cardiovascular Flashcards
(53 cards)
PVD risk factors
Hypertension-constant stretch and pressure on the blood vessels Hyperlipidemia Diabetes Smoking Obesity Family history Age-increasing age Male African American
Peripheral Vascular Arterial Disease-assessments
Intermittent claudication Rest pain Skin changes Diminished or absent peripheral pulses Arterial ulcerations -Feet and toes -Painful
Intermittent claudication
when someone walks or exercises o2 demand is increased, but the arteries cant perfuse enough blood, so muscles get cramped
•Goes away with rest
Peripheral Vascular Arterial Disease
skin changes
Hair loss-hair follicles die
•Dry, scaly, pale, or mottled
•Cool skin-no blood
•Pallor with elevation-harder it becomes for the arteries to get the blood to the location, Rubor when dependent
arterial ulcer
circular
-edges are round and smooth
Peripheral Vascular Arterial Disease-Intervention/Management
- Slowly increase exercise-to promote the arterial blood flow
- Body positioning-raise HOB to relieve pain, want feet down if possible, don’t raise feet above their heart
- Promote vasodilation
- Antiplatelet or anticoagulant to prevent blockages
- Angioplasty-go in and remove the clot
- bi-pass graphing
- Surgery: Arterial revascularization
Peripheral Vascular Arterial Disease-Intervention/Management-promote vasodilation
- No tight clothing-no tight shoes
- Foot care
- Environmental temperature-warm
- Nicotine-no smoking, causes vasoconstriction of the arteries
- Caffeine-limit bc vasoconstricts arteries
aneurysm assessment
dependent on location •Back pain - if below renal arteries •Dyspnea, substernal pain-thoracic •Pulsating abdominal mass-aortic •Claudication(pain with movement)-femoral/popliteal •May be asymptomatic until rupture
Peripheral Vascular Venous Disease
•Venous valves incompetent, leading to venous stasis
-if the valves no longer work as well, the blood may pool
•Venous stasis increases venous pressure which impairs arterial circulation, decreases perfusion
•Tissue hypoxia leads to cell death-necrosis
•Venous stasis ulcers can form
Peripheral Vascular Venous Disease
manifestations
Lower leg edema, aching pain, itching particularly when standing
•Cyanosis with dependency(down). Brown, leathery colog (Hemosiderosis)-from the iron leaving the blood
•Ulcer development: around ankle or medial/anterior aspect of leg
•Dermatitis-inflammation of the skin
Peripheral Vascular Venous Disease-ulcer
all the fluid in their lower extremity, skin will become wet and just fall off
Peripheral Vascular Venous Disease
management
- Focus on symptom relief, promoting circulation, healing of affected skin
- Reduce edema
- Ulcer care
- Comfort measures
Peripheral Vascular Venous Disease
management-reduce edema
Elevation of legs
•No prolonged standing or sitting
•Graduated compression dressings or stockings
-Start really tight at the toes, gradually loser towards the top
-May use an ace wrap, lace up stockings
Peripheral Vascular Venous Disease
ulcer care
Wet-dry dressings
-The area is always wet
•UNNA boot
-Looks like an ace wrap, but has medication on the inside(zinc oxide)
-Chemical reaction when it contacts with air and it becomes hard, so it hardens like a cast
-Promotes venous return, prevent stasis, makes a sterile environment for wound healing
-If a lot of drainage, may change it like 1-2 times a week
Venous ulcers S/S
dull, achy pain
- lower leg edema
- pulse present
- drainage
- sores with irregular borders
- yellow slough or ruddy skin
- location: ankles
arterial ulcers s/s
intermittent claudication pain
- no edema
- no pulse/weak pulse
- no drainage
- round smooth sores
- black eschar
- location: toes and feet
Nursing Diagnoses for Peripheral Vascular Disease
Ineffective Tissue Perfusion
Risk for decreased cardiac tissue perfusion
Chronic Pain
HR is controlled by
sympathetic(speed up) and parasympathetic(slow down)
Stroke Volume (SV)
The volume of blood pumped forward with each ventricular contraction.
SV affected by 3 things
preload, afterload, contractility
Preload
(end diastolic pressure)-the ventricle is full of blood
Contractility
how efficiently the myocardial muscle contracts and pushes the blood out
Afterload
(mean arterial pressure)-how hard heart has to work to push the blood out of the heart
Hypertension Systems of Control
Arterial baroreceptors
ANP and BNP-respond to stretching in the cardiac chamber that release peptides which tell the kidneys to excrete sodium and then water will follow, which will decrease BP
