NUR 240 ch 26 PVD

Question 1

functions of the vascular system

Answer 1

include supplying the circulatory needs of tissue
maintaining blood flow and blood pressure providing capillary filtration and reabsorption hemodynamic resistance

Question 2

intermittent claudication

Answer 2

a muscular, cramplike pain or fatigue in the extremities consistently reproduced with the same degree of exercise or activity and relieved by rest

Question 3

rest pain

Answer 3

persistent pain the the foot or digits when the patient is resting, indicating a severe degree of arterial insufficiency and critical state of ischemia

Question 4

rubor

Answer 4

reddish-blue discoloration of the extremities; indicative of severe peripheral arterial damage in vessels that remain dilated and unable to constrict

Question 5

atherosclerosis

Answer 5

Filling of the vessel with cholesterol, lipids, fats, plaque = small lumen and diameter

inflammatory process involving the accusation of lipids, calcium, blood components, carbs, and fibrous tissue on the intimal layer of a large or medium sized artery

Question 6

arteriosclerosis

Answer 6

hardening of the arteries - loose elasticity

diffuse process where the muscle fibers thicken and the endothelial lining of the walls of SMALL arteries and arterioles become thickened

Question 7

what is the driving force that moves blood through the vascular system

Answer 7

contraction

Question 8

intermittent claudication is caused by

Answer 8

the inability of the arterial system to provide adequate blood flow to the tissues when there is increased demands for nutrients and oxygen during exercise

Question 9

intermittent claudication is relieved by

Answer 9

rest (decrease in metabolic needs)

Question 10

assessing the ____ is important in assessing the status of peripheral arterial circulation

Answer 10

presence or absence and the quality of peripheral pulses

Question 11

absence of peripheral pulses may indicate

Answer 11

stenosis (narrowing or constriction)

Question 12

aging adult considerations for changes in vessels

Answer 12

aging produces changes in the walls of the blood vessels that affect the transport of oxygen and nutrients to the tissues

can cause vessels to stiffen and results in:
increased peripheral resistance
impaired blood flow
increased left ventricular workload

Question 13

physical assessment findings of an impaired vascular system

Answer 13

skin (cool, pale, pallor, rubor (red color),
loss of hair,
brittle nails,
dry or scaling skin,
atrophy,
ulcerations (shallow, circular, pale, not a lot of drainage)
pulses=weak

Question 14

Ankle-brachial index (ABI)

Answer 14

take BP on arm, take BP on leg, compare the values

looking for a 1:1 ratio

Question 15

major goals for someone with peripheral vascular problems

Answer 15

increase arterial blood supply
decrease in venous congestion
promotion of vasodilation and prevention of vascular compression
relief of pain
maintenance of tissue integrity

Question 16

how to improve peripheral arterial circulation

Answer 16

position strategies- dangle the feet (increases blood flow)
exercise- walking, graded isometric exercises
temperature effects of heat and cold (poor circulation- cold=vasoconstriction)
discourage nicotine use- vasoconstrictor
stress reduction (fight or flight pulls all the blood from distal and bring it to trunk)

Question 17

different types of arterial disorders

Answer 17

arteriosclerosis
atherosclerosis
peripheral artery disease
Aneurysms
arterial embolism and arterial thrombosis
raynauds phenomenon

Question 18

risk factors for atherosclerosis and PAD

Answer 18

nicotine use
diabetes
HTN
Hyperlipidemia
diet
stress
sedentary lifestyle
C-ractive protein
hyperhomocysteinemia
increased age
family genes

Question 19

hallmark symptoms for Peripheral artery disease (PAD)

Answer 19

intermittent claudication (relieved with rest)

Question 20

ischemic rest pain is usually worse at

Answer 20

night and often wakes the patient up

Question 21

pharm therapy for PAD

Answer 21

phosphodiesterase III inhibitor
anti platelet (Aspirin)
statins

Question 22

For patients with PAD, blood flow to the lower extremities needs to be enhanced; therefore, the nurse encourages keeping the lower extremities in a neutral or dependent position. In contrast, for patients with venous insufficiency, blood return to the heart needs to be enhanced, so the lower extremities are elevated. Exercise can be prescribed to aid in the development of collateral circulation. Some pain is associated with PAD.

Question 23

Aneurysm

Answer 23

localized sac or dilation formed at a weak point in the wall of the artery

classified by its shape or form

Question 24

most common forms of aneurysms are

Answer 24

saccular and fusiform

Question 25

saccular aneurysm

Answer 25

projects from only one side of the vessel

Question 26

fusiform aneurysm

Answer 26

entire arterial segment becomes dilated

Question 27

raynauds phenomenon

Answer 27

intermittent arterial vas occlusion (spasm), usually of the finger or toes

associated with underlying diseases such as scleroderma

Question 28

signs and symptoms of raynauds

Answer 28

sudden vasoconstriction results in color changes, numbness, tingling, and burning pain

poor circulation to fingers, put spo2 on earlobe

Question 29

raynauds episodes are triggered by

Answer 29

cold weather or stress

Question 30

venous disorder types

Answer 30

venous thromboembolism condition (DVT and PE)
chronic venous insufficiency/post-thrombotic syndrome
leg ulcers
varicose veins

Question 31

difference between leg ulcers in venous and atrial circulation disorders

Answer 31

arterial:
shallow, circular, pale, not a lot of drainage

venous:
more fluid and drainage, larger, red, odor, normal on the gaiter region (behind the ankle, medial)