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Assessment > Ch 20 Vascular & Lymphatic System > Flashcards

Ch 20 Vascular & Lymphatic System Flashcards

1
Q

We never want to stick an artery for arterial blood gas unless we know there is adequate circulation on the other side so we don’t possible destroy the only circulation leading to the hand .. so we do this which determines the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery

A

Allen test

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2
Q

Defect or sac formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defects

A

Aneurysm

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3
Q

Variation from the heart’s normal rhythm

A

Arrhythmia

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4
Q

Thickening and loss of elasticity of the arterial walls

A

Arteriosclerosis

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5
Q

Plaques of fatty deposits formed in the inner layer (intima) of the arteries

A

Atherosclerosis

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6
Q

Slow heart rate <50 beats per min in the adult

A

Bradycardia

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7
Q

Blowing, swooshing sound heard through a stethoscope when an artery is partially occluded

A

Bruit

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8
Q

Dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood

A

Cyanosis

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9
Q

The hearts filling phase

A

Diastole

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10
Q

Calf pain that occurs when the foot is sharply dorsiflexed (pushed up, toward the knee) may occur with deep vein thrombosis, phlebitis, achilles tendinitis, or muscle injury

Nurses will do this to make sure pt does not have a blood clot in their leg

A

Homan’s sign

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11
Q

Deficiency of arterial blood to a body part due to constriction or obstruction of a blood vessel
Deficient in oxygen and need more

A

Ischemia

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12
Q

Swelling of extremities due to obstructed lymph channel, lypmh system isnt working, lymph nodes might have been removed, extra fluid cant be returned because there is no lymphatic network, nonpitting

A

Lymphedema

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13
Q

Small oval clumps of lymphatic tissue located at grouped intervals along lymphatic vessels
Usually in groups, some are deep and some are superficial
Typically filter fluid and microorganisms and engulf pathogens

A

Lymph nodes

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14
Q

Indentation left after examiner depresses the skin over swollen edematous tissue

A

Pitting edema

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15
Q

Viewing the finger from the side to detect early clubbing

A

Profile sign

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16
Q

Pressure wave created by each heartbeat, palpable at body sites where the artery lies close to the skin and over a bone

A

Pulse

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17
Q

Regular rhythm, but force of pulse varies with alternating beats of large and small amplitude

A

Pulsus alternations

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18
Q

Irregular rhythm, every other beat is premature, premature beats have weakened amplitude

A

Pulsus bigeminus

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19
Q

Pulse is weaker with inspiration and stronger with expirations

A

Pulsus paradoxus

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20
Q

The hearts pumping phase

A

Systole

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21
Q

Rapid heart rate >90 beats per minute in an adult

A

Tachycardia

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22
Q

Inflammation of the vein associated with thrombus formation

A

Thrombophlebitis

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23
Q

Open skin lesion extending into dermis with sloughing of necrotic inflammatory tissue

A

Ulcer

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24
Q 
Dilated tortuous (twisting) veins with incompetent valves
Easily seen on surface of the skin
A

Varicose vein

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25
Q

Carries oxygenated blood and nutrients

A

Arteries

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26
Q

Carries deoxygenated blood and waste products from tissues, pulls it from the tissues and brings it back to the heart

A

Veins

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27
Q

Filters microorganisms and helps with immune functions

Eliminates foreign pathogens to keep us healthy

A

Lymphatic system

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28
Q

What happens when there is a complete artery block..

A

It leads to death of the tissue and any clots need to be opened in order to let blood through

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29
Q

What happens when there is a partial artery block..

A

It causes pain or discomfort with exercise or movement

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30
Q

The major artery in the arm that is more difficult to palpate

A

Brachial

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31
Q

The artery in the wrist that is easy to palpate and used to check a pulse

A

Radial

32
Q

The artery in the arm that can be used to assess for circulation

A

Ulnar

33
Q

The major artery in the leg located in the groin area

A

Femoral

34
Q

The artery behind the knee

A

Popliteal

35
Q

The artery in the back of the ankle

A

Posterior tibial

36
Q

The artery in the top of the foot

A

Dorsalis pedis

37
Q

Deep veins typically run along the side of an..

A

Artery

38
Q

How does venous flow keep blood moving

A

Skeletal muscles in the legs contract and this brings the blood proximally or back towards the heart

39
Q

This causes thoracic and abdominal pressure to decrease causing differences in pressure gradients

A

Inspiration

40
Q

Brings smaller and larger veins together

A

Perforators

41
Q

How does the venous flow of a calf pump work

A

As you walk, your calf contracts and rests just like systole and diastole, and returns blood to the heart and the rest of the body

42
Q

Is arterial or venous pressure lower?

A

Venous pressure is lower than arterial

43
Q

Who is at risk for venous stasis

A 
Pregnant women because they have an increased blood flow
Genetics
People who sit or stand a long time
Best rest patients
Obese patients
People who clot too fast
People who have vein wall trauma
People who have varicose veins
People who have poor valves allowing blood to seep backwards
44
Q

Retrieves excess fluid from the tissue space and helps to return it back to the blood stream
Helps conserve the fluid and the plasma proteins that leak out of the capillaries and help return that to the circulatory system

A

Lymphatic system

45
Q

The fluid leaves the capillaries faster than the veins can absorb so if there isnt adequate lymphatic drainage you can develop…

A

Edema

46
Q

Why do you see edema a lot after masectomies

A

They remove the breast but also the lymph nodes as well, then they are put on arm precautions so no BP, needles, etc.

47
Q

There is also a lymphatic system in the abdomen that helps to absorb

A

Lipids form the intestines

48
Q

These drain the head and the neck

A

Cervical nodes

49
Q

These drain the breasts and upper arms

A

Axillary nodes

50
Q

These are in the arm and the antecubital fossa and drain the hand the lower arm
Depression above and behind medial condyle of humerus, in the antecubital area
Assessing for enlargement of that lymph node and if there is do a good inspection of the hand figure out if there is infection causing that

A

Epitrochlear nodes

51
Q

Located in the groin and drain the lymph of lower extremities, external genitalia, and anterior abdominal wall

A

Inguinal nodes

52
Q

Stores red blood cells
Destroys red blood cells that are no longer functional
Makes antibodies to fight off infection
FIlters microorganisms from blood

A

Spleen

53
Q

Helps respond to local information
Become swollen when pathogens get in the throat and try to keep it from going from going into the respiratory tract or the rest of the body
Become inflamed easily

A

Tonsils

54
Q

Flat, pink, grey gland located in superior mediastinum in the chest behind the sternum
More important for developing t-lymphocytes in children
More in younger children
Atrophies occur after the pt has reached puberty

A

Thymus

55
Q

What happens to the peripheral vascular system in older adults

A

Arteries become less efficient: arterial insufficiency
(thin, shiny skin; thick nails; hair loss on legs which normally occurs with aging as well)
Peripheral vessels become more rigid (thick and lose elasticity) called arteriosclerosis
Develop atherosclerosis
Bigger calf veins
Valves become incompetent with age
More varicose veins
DVT and PEs increase due to bed rest

56
Q

What happens to the lymphatic system in older adults

A

Less lymph tissue because we lose lymph nodes creating an increased risk for infections

57
Q

What is it best for older adults to do as they age

A

Like to get them walking
Walking prevents heart attacks
Take a low dose of anticoagulants or blood thinners to prevent clots and PEs

58
Q

What subjective data do we want to know regarding peripheral vascular system

A

Leg pain or cramps possibly indicating DVT
Skin changes on arms or legs possibly indicating arterial or venous disease
Any swelling
Any lymph node enlargements
Medication list for possible increase for clots
–birth control?
–hormone replacement?

59
Q

How should you prepare for an examination of the peripheral vascular and lymphatic system

A 
Full set of vitals
B/P
Comfy room temperature
--cold can cause vasoconstriction
--hot can cause vasodilation
Inspect and palpate bilaterally
--temp, skin, symmetry, color, cap refill, edema
60
Q

What equipment might you need for an examination of the peripheral vascular and lymphatic system

A

Tape measure for calf size in DVT patients
Tourniquet and B/P cuff
Stethoscope
Doppler if unable to palpate pulses

61
Q

What are you looking for when you inspect and palpate the arms

A

Look at the hands
Inspect color, nail beds, cap refill, temp, texture, turgor, lesions, edema, clubbing
Cigarettes, anemia, edema can all cause cold skin

62
Q

What do you want to look at when taking the radial pulse

A

Rate (beats/min)
Rhythm is regular or irregular
Elasticity and force

63
Q

How do you grade the force of a pulse

A

3+ increased, full, bounding (usually with exercise or hyperthyroidism)
2+ normal
1+ weak, thready pulse
0 absent

64
Q

What are you looking for when you inspect and palpate the legs

A

Compare legs
–color, hair distribution, vein size, lesions, ulcers
*Hairy toes = good circulation
Flex knee
Check for tenderness of calf
If asymmetrical legs need to measure calf size for DVT
If lymphedema measure ankle, calf, knee, and thigh
Palpate inguinal lymph nodes
Palpate and grade the 4 arteries in the legs

65
Q

To check for edema press for how many seconds

A

5 seconds

66
Q

How do you grade pitting

A

1+ mild pitting, slight indentation, no swelling
2+ moderate pitting, indentation subsides rapidly
3+ deep pitting, indentation remains, legs look swollen
4+ very deep pitting, indentation lasts a long time, legs very swollen

67
Q

Edema that is non pitting

A

Brawny edema

68
Q 
Detects weak pulses 
Check B/P
Magnifies sounds of that artery
Need to use gel
Swivel under you hear a pulse
Document that you used it
A

Doppler-ultrasonic stethoscope

69
Q

How do you find the ankle brachial index (ABI)

A

Divide ankle or foot systolic pressure by arm systolic pressure
Leg pressure is usually higher than the arm pressure
Normal ABI is 1-1.2
Less than 0.9 indicates peripheral artery disease
Less reliable with diabetes patients

70
Q

What happens to pulses in older adults

A

Distal pulses (dorsalis pedis and posterior tibial pulse) hard to palpate

71
Q

Disease where you get vasospasms in response to stress or cold

A

Raynauds phenomenon

72
Q

What are the color orders in Raynauds phenomenon

A

White/pallor: vasospasms in fingers
Cyanosis: arteries relax
Redness: blood returns and cap beds are dilated again

73
Q

Brown discoloration over lower extremities, usually on shin area

A

Chronic venous stasis

74
Q

Pale skin occurs, cool to touch, pulses diminished, wont be much bleeding because there isnt good blood supply

A

Aterial ischemic ulcer

75
Q

Brownish skin on shin and lower legs, blood pools, gets achy and gets worse after standing, pulses will be normal because its not affecting the arterial system, edema and probably thicker skin around the area

A

Venous ulcer

Assessment (11 decks)

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