Arterioclerosis obliterans is a condition in which the arteries in the lower extremities become so blocked that the transport of oxygenated blood to the tissues is impaired. Occlusion of the arteries can be acute or chronic.
Older men are more at risk than older women. Additional risk factors are a history of coronary artery disease, cerebrovascular disease, diabetes mellitus, and smoking.
Pain is the main symptoms. Intermittent claudication, cramping pain that comes with walking, is extremely common. In advanced cases, patients report cold feet, numbness, tingling, burning pain, or loss of sensation. The skin may be pale or mottled. Pedal pulses are often difficult to locate or are absent. Over a period of time, lack of oxygen causes the legs to take on a shiny appearance. Toenails thicken and hair is sparse on the legs and toes. Leg wounds will not heal well, if at all. A gangrenous limb can be the disastrous outcome.
Treatment attempts to improve circulation to slow the progression of the disease. Programmed walking is often helpful; that is, the patients is instructed to walk until pain sets in, rest, and then walk some more. The head of the bed may be raised three to four inches on blocks to improve circulation at night. Preventing trauma to the legs is also important.
Reference :
Farrell J : Nursing Care of the Older Person, J.B. Lippincott Company, Philadelphia, 1990.
