Sherpath - Vascular Disorders Flashcards
(33 cards)
Which assessment findings is associated with acute dissection of the ascending aorta?
a. Throbbing headache
b. Pulsating substernal mass
c. Chest pain described as ripping in nature
d. Cyanotic toes with palpable dorsalis pedis pulses.
c. Chest pain described as ripping in nature
Which symptom best supports the nurse’s observation that the client is in the initial stage of Raynaud’s disorder?
a. Throbbing, tingling, and swelling of the limbs.
b. Chronic ischemic pain and ulcers on both feet.
c. Hypertension, hyperglycemia, and inflamed arteries
d. Colour changes of fingers and toes from white to blue to red.
d. Colour changes of fingers and toes from white to blue to red.
Which condition would the nurse assess for when conducting an examination of a client who is a smoker with a two-year history of using oral contraceptives?
a. Hypotension
b. Venous thromboembolism
c. Cardiomyopathy
d. Dependent edema
b. Venous thromboembolism
Oral Contraceptives:
• Especially the estrogen-containing ones (which are most of them, by the way), can increase clotting factors in the blood.
• That’s not great. Your blood should not be casually turning into Jell-O unless you’re actively bleeding.
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Smoking:
• Damages the endothelial lining of blood vessels.
• Increases platelet aggregation.
• Promotes inflammation and vasoconstriction.
So yeah, smoking basically makes your vessels angry and twitchy.
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When you combine the two:
Estrogen = more clotting
Smoking = more vascular damage
Together = Hello, Venous Thromboembolism (VTE).
Which can look like:
• DVT (deep vein thrombosis): leg pain, swelling, maybe a fashion-forward calf that’s suddenly twice its normal size.
• PE (pulmonary embolism): shortness of breath, chest pain, dramatic gasping—basically your lungs filing an HR complaint
Which action is priority for the nurse to implement when the client returns to the unit after an aneurysm repair with an endovascular graft?
a. Assess the groin area bilaterally
b. Measure the abdominal girth
c. Determine when the client last urinated
d. Ask the client to rate pain on a 1-10 scale.
a. Assess the groin area bilaterally
Endovascular = catheter route
Catheter route = femoral artery
Femoral artery = groin check party, population: you.
Which statement by the client would indicate an increased risk of venous thromboembolism if a 38-year-old female client was to take the contraceptives?
a. “I smoke 1.5 packs of cigarettes a day.”
b. “I try to go jogging three times a week.”
c. “I try to go jogging three times a week.”
d. “It’s been three years since my last child was born.”
a. “I smoke 1.5 packs of cigarettes a day.”
Which complication is most suspected when a client reports tenderness when the leg over a vein is touched and the nurse assess warmth and palpable cord in the area?
a. Pulmonary embolism
b. Pulmonary hypertension
c. Post-thrombotic syndrom
d. Venous thromboembolism
d. Venous thromboembolism
Which injection site would the nurse use to administer enoxaparin?
a. Buttock, upper outer quadrant
b. Abdomen, anterior-lateral aspect
c. Back of the arm, 2 inches away from a mole
d. Anterolateral thigh, with no scar tissue nearby.
b. Abdomen, anterior-lateral aspect
Enoxaparin is a low molecular weight heparin (LMWH). Its job is to help prevent blood clots, and to do that, it needs to be absorbed in a way that ensures it works fast and reliably. The abdomen is ideal for this purpose. Here’s why:
1. Rich blood supply: The abdomen, specifically the anterolateral (front and sides) area, has a large network of blood vessels, which allows for faster absorption compared to other areas like the arms or thighs. The blood flow is better, which helps the medication get into your bloodstream quickly to do its job.
2. Less painful, easier to inject: While it may feel like a slight pinch, injecting into the abdominal area is generally less painful than other areas like the thigh, where there’s more muscle and less fatty tissue. Fat is actually what helps “cushion” the medication and allows for smoother, more effective absorption.
3. Fat layer: The abdomen, particularly the fatty tissue around the belly (you know, where that comforting food baby sometimes lives), is ideal for subcutaneous injections. It’s where injections can be given with minimal discomfort and maximum efficiency. No muscle, just fat. And that’s good for what you need.
4. Avoiding muscle irritation: Enoxaparin is injected subcutaneously (under the skin but above the muscle), and injecting into areas with more fat (like the abdomen) helps prevent irritation or damage to muscles, which can happen with intramuscular injections
Which medication taken by a client diagnosed with thromboangiitis obliterans is contraindicated and would be questioned by the nurse?
a. Cilostazol
b. Nifedipine
c. Acetaminophen
d. Nicotine transdermal
d. Nicotine transdermal
thromboangiitis obliterans (aka Buerger’s disease) is basically an inflammatory disease of small and medium-sized blood vessels—especially in the hands and feet—that leads to clotting and eventual tissue damage.
And guess what the #1 villain is?
Nicotine.
Like, it’s literally in the “Do Not Invite” list. Smoking is a known trigger for the progression of the disease. Even nicotine patches are off the table because nicotine in any form causes vasoconstriction, which makes the already awful circulation worse.
So the nurse sees “nicotine transdermal” on the med list and is like, “Absolutely not. We’re not fueling the fire while trying to put it out.”
Which statement by a client with venous leg ulcers indicates a need for further education?
a. “I will take a walk daily.”
b. “I will try to lose at least 10 kg “
c. “I will put on my stockings after I get out of bed each day.”
d. “I will not wear knee-high socks that are tight around my calf.”
c. “I will put on my stockings after I get out of bed each day.”
Which clinical manifestation would the nurse expect the client who has Buerger’s disease to report?
a. Back pain when lying flat
b. Chest pain when walking up stairs
c. Leg pain with exercise and relief with rest
d. Reddening of lower legs and feed when elevated
c. Leg pain with exercise and relief with rest
Which information would the nurse teach the client to prevent recurrent episodes of Raynaud’s phenomenon?
a. Wear thin, light clothing to allow better circulation
b. Drink small amounts of caffeine throughout the day to stimulate heartbeat and increase circulation.
c. Immerse hands in warm water to decrease vasospasm and promote normal blood circulation
d. Use a cold compress or heating pad as needed for comfort.
c. Immerse hands in warm water to decrease vasospasm and promote normal blood circulation
Which intervention would the nurse provide on postoperative day 1 for a client with critical limb ischemia who has had peripheral artery bypass surgery?
a. Keep the client on bed rest
b. Assist the client with walking several times.
c. Have the client sit in the chair several times.
d. Place the client on their side with knees flexed.
b. Assist the client with walking several times.
Which interpretation of ankle-brachial index (ABI) test result of 1.10 for a client with diabetes mellitus is correct?
a. The client has peripheral arterial disease
b. The client has normal ABI
c. The client has falsely elevated ABI
c. The client has borderline ABI
c. The client has falsely elevated ABI
What is the antidote of warfarin?
a. Vitamin K
b. Cobalamin
c. Heparin sodium
d. Protamine sulfate
a. Vitamin K
What risk factor is the most important one for peripheral artery disease?
a. Tobacco use
b. Excess weight
c. Sedentary lifestyle
d. High blood pressure
a. Tobacco use
Which site would the nurse select for injection of enoxaparin?
a. Thigh
b. Flank
c. Abdomen
d. Buttock
c. Abdomen
Which diagnosis causes colour and temperature changes of the limbs and treatment includes smoking cessation and trauma and cold temperature avoidance?
a. Buerger’s disease
b. Venous thrombosis
c. Acute arterial ischemia
d. Raynaud’s Phenomenon
a. Buerger’s disease
Which description is characteristic of pain experienced by a client diagnosed with Raynaud’s phenomenon?
a. Ripping type chest pain
b. Leg pain with exercise that resolves with rest
c. Leg pain that resolves when the leg is lowered.
d. Pain in fingers or toes with colour changes in the skin.
d. Pain in fingers or toes with colour changes in the skin.
Which information would the nurse include in the discharge teaching plan for a client with venous thromboembolism who is prescribed warfarin?
a. No routine laboratory monitoring is needed.
b. Avoid contact sports and high risk activities
c. Increase daily intake of dark leafy vegetables
d. Continue to use garlic as a diety supplement.
b. Avoid contact sports and high risk activities
Which intervention is most important to include in the client’s treatment plan for moderate symptoms of thromboangiitis obliterans (Buerger’s disease)?
a. Administer IV iloprost
b. Prepare for diagnostic tests that will be prescribed
c. Advise complete cessation of tobacco
d. Encourage the client to walk for 30 to 40 minutes three to four times a week.
c. Advise complete cessation of tobacco
Which intervention is priority in the care of a client with chronic venous insufficiency (CVI)?
a. Applying topical antibiotics to venous ulcers.
b. Administering oral subcutaneous anticoagulants
c. Maintaining the client’s legs in a dependent position
d. Teaching the client the correct use of compression stockings.
d. Teaching the client the correct use of compression stockings.
Which is the desired effect of aspirin 75 mg daily for a client who underwent percutaneous transluminal angioplasty?
a. Prevent platelet agglutination
b. Stimulate collateral circulation
c. Decrease liver production of vitamin K
d. Control pain resulting from the procedure
a. Prevent platelet agglutination
Which symptom would be the highest priority to ask when obtaining a medical hx from a client with a suspected abdominal aortic aneurysm?
a. Back pain
b. Blood in urine
c. Frequent headaches
d. Black or tarry stools
a. Back pain
Which diagnostic test would the nurse expect to teach a client who is being examined for venous thromboembolism (VTE) in the calf?
a. Duplex ultrasound
b. Contrast venography
c. Magnetic resonance venography
d. Computed tomography venography
a. Duplex ultrasound
