PVD, Thromboembolic disease (DVT), Cardiovascular Trauma, Cardiogenic & Obstructive Shock

Question 1

decreased cellular perfusion secondary to failure of the central pump

Answer 1

cardiogenic shock

Question 2

decreased cellular perfusion secondary to obstruction of blood into or our of the heart (PE, pericardial tamponade, tension pneumothorax)

Answer 2

obstructive shock

Question 3

severe, unbearable, sudden onset, burning ischemic pain

decreased/absent pulse, pallor (elevation)/hyperemia (Dependency), numbness/paralysis, cool extremity

elevated HOB, but DONT elevate extremity

encourage activity

AC (heparin), surgical intervention, thrombolytic therapy

Answer 3

acute arterial occlusion

Question 4

muscular cramp, ache, numbness, tightness, weakness which is provoked by exercise, relieved by rest (usually w/in 5 min)

Answer 4

intermittent claudication

Question 5

intermittent claudication, pain when leg is elevated (night) and relieved when dependent

muscle atrophy, loss of hair to digits, thickened nail beds, shiny, scaly skin, non healing wound/ulcer

elevate HOB but DONT elevate extremity

encourage activity (but discourage actions which could cause limb injury)

antiplatelet therapy (ASA, clopidogrel)

control underlying condition

prevent injury to limb

Answer 5

chronic arterial occlusion

Question 6

deep aching/throbbing pain localized to area of occlusion

increased w activity, decreased w rest

tenderness w palpation over the area

homans sign

leg erythema and warmth, ipsilateral pitting edema

elevate affected extremity

discourage activity

AC or thrombolytics, warm packs over site, increased fluids, monitor for PE

Answer 6

venous occlusion (DVT)

Question 7

pain on dorsiflexion

Answer 7

homans sign

Question 8

injury to the heart secondary to blunt trauma

will often have trauma to chest wall (bruising, seatbelt marks etc)

Answer 8

blunt cardiac injury