Cardiovascular System (Exam Two)

Question 1

What is peripheral artery disease (PAD)?

Answer 1

• Progressive narrowing of arteries

- Degeneration of arteries

Question 2

What is considered the leading cause of peripheral artery disease (PAD)?

Answer 2

Atherosclerosis

Question 3

List the common sites of atherosclerotic lesions.

Answer 3

• Iliac artery
• Femoral artery
• Popliteal artery
• Tibial artery
• Peroneal artery

Question 4

What are the risk factors for developing peripheral artery disease?

Answer 4

• Tobacco use
• Over age 60
• African American
• Women
• Diabetes mellitus

Question 5

What are the clinical manifestations of peripheral artery disease (PAD)?

Answer 5

• Intermittent claudication
• Thin, shiny, taut skin
• Diminished/absent pulses
• Paresthesia
• Loss of hair on lower legs

Question 6

Describe intermittent claudication.

Answer 6

• Ischemic muscle pain caused by exercise
• Resolves in 10 minutes or less with rest
• Reproducible

Question 7

A nurse caring for a patient diagnosed with peripheral artery disease (PAD) would expect the capillary refill in the lower extremities to be what?

Answer 7

Prolonged

Question 8

The nurse knows that the most serious complication(s) of peripheral artery disease (PAD) is/are what?

Answer 8

• Nonhealing Arterial ulcers

- Gangrene

Question 9

Arterial ulcers most commonly occur over bony prominences on the: (SATA)

A. Lower legs
B. Hands
C. Upper legs 
D. Toes
E. Feet

Answer 9

A, D, E

Question 10

List the medications commonly prescribed for a patient diagnosed with peripheral artery disease (PAD).

Answer 10

• Statins
• ACE inhibitors
• Anti-platelet agents
• Cilostazol (Pletal)

Question 11

Why are anti-platelet agents not prescribed, or given concurrently, with omeprazole?

Answer 11

Omeprazole will reduce absorption of the anti-platelet

Question 12

T/F: Compression stockings or TED hose are NOT utilized in patients with peripheral artery disease (PAD).

Answer 12

True

Question 13

What education should the nurse provide to a patient with peripheral artery disease (PAD)?

Answer 13

• Avoid knee-flexed positions
• Do not cross legs
• Turn and reposition frequently
• Avoid using heating-pads
• Avoid compression stockings

Question 14

What are the characteristics of critical limb ischemia?

Answer 14

• Chronic ischemic rest pain that lasts more than two weeks
• Nonhealing arterial leg ulcers
• Gangrene of the leg

Question 15

What is considered the cure for critical limb ischemia?

Answer 15

Revascularization via bypass surgery

Question 16

What is the priority nursing intervention for a patient who is post-operative from a percutaneous transluminal angioplasty (PTA) due to critical limb ischemia?

Answer 16

Assess vital signs for changes

Question 17

What is an aneurysm?

Answer 17

Outpouching of arterial wall

Question 18

What is the most common location for an aortic aneurysm to occur?

Answer 18

Abdominal aorta

Question 19

List the signs and symptoms of a thoracic aortic aneurysm.

Answer 19

• Difficulty swallowing
• Hoarseness
• Chest pain

Question 20

What is the highest risk factor for aortic aneurysm rupture?

Answer 20

Hypertension

Question 21

In order for an aortic aneurysm to be surgical repaired, it must be greater than ______ in diameter.

Answer 21

5 cm

Question 22

What is the priority nursing management for a patient with an aortic aneurysm?

Answer 22

• Monitor intake and output
• Daily weights
• Avoid severe hypertension
• Frequent neuromuscular assessment

Question 23

Describe an aortic dissection.

Answer 23

• Tear occurs in inner layer of aorta
• Middle layer is stripped from the inner layer
• Results in “dissection”

Question 24

List the signs and symptoms of a Type A: Acute ascending aortic dissection.

Answer 24

• Severe, sudden onset
• Excruciating chest/back pain
• Radiates to neck and shoulders

Question 25

List the signs and symptoms of a Type B: Acute ascending aortic dissection.

Answer 25

- More likely to report pain in back - Abdomen - Legs - Pain described as sharp, worst ever, tearing, ripping

Question 26

If the nurse is suspicious of a acute ascending aortic dissection, what is the priority intervention?

Answer 26

- Assess blood pressure | - Assess heart rate

Question 27

What is the target heart rate for a patient who is being treated for an aortic dissection? What medication is often utilized to reach this target heart rate?

Answer 27

- 60 bpm or less | - Morphine

Question 28

Which type of aortic dissection is considered a surgical emergency?

Answer 28

Type A: Acute ascending aortic dissection

Question 29

What are the priority nursing intervention(s) for a patient following surgical repair of an aortic aneurysm?

Answer 29

- Cardiac monitor - Monitor intake/output - Neurovascular assessment

Question 30

What is the most common disorder of the veins?

Answer 30

Venous thrombosis

Question 31

Venous thrombosis can result in what other disorders?

Answer 31

- Pulmonary embolism (PE) | - Deep vein thrombosis (DVT)

Question 32

List the risk factors for developing deep vein thrombosis (DVT).

Answer 32

- Pregnancy - Surgery - Contraceptives - Prolonged sitting - Prolonged standing - Obesity

Question 33

What are the signs and symptoms of deep vein thrombosis?

Answer 33

- Unilateral leg edema - Systemic temperature >100.4 - Fullness in thigh or calf - Paresthesia - Warm skin - Redness

Question 34

What is/are an uncommon, but severe form of deep vein thrombosis (DVT)?

Answer 34

- Phlegmasia cerulea dolens | - Phlegmasia alba dolens

Question 35

A patient is admitted to the ED with phlegmasia cerulea dolens and/or phlegmasia alba dolens. The nurse knows this patient will require what type of treatment?

Answer 35

Revascularization surgery

Question 36

What is considered the therapeutic range for INR?

Answer 36

2 - 3