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From Flashcardlet > (3) Exam 3-❤️ Lecture #3- Peripheral Artery Disease > Flashcards

(3) Exam 3-❤️ Lecture #3- Peripheral Artery Disease Flashcards

0
Q

Peripheral Artery Disease

🚬 PAD is a slow progressive disease that usually affects men over what age?

A

> 50

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1
Q

Peripheral Artery Disease

The biggest problem for people with PAD is getting blood to what area of the body?

A

Feet because theres a blockage in the way

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2
Q

Peripheral Artery Disease

🚬 What are the risk factors for PAD?

A

▪️Smoking
▪️HTN
▪️Hyperlipidemia
▪️Diabetes

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3
Q

Peripheral Artery Disease

🚬 Patients with what advanced disease are likely to have PAD?

A

CAD

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4
Q

Peripheral Artery Disease

What are the two common sites for Atherosclerotic Lesions?

A

▪️Bifurcations (Branch / Fork in iliac crest area)

▪️Femoral Area (Behind the knee at the Popliteal Artery)

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5
Q

Peripheral Artery Disease

💊 What surgical therapy is used to redirect blood from the Femoral Artery to the Popliteal Artery?

A

Fempop Bypass

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6
Q

Peripheral Artery Disease

📈 What common test used for PAD is a noninvasive ultrasound sensor to view arterial blood flow?

A

Doppler

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7
Q

Peripheral Artery Disease

😰 PAD pain is usually described as what type of pain?

A

Ischemic Pain in the legs
▪️Aching
▪️Cramping
▪️Burning

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8
Q

Peripheral Artery Disease

😰 PAD pain is usually bilateral and distal to what?

A

Obstruction

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9
Q

Peripheral Artery Disease

😰 What position may decrease PAD pain?

A

Dangling

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10
Q

Peripheral Artery Disease

😰 In advanced PAD, what placement of the lower extremities may aggravate the pain?

A

Elevation or Horizontal

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11
Q

Peripheral Artery Disease

😰 A build up of what causes PAD pain?

A

Lactic Acid

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12
Q

Peripheral Artery Disease
😰 What is the patient experiencing if they have pain in the calf / major muscle during exercise (even walking) which subsides with rest?

A

Intermittent Claudication

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13
Q

Peripheral Artery Disease

😰 If patients with Intermittent Claudication sit down and rest, how long will it take for the pain to go away?

A

About 10 mins

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14
Q

Peripheral Artery Disease

📚 What do you want to teach patients with Intermittent Claudication about exercise?

A

Exercise to the point that it hurts and then rest but should continue to exercise.

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15
Q

Peripheral Artery Disease

😰 What skin changes occur in patients with PAD when their extremity is elevated?

A

Cold and Pale

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16
Q

Peripheral Artery Disease

😰 What skin changes occur in patients with PAD when their extremity is dependent?

A

Rubor & Cyanotic

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17
Q

Peripheral Artery Disease

😰 How does the skin appear in patients with PAD due to decreased oxygen and nutrients?

A

▪️Shiny
▪️Thin
▪️Taut
▪️Loss of Hair

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18
Q

Peripheral Artery Disease

😰 Lack of blood flow and oxygen may cause what S/S in patients with PAD?

A

Numbness and Tingling - Nerve endings are being damaged

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19
Q

Peripheral Artery Disease

😰 When auscultating, the Peripheral Pulses may be decreased, absent, or what sound may be heard?

A

Bruit

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20
Q

Peripheral Artery Disease

😰 What may develop between the toes or on bony prominences on the top of the feet in patients with PAD?

A

Ischemic Arterial Ulcers

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21
Q

Peripheral Artery Disease

😰 How does pain of Arterial Ulcers compare to Venous Ulcers?

A

Arterial Ulcers are more painful

22
Q

Peripheral Artery Disease

😷 What risk factor modifications can be made to prevent PAD?

A

▪️Tobacco Cessation
▪️Aggressive treatment of Hyperlipidemia
▪️BP maintained < 140/90
▪️Glycosylated Hemoglobin < 7% - Control Diabetes

23
Q

Peripheral Artery Disease

💊 What drug therapy is used for patients with PAD?

A

▪️ACE Inhibitors

▪️Anti-platelet Agents

24
Q

Peripheral Artery Disease

💊 What ACE Inhibitor is used for the treatment of PAD?

A

Ramipril (Altace)
↓Cardiovascular Morbidity & Mortality
↑Peripheral Blood flow, ABI, & Walking Distance

25
Q

Peripheral Artery Disease

💊 What anti-platelet drugs are given for PAD?

A

▪️Aspirin (1 per day)

▪️Clopidogrel (Plavix)

26
Q

Peripheral Artery Disease

💊 What drug therapy is used for the treatment of Intermittent Claudication?

A

▪️Cilostazol (Pletal) -↑Vasodilation

▪️Pentoxifylline (Trental)

27
Q

Peripheral Artery Disease

💊 What is the only drug that actually thins the blood by making RBC’s more flexible and slippery?

A

Pentoxifylline (Trental)

28
Q

Peripheral Artery Disease

💊 What non-surgical interventional Radiology Procedures can be used on patients with PAD?

A

▪️Percutaneous Transluminal Balloon Angioplasty (PTA)
▪️Atherectomy
▪️Cryoplasty

29
Q

Peripheral Artery Disease

💊 What are the indications for non-surgical interventional Radiology procedures in patients with PAD?

A

▪️Intermittent Claudication symptoms become incapacitating
▪️Pain at rest
▪️Ulcerations or Gangrene severe enough to threaten viability of the limb

30
Q

Peripheral Artery Disease
💊 What non-surgical procedure used for the treatment of PAD involves the insertion of a catheter through the femoral artery that presses plaque back into the lining of the vessel and a stent is usually placed?

A

Percutaneous Transluminal Balloon Angioplasty (PTA)

31
Q

Peripheral Artery Disease
💊 What non-surgical procedure used for the treatment of PAD uses a cutting disc, laser, or rotating diamond tip device to cut or grind down plaque?

A

Atherectomy

32
Q

Peripheral Artery Disease
💊 What non-surgical procedure used for the treatment of PAD uses liquid nitrous oxide and a balloon to freeze anything it touches and causes plaque to disintegrate?

A

Cryoplasty

33
Q

Peripheral Artery Disease
💊 What is the most common surgical approach used for treatment of PAD which uses a vein or synthetic graft to bypass blood around the lesion and may be used in combination with PTA?

A

Peripheral Artery Bypass with Autogenous (their own vein)

34
Q

Peripheral Artery Disease

😷 What areas should be checked for good circulation on patients with PAD after bypass surgery?

A

6 P’s distal to surgical site

35
Q

Peripheral Artery Disease

😷 How long after bypass surgery for treatment of PAD should the patient ambulate?

A

Out of bed on the first day to promote blood flow through the graft

36
Q

Peripheral Artery Disease

📚 What should the patient be taught NOT to do after bypass surgery for the treatment of PAD?

A

▪️Bending
▪️Sitting in a Chair
▪️Cross legs at ankles or knees

37
Q

Peripheral Artery Disease

💊 Besides bypass surgery, what other surgical therapy can be used for the treatment of PAD?

A

▪️Endarterectomy- Scalpel removes inner lining of artery

▪️Patch Graft Angioplasty- Tissue lining the vessel is missing

▪️Amputation- Last effort. Severe pain at rest & infection

38
Q

Peripheral Artery Disease

🍓 What diet modifications should be made for patients with PAD?

A

↓Fat

↓Cholesterol

39
Q

Peripheral Artery Disease

📚 What should patients with PAD be taught about proper care of feet?

A

▪️Check feet daily
▪️Protect extremities
▪️Never soak the feet
▪️Contact HCP with any injury or inflammation to the feet

40
Q

Peripheral Artery Disease

📚 What should patients with PAD be encouraged to do to improve peripheral arterial circulation?

A

▪️Exercise (Walking & Graded Isometric Exercises

▪️Don’t bend at the groin

▪️Temperature considerations

▪️Stop Smoking

▪️Stress Reduction

41
Q

Peripheral Artery Disease
📚 Because patients with PAD may not have full feeling in their feet, what should they be instructed to do to warm their feet?

A

Use a couple of blankets

42
Q

Peripheral Artery Disease

📚 What type of footwear should patients with PAD use to protect their feet?

A

▪️Cotton or Wool Socks
▪️Round Toe Shoes
▪️Shoes Tied Loosely

43
Q

Peripheral Artery Disease
♿️ Embolism, Thrombosis of Plaque, and trauma can cause Acute Arterial Ischemia in patients with PAD but the most frequent cause of Acute Arterial Ischemia is embolization of thrombus from what area?

A

Heart

44
Q

Peripheral Artery Disease

♿️ Without immediate intervention, Acute Arterial Ischemia may progress to necrosis and gangrene within how long?

A

A few hours

45
Q

Peripheral Artery Disease

😷 What are the 6 P’s?

A 
▪️Pain
▪️Pallor
▪️Pulselessness
▪️Paresthsia (Pins & Needles feeling)
▪️Paralysis
▪️Poikilothermia / Cold (Polar)
46
Q

Peripheral Artery Disease

💊 What treatment is recommended for Acute Arterial Ischemia?

A

Surgical Thrombectomy

47
Q

Peripheral Artery Disease
💊 Besides Surgical Thrombectomy which is recommended, what other surgical procedures can be used for the treatment of Acute Arterial Ischemia?

A

▪️Percutaneous catheter with direct Thrombolytic Therapy

▪️Percutaneous Mechanical Thrombectomy (Pull thrombus out)

▪️Surgical Bypass

48
Q

Peripheral Artery Disease
💊 What is used to dissolve the clot when using Percutaneous Catheter-Directed Thrombolytic Therapy for the treatment of Acute Arterial Ischemia?

A

tPA or Urokinase

49
Q

Peripheral Artery Disease

💊 What is often a long term need after surgical treatment for Acute Arterial Ischemia?

A

Oral Anticoagulation

50
Q

Peripheral Artery Disease

💊 If Heparin is used during procedures, what reversal agent must be kept at the bedside?

A

Protamine Sulfate

51
Q

Peripheral Artery Disease

💊 To prevent the breakdown which will cause the patient to bleed out, how should Protamine Sulfate be stored?

A

Must be kept refrigerated

52
Q

Peripheral Artery Disease

💊 What anticoagulant is administered in patients with Acute Arterial Ischemia?

A

Lovanox SubQ

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