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Nursing of Adults I > Chapter 41: Vascular Disorders > Flashcards

Chapter 41: Vascular Disorders Flashcards

1
Q

two risk factors for thromboangiitis obliterans (Buerger’s disease)

A

men younger than 45 years
long history of tobacco and/or marijuana use
(without other CVD risk factors)

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2
Q

treatment for peripheral artery disease involves _____________ modification, ______ therapy, __________ therapy, ______________ therapy, and sometimes __________.

A

risk factor, drug, exercise, nutrition, surgery

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3
Q

surgery that involves opening the artery and removing the obstructing plaque

A

endarterectomy

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4
Q

peripheral artery disease or venous disease: ulcer drainage moderate to large amount

A

peripheral venous disease

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5
Q

three examples of complimentary alternative medicines used for peripheral artery disease

A

DHEA omega 3 fatty acids
black cohosh
garlic supplements

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6
Q

peripheral artery disease or venous disease: ankle-brachial index >0.90

A

peripheral venous disease

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7
Q

severe, life-threatening complication of acute ascending aorta dissection that occurs when blood escapes from dissection into pericardial sac

A

cardiac tamponade

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8
Q

in diagnosing aneurysms, ___________ may reveal abnormal widening of the thoracic aorta, and ________________ may show calcification within the aortic wall

A

chest X-ray, abdominal X-ray

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9
Q

Manifestations of peripheral artery disease: pallor develops when the leg is ____________

A

elevated

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10
Q

peripheral artery disease or venous disease: dermatitis often occurs

A

peripheral venous disease

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11
Q

Aortic surgery patients with a history of CVD should receive a drug from this class

A

beta blocker

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12
Q

disorder that involves the formation of a thrombus with vein inflammation

A

venous thrombosis

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13
Q

type of aneurysm that is typically asymptomatic or mimic pain associated with abdominal or back disorders; a pulsatile mass in periumbilical area slightly to the left of the midline may be present on physical assessment

A

abdominal aortic aneurysm (AAA)

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14
Q

in diagnosing aneurysms, _______________ gives helpful information by using contrast imaging to map the entire aortic system

A

angiography

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15
Q

peripheral artery disease or venous disease: hair may be present or absent

A

peripheral venous disease

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16
Q

condition characterized by chronic ischemic rest pain lasting more than 2 weeks, nonhealing arterial leg ulcers, or gangrene of the leg from PAD

A

critical limb ischemia (CLI)

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17
Q

potentially lethal complication in emergency repair of AAA is development of this impaired organ perfusion caused by IAH and resulting multisystem organ failure

A

abdominal compartment syndrome

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18
Q

episodic vasospastic disorder of small cutaneous arteries, most often involving the fingers and toes

A

Raynaud’s phenomenon

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19
Q

results from the creation of a false lumen between the intima and the media of arterial wall

A

aortic dissection

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20
Q

type of aneurysm that is circumferential and relatively uniform in shape

A

fusiform aneurysm

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21
Q

Manifestations of peripheral artery disease: ______ pain can occur with progression and worsening of disease

A

rest

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22
Q

seepage of blood back into the old aneurysm

A

endoleak

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23
Q

Aortic aneurysm surgery: Adequate _____ is important to maintain graft patency. Give __________ and _________________ to maintain blood flow.

A

blood pressure (BP), IV fluids, blood components

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24
Q

Educating patients with critical limb ischemia involves ____________, ____________, and _________________ the feet to prevent skin cracking and infection, keeping the affected foot ________ and ______, wearing ______, ________, and ___________ footwear, and avoiding ____ and _____ extremes

A

inspecting, cleansing, lubricating, clean, dry, soft, roomy, protective, hot, cold

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25
Q

non-atherosclerotic, segmental, recurrent inflammatory disorder of the small and medium arteries and veins of the arms and legs

A

thromboangiitis obliterans (Buerger’s disease)

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26
Q

five risk factors of peripheral artery disease (PAD)

A

age over 60
hypertension
hyperlipidemia
smoking
diabetes

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27
Q

peripheral artery disease or venous disease: capillary refill <3 seconds

A

peripheral venous disease

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28
Q

In diagnosing aortic dissection, this may show a widening of the mediastinum and pleural effusion

A

chest X-ray

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29
Q

peripheral artery disease or venous disease: edema is absent unless leg is constantly in dependent position

A

peripheral artery disease

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30
Q

peripheral artery disease or venous disease: ulcer tissue: yellow slough or dark red, “ruddy” granulation

A

peripheral venous disease

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31
Q

may occur in isolation but could occur with thyroid, scleroderma, SLE, environmental factors (vibratory or cold machinery, exposure to heavy metals)

A

Raynaud’s phenomenon

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32
Q

peripheral artery disease or venous disease: ulcer often painful

A

peripheral venous disease

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33
Q

formation of a thrombus in a superficial vein

A

superficial vein thrombosis

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34
Q

in diagnosing aneurysms, a(n) ________ may rule out an MI

A

ECG

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35
Q

conservative management for patient with critical limb ischemia involves protecting the extremity from ___________, decreasing ______________, preventing and controlling ____________, and improving ___________

A

trauma, ischemic pain, infection, perfusion

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36
Q

peripheral artery disease or venous disease: loss of hair on legs, feet, toes

A

peripheral artery disease

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37
Q

type of aneurysm that is a disruption of all arterial wall layers with bleeding that is contained by surrounding anatomic structures

A

false aneurysm or pseudoaneurysm

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38
Q

if acute arterial ischemia is present, immediate intervention is needed to avoid these three things

A

ischemia, necrosis, gangrene

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39
Q

represents the spectrum from deep vein thrombosis to pulmonary embolism

A

venous thromboembolism (VTE)

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40
Q

type of aneurysm in which the wall of the artery forms the aneurysm with at least 1 vessel layer still intact

A

true aneurysm

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41
Q

peripheral artery disease or venous disease: skin color bronze-brown pigmentation

A

peripheral venous disease

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42
Q

these two diagnostic tests show the location and extent of peripheral artery disease (PAD)

A

angiography
magnetic resonance angiography

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43
Q

in diagnosing aneurysms, a ______ or ________ can diagnose and assess the location and severity of aneurysms

A

CT, MRI

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44
Q

potentially lethal complication in emergency repair of AAA is development of this reduction of blood flow to the viscera

A

intraabdominal hypertension (IAH)

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45
Q

six manifestations of acute arterial ischemia

A

pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

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46
Q

peripheral artery disease or venous disease: ulcer located near medial malleolus

A

peripheral venous disease

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47
Q

this type of aneurysm surgical repair involves a large abdominal incision through which the surgeon cuts into the diseased aortic segment, removes any thrombus or plaque, sutures a synthetic graft to the aorta proximal and distal to the aneurysm, and sutures the native aortic wall around the graft to act as a protective cover

A

open aneurysm repair (OAR)

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48
Q

peripheral artery disease or venous disease: decreased or absent peripheral pulses

A

peripheral arterial disease

49
Q

these are expandable metallic devices that are placed in the artery after balloon angioplasty

A

stents

50
Q

this type of aortic dissection affects the ascending aorta and arch

A

Type A

51
Q

peripheral artery disease or venous disease: dermatitis rarely occurs

A

peripheral artery disease

52
Q

peripheral artery disease or venous disease: ankle-brachial index ≤0.90

A

peripheral artery disease

53
Q

type of aneurysm that is asymptomatic or manifests as deep, diffuse chest pain that may extend to the interscapular area

A

thoracic aortic aneurysm (TAA)

54
Q

combination of percutaneous transluminal angioplasty (PTA) and cold therapy

A

cryoplasty

55
Q

peripheral artery disease or venous disease: ulcer margin irregularly shaped

A

peripheral venous disease

56
Q

peripheral artery disease or venous disease: ulcer tissue: black eschar or pale pink granulation

A

peripheral artery disease

57
Q

health promotion for PAD and aneurysms involves

A

reducing CVD risk factors (controlling BP, ceasing tobacco use, maintaining normal body weight and serum lipids)

58
Q

peripheral artery disease or venous disease: intermittent claudication or rest pain in foot

A

peripheral artery disease

59
Q

peripheral artery disease or venous disease: capillary refill >3 seconds

A

peripheral artery disease

60
Q

In diagnosing aortic dissection, this rules out cardiac ischemia

A

ECG

61
Q

PAD: long-term ____________ therapy is used after surgery with one of these two drugs

A

antiplatelet, aspirin, clopidrogel

62
Q

type of aneurysm that is pouchlike with a narrow neck connecting the bulge to one side of the arterial wall

A

saccular aneurysm

63
Q

involves thickening of artery walls, resulting in a progressive narrowing of the arteries of the upper and lower extremities

A

peripheral artery disease (PAD)

64
Q

classic symptom of lower extremity peripheral artery disease (PAD)

A

intermittent claudication

65
Q

peripheral artery disease or venous disease: skin temperature cool, temperature gradient down the leg

A

peripheral artery disease

66
Q

in diagnosing aneurysms, _____________ is useful for aneurysm screening and to monitor aneurysm size

A

ultrasound

67
Q

Aortic aneurysm surgery: reason to keep continuous ECG monitoring

A

myocardial ischemia/infarction or dysrhythmias may occur

68
Q

treatment not indicated for PAD and why

A

anticoagulant therapy; no benefit and increased risk for bleeding

69
Q

peripheral artery disease or venous disease: dull ache or heaviness in calf or thigh

A

peripheral venous disease

70
Q

this type of surgery is used to treat acute type A aortic dissections

A

open aneurysm repair (is a surgical emergency)

71
Q

most frequent cause of acute arterial occlusion

A

embolization of a thrombus from the heart

72
Q

peripheral artery disease or venous disease: ulcer drainage minimal

A

peripheral artery disease

73
Q

Aortic aneurysm surgery: to prevent infection, give ___________________ as prescribed

A

broad-spectrum antibiotic

74
Q

acute inflammation of the walls of small, cannulated veins

A

phlebitis

75
Q

peripheral artery disease or venous disease: lower leg edema present

A

peripheral venous disease

76
Q

peripheral artery disease or venous disease: pruritus rarely occurs

A

peripheral artery disease

77
Q

These three tests are equally reliable for diagnosing aortic dissection

A

MRI
3D CT scanning
transesophageal echocardiography (TEE)

78
Q

peripheral artery disease or venous disease: normal or thickened nails

A

peripheral venous disease

79
Q

peripheral artery disease or venous disease: pruritus often occurs

A

peripheral venous disease

80
Q

Manifestations of peripheral artery disease: _________________ develops when the limb is in a dependent position, also known as ________________

A

reactive hyperemia, dependent rubor

81
Q

Aortic aneurysm surgery: Assess bowel sounds every ___________

A

4 hours

82
Q

Aortic surgery patients have a __________ preparation and _______ cleansing with a(n) _______________ agent the day before surgery.

A

bowel, skin, antimicrobial

83
Q

peripheral artery disease or venous disease: skin temperature warm, no temperature gradient

A

peripheral venous disease

84
Q

manifestations include hypotension, narrowed pulse pressure, distended neck veins, muffled heart sounds, and pulsus paradoxus

A

cardiac tamponade

85
Q

After surgical or radiologic intervention for PAD, check the operative extremity every ________ and later every _______. Assess these six things

A

15 minutes, 1 hour
color, temperature, capillary refill, peripheral pulses, sensation, movement

86
Q

this type of surgery is a treatment option for acute and chronic type B aortic dissections with complications

A

endovascular aortic repair (EVAR)
(alternative is thoracic EVAR or TEVAR)

87
Q

peripheral artery disease or venous disease: varicose veins may be visible

A

peripheral venous disease

88
Q

removal of obstructing plaque

A

atherectomy

89
Q

PAD: Postoperative ankle brachial index (ABI) measurements place the patient at risk for this

A

graft thrombosis

90
Q

most common complication of AAA repair

A

endoleak

91
Q

characterized by vasospasm-induced color changes from white to blue to red

A

Raynaud’s phenomenon

92
Q

peripheral artery disease or venous disease: skin color dependent rubor, elevation pallor

A

peripheral artery disease

93
Q

peripheral artery disease or venous disease: skin texture thick, hardened, and indurated

A

peripheral venous disease

94
Q

The initial goals of therapy for acute aortic dissection without complications are _____ and _____ control and ________ management

A

HR, BP, pain

95
Q

involves a thrombus in a deep vein (most often iliac and/or femoral)

A

deep vein thrombosis (DVT)

96
Q

peripheral artery disease or venous disease: ulcer located on tips of toes, foot, or lateral malleolus

A

peripheral artery disease

97
Q

peripheral artery disease or venous disease: thickened, brittle nails

A

peripheral artery disease

98
Q

phlebitis usually resolves quickly after this intervention

A

IV catheter removal

99
Q

optimal therapy for patient with critical limb ischemia

A

revascularization via bypass surgery using autologous vein

100
Q

this type of aortic dissection, when without complications, can be treated conservatively

A

Type B

101
Q

peripheral artery disease or venous disease: skin texture thin, shiny, taut

A

peripheral artery disease

102
Q

six modifiable risk factors for aortic aneurysms

A

hypertension, CAD, tobacco use, high cholesterol, previous stroke, obesity

103
Q

this type of aortic dissection begins in the descending aorta

A

Type B

104
Q

in treating aortic dissection, this drug is titrated to a target HR under 60 bpm or SBP between 100-110

A

IV beta blocker

105
Q

peripheral artery disease or venous disease: ulcer may or may not be painful

A

peripheral artery disease

106
Q

conservative medical therapy is used to treat aneurysms of this size (risk factor modification)

A

<5.4 cm

107
Q

Aortic aneurysm surgery: When the descending aorta is involved perform a _______________ assessment

A

neurovascular

108
Q

three nonmodifiable risk factors for aortic aneurysms

A

age, male gender, family history

109
Q

peripheral artery disease or venous disease: ulcer margin rounded, smooth, looks “punched out”

A

peripheral artery disease

110
Q

how the ankle-brachial index is calculated

A

(ankle SBP/brachial SBP)

111
Q

peripheral artery disease or venous disease: peripheral pulses present, may be hard to palpate with edema

A

peripheral venous disease

112
Q

Aortic aneurysm surgery: Avoid heavy lifting for _________

A

6 weeks

113
Q

surgical repair is used to treat aneurysms of this size

A

> 5.4 cm

114
Q

in diagnosing aneurysms, _____________________ assesses the function of the aortic valve

A

echocardiography

115
Q

those with small aneurysms of ________ cm should have monitoring of aneurysm size using ultrasound or CT every _______ months

A

4.0-5.4; 6-12 months

116
Q

three key factors that cause venous thrombosis

A

Virchow triad: venous stasis, damage of endothelium, hypercoagulability

117
Q

Aortic aneurysm surgery: When the ascending aorta and aortic arch are involved, perform a ____________ assessment

A

neurologic (LOC, pupil size and responsiveness to light, facial symmetry, tongue position, speech, upper extremity movement, quality of hand grasps)

118
Q

this type of aneurysm surgical repair is a minimally invasive procedure that involves the placement of a sutureless aortic graft into the abdominal aorta inside the aneurysm via the femoral artery

A

endovascular graft procedure (EVAR)

Nursing of Adults I (21 decks)

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