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Nursing 281 > 10 minute topic vascular disease > Flashcards

10 minute topic vascular disease Flashcards

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1
Q

Vascular diseases

A

PVD (peripheral vascular disease) and PAD (peripheral arterial disease)
both have interference of normal blood flow

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2
Q

PAD (peripheral arterial disease)

A

results from atherosclerosis usually the lower extremities

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3
Q

Atherosclerosis

A

gradual thickening of the intima and media of the arteries, ultimately resulting in the progressive narrowing of the vessel lumen

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4
Q

Classifications of PAD

A

Inflow (distal aorta and iliac arteries)

Outflow – femoral, popliteal & tibial artery

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5
Q

subtypes of PAD

A

Buerger’s, subclavian steal, thoracic outlet syndrome, Raynaud’s, popliteal entrapment

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6
Q

PAD risk factors

A

HTN, hyperlipidemia, DM, Smoker, Obesity, sedentary lifestyle, familial predisposition, age

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7
Q

PAD s/sx

A 
Burning pain during exercise (intermittent claudication)
Pain while in bed
< cap refill
< distal pulse
Loss of hair on calf
Dry, scaly skin
thick toenails
muscle atrophy
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8
Q

PAD diagnostic tests

A

Arteriography
Exercise tolerance test
Plethysmography

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9
Q

PAD Arteriography

A

arterial injection of contrast medium, under fluoroscopy

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10
Q

PAD Arteriography nursing actions

A

(same as with cardiac cath) Observe for bleeding and hemorrhage. Palpate pedal pulses to identify possible post-procedure occlusions

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11
Q

PAD Exercise tolerance test

A

used to evaluate claudication during exercise

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12
Q

PAD Plethysmography

A

used to determine the variations of blood passing through an artery, thus identifying abnormal arterial flow in the affected limb

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13
Q

PAD nursing care

A

encourage exercise
avoid crossing legs
elevate the legs but not above the heart
promote vasodilation and reduce vasoconstriction

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14
Q

Medications for PAD

A

ASA, clopidogrel (Plavix) Pentoxifylline (Trental)
give with meals
need several weeks to take effect
Antiplatelets

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15
Q

Anti-platelet teaching

A

take with food
monitor for signs of bleeding
meds take weeks for effect

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16
Q

PAD surgical interventions

A

Percutaneous transluminal angioplasty

Arterial revascularization

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17
Q

Percutaneous transluminal angioplasty

A

balloon or stint them open

will be on anti-platelet therapy for 1-3 months

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18
Q

Arterial revascularization

A

used for severe claudication and/or limb pain at rest

bypass graft around occlusion

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19
Q

Arterial revascularization post procedure nursing actions

A

monitor BP, hypotension increases risk of clot or graft collapse
limit hip and knee bending
pain may be severe when reestablishing blood flow

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20
Q

Arterial revascularization PT teaching

A

avoid crossing legs
loose clothing
no smoking or cold due to vasoconstriction
foot care

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21
Q

Arterial revascularization complications

A

Graft occlusion

Compartment syndrome

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22
Q

Compartment syndrome

A

Tissue pressure within a confined body space can restrict blood flow and the resulting ischemia can lead to irreversible tissue damage

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23
Q

Examples of PVD’s

Study These Flashcards
A 
venous thromboembolism (VTE)
venous insufficiency
varicose veins
24
Q

venous thromboembolism (VTE)

Study These Flashcards
A

blood clot formed as a result of venous stasis, endothelial injury, or hypercoagulability (hypercoagulation)

25
Thrombophlebitis
thrombus that is associated with inflammation
26
Venous insufficiency
occurs secondary to incompetent valves in the deeper veins of the lower extremities
27
Varicose veins
enlarged, twisted and superficial veins
28
VTE risk factors
``` Hip surgery, total-knee replacement, open prostate surgery Heart failure Immobility Pregnancy Oral contraceptives ```
29
Venus insufficiency risk factors
Sitting or standing in one position over a long time Obesity Pregnancy Thrombophlebitis
30
Varicose veins risk factors
``` A person over 30yrs with standing occupation Pregnancy Obesity Systemic diseases Family history ```
31
VTE s/sx
``` Can be asymptomatic Calf or groin pain – classic sign Tenderness – classic sign Sudden onset of swelling – classic sign assess for SOB & chest pain (feeling of impending doom) ```
32
Venus insufficiency s/sx
Pain Stasis ulcers -typically found around ankles Stasis dermatitis (brown discoloration around ankles that can extend up the calf relative to the level of insufficiency) Edema
33
Varicose veins s/sx
Aching pain (dull) Distended superficial veins (visible just below the skin) Tortuous in nature
34
D-dimer diagnostic test
measures fibrin degradation products present in the blood produced from fibrinolysis. indicates thrombus formation has possibly occurred
35
Venous duplex ultrasonography diagnostic test
uses high-frequency sound waves to provide picture of the blood flow through a blood vessel.
36
Impetus plesmography
determine the variations of blood passing through a vein, thus identifying abnormal venous flow in the affected limb
37
Venogram
if other tests are negative but they still suspect a DVT | they put a contrast medium material into the vein and use x-ray and fluoroscopy to see it
38
Trendelenburg test
used for varicose veins If they fill proximally there are varicose veins If they fill distally there are none (normal)
39
DVT & thromblophlebitis nursing care
``` encourage rest elevate extremity no massage warm compress compression or antiembolism stockings ```
40
Venous Insufficiency nursing care
Elevate legs several times a day for at least 15 to 30 min Elevate feet at least 6 inches at night Avoid crossing legs and constrictive clothing or stockings TED hose – after the legs have been elevated and when swelling is at a minimum.
41
Therapeutic procedures for varicose veins
sclerotherapy Vein Stripping Endovenous Laser Treatment Radiofrequency Energy application
42
sclerotherapy
chemical solution is injected into the varicose vein to produce localized inflammation which will, close the lumen of the vessel over time and it will collapse on itself
43
Vein Stripping
moval of large varicose veins that cannot be treated with less-invasive procedures
44
Vein Stripping post procedure
keep legs elevated encourage ROM need compression stockings
45
Radiofrequency Energy application
electrode will scar the dilated vein causing it to close down on itself
46
Endovenous Laser Treatment
heat from a laser is used to close the dilated vein.
47
Aneurysms
weakness in a section of a dilated artery that causes widening or ballooning in the wall of the blood vessel
48
Aneurysm forms
Saccular (only affecting one side of the artery) | Fusiform (involving the complete circumference of the artery)
49
abdominal aortic aneurysms
account for 75% of aneurysms
50
Aneurysm prevention
no smoking decrease WT healthy diet/exercise control BP (#1)
51
Aneurysm risk factors
Atherosclerosis | Age (arterial stiffening occurs)
52
Aneurysm s/sx
none initially
53
Abdominal aortic aneurysm (AAA) s/sx
``` Abdominal pain pulsating abdominal mass (no not palpate) > BP Aortic dissections (likely fatal) ```
54
Thoracic aortic aneurysm s/sx
Coolness or cyanosis below Severe back pain Hoarseness, cough, shortness of breath, and difficulty swallowing Decrease in urinary output
55
Aneurysm diagnosis
x-ray | CT and ultrasound to assess location and size
56
Percutaneous aneurysm repair
Insertion of endothelial stent grafts | typically used for aortic aneurysms, but can be used to repair a thoracic aortic aneurysm
57
Thoracic aortic repair
similar to open heart surgery

Nursing 281 (34 decks)

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