertension, and shock.
- http://www.heart.org/HEARTORG/
http://millionhearts.hhs.gov/index.html
http://www.nhlbi.nih.gov/
Rubric:
Quality of Work Submitted: The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.–Levels of Achievement:Excellent 27 (27%) – 30 (30%) Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.Good 24 (24%) – 26 (26%) Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.Fair 21 (21%) – 23 (23%) Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.Poor 0 (0%) – 20 (20%) Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.Feedback:Quality of Work Submitted: The purpose of the paper is clear.–Levels of Achievement:Excellent 5 (5%) – 5 (5%) A clear and comprehensive purpose statement is provided which delineates all required criteria.Good 4 (4%) – 4 (4%) Purpose of the assignment is stated, yet is brief and not descriptive.Fair 3.5 (3.5%) – 3.5 (3.5%) Purpose of the assignment is vague or off topic.Poor 0 (0%) – 3 (3%) No purpose statement was provided.Feedback:Assimilation and Synthesis of Ideas: The extend to which the work reflects the student’s ability to:
Understand and interpret the assignment’s key concepts.–Levels of Achievement:Excellent 9 (9%) – 10 (10%) Demonstrates the ability to critically appraise and intellectually explore key concepts.Good 8 (8%) – 8 (8%) Demonstrates a clear understanding of key concepts.Fair 7 (7%) – 7 (7%) Shows some degree of understanding of key concepts.Poor 0 (0%) – 6 (6%) Shows a lack of understanding of key concepts, deviates from topics.Feedback:Assimilation and Synthesis of Ideas: The extend to which the work reflects the student’s ability to:
Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.–Levels of Achievement:Excellent 18 (18%) – 20 (20%) Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.Good 16 (16%) – 17 (17%) Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.Fair 14 (14%) – 15 (15%) Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.Poor 0 (0%) – 13 (13%) Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.Feedback:Assimilation and Synthesis of Ideas: The extend to which the work reflects the student’s ability to:
Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.–Levels of Achievement:Excellent 18 (18%) – 20 (20%) Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.Good 16 (16%) – 17 (17%) Summarizes information gleaned from sources to support major points, but does not synthesize.Fair 14 (14%) – 15 (15%) Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.Poor 0 (0%) – 13 (13%) Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.Feedback:Written Expression and Formatting
Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.–Levels of Achievement:Excellent 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarityGood 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.Fair 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.Poor 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.Feedback:Written Expression and Formatting
English writing standards: Correct grammar, mechanics, and proper punctuation–Levels of Achievement:Excellent 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.Good 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors.Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors.Poor 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Feedback:Written Expression and Formatting
The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–Levels of Achievement:Excellent 5 (5%) – 5 (5%) Uses correct APA format with no errors.Good 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors.Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors.Poor 0 (0%) – 3 (3%)
Expert Solution Preview
The pathophysiology of chronic venous insufficiency (CVI) involves venous hypertension and inadequate venous return due to damaged venous valves. This leads to increased hydrostatic pressure in the veins, causing fluid leakage into the surrounding tissues and the development of edema. CVI is often associated with varicose veins, which are dilated, tortuous veins that result from chronic venous hypertension.
On the other hand, deep venous thrombosis (DVT) occurs when a blood clot forms in the deep veins, typically in the lower extremities. The clot formation can obstruct blood flow and cause inflammation in the affected area. If the clot dislodges and travels to the lungs, it can result in a life-threatening condition known as pulmonary embolism.
Venous thrombosis differs from arterial thrombosis in several ways. Arterial thrombosis usually occurs in the arteries and is associated with atherosclerosis, a condition characterized by the buildup of plaque in the arterial walls. The clot in arterial thrombosis is typically composed of platelets and fibrin, while the clot in venous thrombosis is primarily made up of red blood cells and fibrin. Additionally, arterial thrombosis is more likely to cause severe tissue damage due to the lack of oxygen and nutrients supplied by the affected artery.
The patient factor I selected is age. Aging can contribute to the development of both CVI and DVT. As individuals age, the elasticity of the blood vessels decreases, making them more prone to damage and dysfunction. This can lead to the development of varicose veins and venous insufficiency. Additionally, with age, the blood flow in the veins may slow down, increasing the risk of blood clot formation. Age-related conditions such as obesity, immobility, and underlying chronic diseases further increase the risk of CVI and DVT.
To diagnose CVI and DVT in an older adult patient, a thorough history and physical examination would be necessary. The patient’s symptoms, such as leg pain, edema, and skin changes, would be assessed. Diagnostic tests such as duplex ultrasound, venography, and D-dimer blood test may be utilized to confirm the diagnosis. Treatment for CVI may include measures to manage symptoms, such as elevating the legs, wearing compression stockings, and promoting regular exercise. In severe cases, surgical interventions such as venous ablation or bypass surgery may be considered. Treatment for DVT typically involves anticoagulation therapy to prevent further clot formation and promote clot resolution.
In summary, chronic venous insufficiency and deep venous thrombosis have distinct pathophysiologies. Venous thrombosis differs from arterial thrombosis in terms of clot composition and associated complications. Age can impact the development of CVI and DVT, and it should be considered in the diagnostic and treatment approach for these conditions in older adult patients. Mind maps can be used as visual tools to summarize and organize the epidemiology, pathophysiology, clinical presentation, and treatment strategies for CVI and DVT.
