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MedSurg > T2: PAD, PVD, Acute MI, Cardiac Tamponade, Pericardium > Flashcards

T2: PAD, PVD, Acute MI, Cardiac Tamponade, Pericardium Flashcards

1
Q

buildup of fats, cholesterol and other substances in and on the artery walls

A

arthosclerosis

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2
Q

systemic atherosclerosis; partial or total blockage decreasing perfusion to extremities

A

Peripheral artery disease

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3
Q

Peripheral artery disease in legs is called

A

Lower extremity arterial disease (LEAD)

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4
Q

Peripheral artery disease inflow:
Obstruction ____ end of aorta and _____, ______, _____ iliac arteries; pain at __, ___, or _____

A

-distal end of aorta
-common, internal, and external iliac arteries
-pain at low back, buttocks, or thighs

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5
Q

Most inflow PAD patients seek medical attention due to

A

leg pain
(intermittent claudication)

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6
Q

When pulse is not palpable, use:

A

doppler ultrasound

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7
Q

Peripheral artery disease outflow:
Burning or cramping in the ____, _____, _____, and _____; pain at instep or foot discomfort =

A

-calves, ankles, feet, and toes
-obstruction below the politely artery

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8
Q

PAD outflow pain level:
experience pain after walking approx. 5 blocks

A

mild

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9
Q

PAD outflow pain level:
experience pain after walking 2 blocks

A

moderate

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10
Q

PAD outflow pain level:
experience pain after walking 1 block or less or pain at rest

A

severe

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11
Q

PAD outflow S/S (4)

A

-hair loss on lower calf, ankle, and foot
-dry scaly, dusky, pale, or mottled skin
-thickened toenails
-severe-cold and cyanotic or darkened

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12
Q

PAD interventions used to increase arterial flow to the affected leg (s) (6)

A

-exercise
-positioning
-promoting vasodilation
drug therapy
-invasive nonsurgical procedures
-percutaneous vascular intervention
-bypassing arterial occlusions avocet the superficial femoral arteries (SFAs)

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13
Q

Hemorheologic agent that increases the flexibility of red blood cells

A

Pentoxifylline

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14
Q

PAD interventions: medications (2)

A

-hemorrheologic agents
-anti-platelet agents

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15
Q

PAD stage:
-No claudication is present
-Bruit or aneurysm may be present
-Pedal pulse are decreased or absent

A

Stage I: asymptomatic

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16
Q

PAD stage:
-Muscle pain, cramping, or burning occurs with exercise and is relieved with rest
-Symptoms are reproducible with exercise

A

Stage II: Claudication

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17
Q

PAD stage:
-Pain while resting commonly awakens the patient at night
-Pain is described as numbness, burning, toothache-type pain
-Pain usually occurs in the distal part of the extremity (toes, arch, forefoot, or heel), rarely in the calf or ankle
-Pain is relieved by placing the extremity in a dependent position

A

Stage III: Rest Pain

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18
Q

PAD stage:
-Ulcers and blackened tissue occur on the toes, forefoot, and heel
-Distinctive gangrenous odor is present

A

Stage IV: Necrosis/Gangrene

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19
Q

Peripheral Venous disease includes both _____ and _____ complications

A

thrombus and embolus

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20
Q

Peripheral venous disease:
altered immunity

A

-inflammation occurs around the clot
-vein wall thickens
-possible embolization (PE is most common)

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21
Q

Most common type of thrombophlebitis

A

deep vein thrombosis (DVT)

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22
Q

DVT are most often in ___ but can occur in ______ due to central venous devices

A

-legs
-upper arms

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23
Q

interventions to prevent DVT (8)

A

-Patient education
-Leg exercises
-Early ambulation
-Adequate hydration
-Graduated compression stockings
-Intermittent pneumatic compression, such as sequential compression devices (SCDs)
-Venous plexus foot pump
-Anticoagulant therapy

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24
Q

PVD nursing consideration:
notify the health care provider if:

A

-aPTT value is greater that 70 seconds

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25
Q

PVD nursing consideration: assess patient for S/S of bleeding which includes: (6)

A

-hematuria
-frank/occult blood in stool
-ecchymosis (bruising)
-petechiae
-altered level of consciousness
-pain

26
Q

PVD nursing consideration:
if bleeding occurs:

A

stop the anticoagulant immediately and call the health care provider or call Rapid Response Team

27
Q

chest pain caused by a temporary imbalance between the coronary arteries’ ability to supply oxygen and the cardiac muscle’s demand for oxgygen

A

angina pectoris

28
Q

two types of angina pectoris

A

-Chronic stable
-Unstable

29
Q

Characteristics of Chronic Stable Angina pectoris (3)

A

-chest discomfort occurring with moderate to prolonged exertion in a familiar pattern to the client
-Frequency, duration, and intensity of the symptoms do not change over several months
-usually relieved by nitroglycerin

30
Q

unstable angina or ________ = acute coronary syndrome

A

acute myocardial infarction

31
Q

rupture of atherosclerotic plaque in the coronary artery ruptures

A

Acute coronary syndrome

32
Q

Characteristics of Acute Coronary Syndrome (3)

A

-Platelete aggregation “clumping”
-Thrombus (clot) formation
-Vasoconstriction

33
Q

ACS: the amount of plaque disruption determines:

A

the degree of the artery blockage and specific disease process

34
Q

ACS:
_____% occlusion of artery = impaired blood flow = ______ when the myocardial demand is increased

A

50%
myocardia ischemia

35
Q

chest pain/discomfort that occurs at rest of within exertion causing severe activity limitation

A

unstable angina

36
Q

unstable angina
-may last longer than ______
-______ relieved by nitroglycerin

A

-15 minutes
-poorly

37
Q

Myocardial tissue is abrupt ly and severely deprived of oxygen

A

Acute Myocardial INfarction

38
Q

Acute MI:
_______% reduction in blood flow causing ischemia

A

80-90%

39
Q

injury and necrosis of myocardial tissue if oxygenation not restored

A

ischemia

40
Q

Have an ST segment and T-wave changes seen on ECG showing myocardial ischemia

A

Non-ST-segment elevation myocardial infarction (NSTEMI)

41
Q

NSTEMI characteristics (3)

A

-ST depression
-T-wave inversion
-May haver elevated tropic indicating cell death or necrosis

42
Q

NSTEMI causes (3)

A

-Coronary vasospasm
-Spontaneous dissection
-Sluggish blood flow (narrowing of the coronary artery)

43
Q

Acute MI typical S/S

A

-chest discomfort
-SOA
-Nausea
-Sweating

44
Q

Acute MI female/older adult S/S

A

-Neck, Jaw, Shoulder, upper back, upper abdominal discomfort
-SOA, nausea, vomiting
-heartburn
-Pain in both arms

45
Q

ST-elevation myocardial infarction (STEMI) characteristics (3)

A

-indicates MI/necrosis
-Rupture of the fibrous atherosclerotic plaque
-Thrombus formation

46
Q

STEMI:
the thrombus causes an abrupt ______% occlusion to the coronary artery; this is a ____________ and requires immediate:

A

-100%
-Medical Emergency
-Revisualization of the blocked coronary artery

47
Q

Acute MI treatment was: (4)

A

MONA
-Morphine
-Oxygen
-Nitroglycerin
-Aspirin

48
Q

Acute MI treatment now is: (10)

A

THRMOBINSS
-Thienopyridines
-Heparin/enoxaparin
-Reninangiotensin System Blockers
-Oxygen
-Morphine
-Beta blockers
-Intervention
-Nitroglycerin
-Statin
-Salicylate

49
Q

Acute MI treatment note: Thienopyridines include (3)

A

-Clopidogrel
-Prasugrel (unless hx of stroke or TIA)
-Ticagrelor

50
Q

Acute MI treatment note: oxygen

A

oxygen applied if SpO2 is <90%

51
Q

Acute MI treatment note: Beta-blockers (7)

A

Contraindications
-Older than 70 years old
-Systolic BP < 120
-HR >110 or <60
-Pulmonary edema- HF
-Active asthma or RAD
-PR interval >0.24 sec
-2nd or 3rd heart block without a pacemaker

52
Q

Actue MI treatment note: nitroglycerin

A

make sure client is sitting down prior to administering

53
Q

Tests used to diagnose MI (9)

A

-Troponin T and I
-Chest x-ray
-CT
-64-clice computed tomography coronary angiography (CTCA)
-THallium scans
-Contrast-enhanced cardiovascular magnetic resonance (CMR) imaging
-Twelve-lead ECG
-Cardiac catheterization
-Angiography

54
Q

assess for ischemia or necrosis; radioisotopes cannot reach areas with decreased or absent perfusion and they appear as “cold spots:

A

Thallium scans

55
Q

can result from fluid accumulation in the pericardial sac

A

Cardiac tamponade

56
Q

Cardiac tamponade S/S (4)

A

-Hypotension
-Jugular venous distention
-muffled heart sounds
-paradoxical pulse (variance of 10 mmHg or more in systolic blood pressure between expiration and inspiration

57
Q

If cardiac tamponade S/s are observed in patient, nurse should: (4)

A

-notify provider immediately
-administer fluids to combat hypotension as prescribed
-expect provider to order chest x-ray or echocardiogram
-prepare client for pericardiocentesis if ordered

58
Q

preparing client for pericardiocentesis (3)

A
  • informed consent
    -gather materials
    -administer prescribed medications
59
Q

during/after pericardiocentesis (3)

A

-monitor hemodynamic pressures
-monitor heart rhythm
-monitor for reoccurrence of s/s after the procedure

60
Q

inflammation of the pericardium; can be caused by an MI

A

Pericarditis

61
Q

Pericarditis s/s (4)

A

-chest pressure/pain
-friction rub auscultated int eh lungs
-shortness of air
-pain relived when sitting and leaning forward

MedSurg (14 decks)

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