HA | PAD vs PVD Only

This episode covers everything PAD vs PVD and highlighting the differences and similarities. 🔎 Big Picture (Pareto)PAD = arterial inflow failure ➜ ischemia.PVD (venous) = return failure ➜ pooling/edema.Position test: PAD pain ↓ with dangling ⬇️🦵; PVD pain/edema ↓ with elevation ⬆️🦵.Skin/ulcers: PAD = pale, cool, shiny, hairless; distal, dry “punched-out” ulcers (toes). PVD = warm, brown (hemosiderin), thick; medial ankle, wet/irregular ulcers.Pulses: PAD weak/absent 🚫; PVD usually present ✅.🩸 PAD (Peripheral Artery Disease)Patho: Progressive arterial narrowing → ↓ perfusion → claudication → rest pain → CLI. Hallmarks: Intermittent claudication (exertional ischemic pain, resolves ≤10 min with rest), paresthesia, shiny/taut skin, hair loss, elevation pallor & dependent rubor, rest pain worse at night/elevation. CLI red flags: >2 wks rest pain, nonhealing arterial ulcers, gangrene (↑ risk w/ DM, HF, prior stroke).Dx 🧪:ABI = ankle SBP / higher brachial SBP (⚠️ may be falsely high in DM/elderly due to calcification).Doppler/duplex, segmental pressures, (MR)angiography.Procedures: PTA ± stent; surgical bypass (autogenous vein preferred); prostanoids (CLI, not FDA-approved for CLI); conservative CLI care (pain control, infection prevention, protect limb).Nursing priorities 🩺:Post-revasc: Hourly distal pulses, color/temp/cap refill; REPORT new pain, pallor/cyanosis, numbness/tingling, pulse loss ➜ possible acute occlusion.Positioning: Avoid knee flexion, early ambulation, no prolonged sitting.Education: Smoking cessation, daily foot checks, protective shoes (round toe, soft insole), avoid trauma.Symptom relief: Dangle legs for rest pain (gravity aids flow).♻️ CVI & Venous Leg Ulcers (chronic venous PVD)Patho: Venous hypertension → fluid/RBC leak → edema, inflammation, brown (hemosiderin) discoloration, thick/leathery skin; eczema; painful dependent legs; high infection risk.Cornerstones of care 🧵:Compression = primary (stockings/bandages/IPC/wraps) ONLY after ruling out PAD (ABI first).Elevate legs above heart, daily walking; avoid prolonged sitting/standing & trauma.Moist wound care, monitor for infection; nutrition: protein + vitamins A/C + zinc; tight glucose control in DM.🚨 Rapid Compare (teach-back)Pain: PAD ⛔ elevation, ✅ dangling; PVD ✅ elevation.Pulses/Temp: PAD ↓/cool; PVD normal/warm.Color/Skin: PAD pale→rubor, shiny/hairless; PVD brown, thick, edematous.Ulcers: PAD toe/distal, dry & round; PVD medial ankle, wet & irregular.First moves: PAD ➜ assess pulses, dangle, no compression; PVD ➜ elevate + compress (if no PAD). ✅