PVD Management

Question 1

Arterial Disease: What 6 things can be done for rehab?

Answer 1

1. Risk factor modification
2. Limb protection
3. Exercise training for pts with PAD
4. LE Exercise
5. Medical Mgmt
6. Surgical Mgmt

Question 2

Arterial Disease:
Limb protection: Avoid excessive ___, protection of extremities from ___, and extremes of ___.
Bed rest may be required if ___, ___, ___ ___ ___ are present.

Answer 2

Strain
Injury
Temperature
Gangrene, ulceration, acute arterial disease

Question 3

Arterial Disease:
Ex training: may result in improved ___ ___, improved peripheral blood flow via ___ ___ and muscle ____ ___. Consider ___ training.

Answer 3

Functional capacity
Collateral circulation
Oxidative capacity
Interval

Question 4

Arterial Disease:

Walking program- what should intensity be? Total of ___ minutes, ___x/week

Answer 4

Intensity such that pt reports 1 on claudication scale within 3-5 minutes, stopping if they reach 2 (until pain subsides)
Total of 30-60 minutes, 3-5 days/week

Question 5

Arterial Disease:
Exercise training for PAD
_____ essential for pts with insensitive feet, teach techniques of ____.

Answer 5

Well-fitting shoes

Foot inspection

Question 6

Arterial Disease:
Exercise training
Beta blockers for tx of HTN or cardiac disorders may ____ time to claudication or ___ symptoms. Pentoxifylline, dipyridamole, aspirin, and warfarin may ___ time to claudication.

Answer 6

Decrease
Worsen
Increase

Question 7

Arterial Disease:

Exercise training for PAD— high risk for ___

Answer 7

CAD

Question 8

Arterial Disease:
LE Exercise:
What are Modified Buerger-Allen exercises?
Effects are less pronounced in pts with ____
Resisted ___ exercises are most effective method for increasing blood flow.

Answer 8

Postural exercise plus active PF and DF of ankle
Exercises improve blood flow during/after exercises
Effects less pronounced in pts with PAD
Calf

Question 9

Arterial Disease:
Medical tx: meds to decrease ____ ____, prevent thrombus formation (heparin). Vasodilators are ____. CCB for _____ disease.

Answer 9

Blood viscosity
Controversial
Vasospastic

Question 10

Arterial Disease:
Surgery: Atherectomy, thromboembolectomy, laser therapy.
Revascularization via ____ or ____ ____. Sympathectomy results in permanent _____, improvement of blood flow to skin. Amputation when ____ present.

Answer 10

Angioplasty, bypass grafting
Vasodilation
Gangrene

Question 11

Venous Disease: Venous thromboembolism (VTE)-
Initiate preventative measures: ?
Initiate ____ and ____ once LMWH therapeutic levels of meds achieved.
Utilize ____ ____ ___ with at least ___ mmHg of pressure at ankle. Trial of intermittent pneumatic compression may be appropriate for pts with ____. Assess for ___ ___.

Answer 11

Prompt referral to MD
Ambulation, leg exercises (calf pumps)
Graded compression stockings, 30
postthrombotic syndrome (PTS)
Falls risk

Question 12

Venous Disease: Chronic venous insufficiency (CVI)
Mgmt of ____. Positioning with extremity in ___ minimum of ____ above heart. Compression therapy- bandages applied within ____ of rising. Paste bandages (___ boot), gauze impregnated with _____, gelatin, and glycerine applied for _____ days. Graduated compression stockings with pressure gradient of ____ mmHg. Compression pump therapy for ____ session twice daily.

Answer 12

Edema
Elevation
18cm
20 minutes
Unna
Zinc oxide
4-7 days
30-40
1-2 hrs

Question 13

Venous Disease

RED FLAG: consider consequences of compression therapy to limb with ABI _______ or with evidence of ____ or ____

Answer 13

<0.8

Active cellulitis, infection

Question 14

Venous Disease: CVI

Exercise: what kind? (3)

Answer 14

Ankle pumps
Cycle ergometry
Early ambulation 3-4x/day

Question 15

Venous disease: CVI

Severe conditions with dermal ulceration may require surgery (ligation and vein ___, vein ___, _____)

Answer 15

Stripping
Grafts
Valvuloplasty