PVD week 3 Flashcards

Question

Compartment syndrome: goal

Answer 1

pain relief | maintain tissue integrity

Answer 2

Emotional factors

Answer 3

Cyanosis r/t vasospasm then vasodilation causes redness (rubor)

Answer 4

numbness, tingling and burning may occur

Answer 5

Avoid vasoconstrictive activity (cold, smoking, caffeine) Ca2+ channel blocker to decrease s/s Sympathectomy (interruption of the sympathetic nerves) may be also needed

Answer 6

Autoimmune disease Recurring inflammation of the intermediate and small arteries and vein resulting in thrombus formation and vessel occlusion

Answer 7

Tobacco use is a causative factor

Answer 8

Deep vein thrombosis (DVT) Thrombophlebitis Venous thromboembolism

Answer 9

Stasis of blood vessel wall injury altered coagulation

Answer 10

edema, discoloration

Answer 11

1. Note calf, thigh or groin pain with or without swelling warmth and tenderness superficial to area of pain 2. Measure calves and thighs for comparison and baseline 3. Superficial venous thrombosis (SVT) – vein can be itchy swollen red or warm 4. With venous thromboembolism – SVT + paresthesias – may have fever – marked edema, painful

Answer 12

1. Venous duplex ultrasound 2. d-dimer- if elevated suggests VTE 3. CT/MRI 4. PTT, PT INR, Hgb, Hct bc on anticoag

Answer 13

1. larger- anticoagulants 2. Pain medications, compression stockings, light ambulation 3. Acute VTE- bedrest, elevate extremity, antiembolic stockings (pneumatic compression boots), progressive activity 4. Anticoagulation =prevent clot increase in size or new clot development 5. Warm moist compress

Answer 14

1. Superficial may progress to VTE 2. Pulmonary Embolism Avoid – massaging clot site and pneumatic compression devices with VTE – may mobilize the clot 3. Post-thrombotic syndrome-20-50% of clients with VTEvenous stiffening, hypertension, and scarring-symptoms include pain, swelling, tingling, venous ulceration

Answer 15

1. Assess clients at risk and provide preventive teaching and care-exercise, refraining from constrictive clothing 2. Assess for risk for bleeding on hemorrhage in clients on anticoagulant therapy (bleeding precautions) 3. Avoid massaging of clot site and avoid pneumatic compression devices with actual VTE -may mobilize clot 4. Avoid antiplatelets or NSAIDs with anticoagulants 5. Encourage clients on bed rest to turn 6. Change position every two hours and perform leg exercises every two hours while awake

Answer 16

Anticoagulant ◦ Subcutaneously or continuous IV infusion ◦ Monitor aPTT (normal 25-35 seconds, on heparin-1.5-2.5 times the normal) ◦ Antidote is protamine sulfate ◦ With subcutaneous injection, deep into the tissue, do not aspirate or rub site ◦ Watch for heparin-induced thrombocytopenia ◦ Monitor for osteoporosis

Answer 17

◦ Anticoagulant ◦ Monitor INR (International normalized ratio) (0.9-1.1 not on anticoagulants, 2-3 on warfarin, 2.5-3.5 for high-risk clients) ◦ Vitamin K is antidote

Answer 18

◦ Low molecular weight heparin ◦ Monitor CBC at regular intervals ◦ Clients may be taught self-administration ◦ Rotate injection sites

Answer 19

risk of VTE with oral contraceptives or hormone replacement, especially when combined with smoking prevention for those at risk including leg exercises, increased activity, early ambulation, elastic stockings (must be fitted and worn correctly), sequential compression boots (while in hospital), avoid restrictive clothing or crossing legs when sitting some herbs (ginger, garlic, ginseng, gingko) increase bleeding avoid smoking or vasoconstrictive activities

Answer 20

Damage to the media layer of the vessel | >3 cm aorta

Answer 21

Severe back pain | Pulsating mass in abdomen

Answer 22

Medicine | Surgical treatment -- same as thoracic management

Answer 23

atherosclerosis | genetic mutation

Answer 24

pain or dyspnea, difficulty swallowing

Answer 25

BP control | Post op assessments

Answer 26

poorly controlled hypertension | blunt force trauma

Answer 27

severe tearing pain

Answer 28

Bacteria enters the subcutaneous tissue

Answer 29

swelling, redness, pain systemic signs of fever, chills and sweating mark it to see if infections of getting bigger or smaller

Answer 30

Complete blood count will show elevated white blood cell count Wound culture will show the causative bacteria (if it is a seeping wound) X-ray or computed tomography (CT) scan to look for foreign objects in wound (as in an object left in a surgical wound) or examine deep tissues for signs of infection

Answer 31

Assess client for fever and chills, indicative of an infection * Assess wound for tenderness, swelling, warmth, malodorous and purulent drainage * Assess pain level. There is usually pain with an infected wound and with cellulitis * Assess size of wound. Examine wound for dead tissue as necrotic tissue is often present in infected wounds * Assess complete blood count, expect increase in white blood cells due to infection and fever * Assess vital signs, expect temperature elevation. * Assess for cellulitis, manifested as inflammation to surrounding skin and soft tissues under the skin, and red streaking to the skin * If there is cellulitis, perform ongoing assessments to determine if fever, tachycardia and tachypnea are resolving with treatment * Assess for septicemia, manifested as chills, fever, tachycardia and tachypnea. Confusion, reduced urine output and shock are likely if septicemia progresses without treatment * Perform a complete physical assessment * Complete a detailed health history

Answer 32

Collect wound samples for culture and sensitivity and send to the lab promptly * Administer prompt treatment of septicemia. If present, to prevent progression to sepsis and septic shock. * Administer antibiotics promptly as prescribed and monitor for effectiveness * Administer wound treatment as prescribed * Monitor wound to determine effectiveness of treatment * Monitor blood test to determine decrease in white blood cell count * Monitor skin with cellulitis to determine if inflammation is resolving * Administer analgesics for pain, especially before performing wound care * Assist with wound debridement procedure to remove dead tissue from wound * If foreign body in wound, prepare client for procedure to remove the object * Apply wound vacuum to assist with wound healing, if prescribed and monitor wound drainage

Answer 33

Chronic infection Loss of limb as a result of untreated infected wound Septicemia, which is bacteria in the blood that can result in sepsis. Some still refer to septicemia as blood poisoning or bacteremia. -Septicemia occurs when bacteria gets into the bloodstream from another part of the body, as in an infected wound. Client can have chills, fever, fast heart rate and respirations, confusion, reduced urine output and shock Sepsis is a widespread and potentially fatal inflammation of the body in response to bacteria in the bloodstream. Both septicemia and sepsis must be treated promptly

Answer 34

Cellulitis can occur as a result of a wound infection, but it can also be seen in other conditions such as a foreign body in the skin, a tear to the skin, or chronic conditions such as eczema. Cellulitis must be treated promptly

Answer 35

Q6 | First generation cephalosporin –tx bacterial and skin infections

Answer 36

Q6 | In PCN family –skin infections

Answer 37

finish all the antibiotics prescribed how to care for wound at home to prevent re-infection signs and symptoms of septicemia signs and symptoms of wound infection and when to contact the healthcare provider importance of follow-up medical care healthy nutrition to promote wound healing management of other health conditions the client has, especially those associated with poor wound healing, like diabetes management of other health conditions the client has, especially those associated with poor wound healing, like diabetes schedule visits to a wound care clinic if client is unable to care for wound

Answer 38

end of toes, top of feet, lateral ankle region very little drainage; little tissue granulation (pale, very light pink, or necrotic/black) deep "punched out" with noticeable margins/edges that gives it a round appearance

Answer 39

Medial parts of lower legs; medial ankle region Swollen with drainage Granulation present (deep pink to red) Irregular edges Shallow

Answer 40

Increases pigmentation of the skin (hemosiderosis) | Varicosities and telangiectasis

Answer 41

result of increased venous pressure or external trauma | - venous or arterial

Answer 42

Medication Wound cleaning and debridement wound dressing

Answer 43

obstruction of lymph vessels

Answer 44

pharm therapy exercise and compression surgery