T1 Blueprint - Vascular Disease (Josh) Flashcards Preview

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Flashcards in T1 Blueprint - Vascular Disease (Josh) Deck (37):
1

What is the definition of HTN?

140/90 or greater in people without DM

2

For HTN, what cholesterol levels should we keep in our diet?

less than 200 mg/dL

3

With PAD, where would pain be for INFLOW DISEASE?

lower back, buttocks, and thighs

4

With PAD, where would pain be for OUTFLOW DISEASE?

burning or cramping in calves, ankles, feet, and toes

5

What are the 6 P's of PAD?

Pain

Pallor

Pulselessness

Paresthesia

Paralysis

Pokilothermia (coolness)

6

PAD:

How is the pain alleviated?

when the lower extremity is placed in dependent postion

7

PAD:

When does pallor occur?

when the extremity is raised above heart level

8

What are the Stages of Chronic PAD?

Stage I: no claudication, bruit may be present

Stage II: claudication with exercise

Stage III: pain while at rest, frequently at night

Stage IV: ulcers or blackened tissue present

9

What is postop nursing responsibility for Bypass for PAD?

Deep breathing q 1-2 hr

Monitor for graft occlusion (emergency)

Monitor for compartment syndrome

Assess for infection

10

PAD Postop:

What is the most common type of graft occlusion?

embolis

***Most common in lower extremities

11

What is Buerger's Disease?

occlusive disease of arteries and veins in distal portion of upper and lower extremities

**eventually become gangrenous

12

What is associated with Buerger's Disease?

tobacco smoking

13

What are S/S of Buerger's Disease?

Claudication

Aching pain

Sensitivity to cold

Diminished pulse

Cool, red, or cyanotic extremities

14

How do you manage Buerger's Disease?

Avoid all forms of tobacco

Avoid exposure to cold

Vasodilators

15

Where would pain from an Abdominal Aortic Aneurysm be located?

abdomen

flank

back

16

S/S of Thoracic Aneurysm?

Coughing / Wheezing

Horner's Syndrome

Hoarse Voice

Difficulty swallowing

Back pain

Mass visible above suprasternal notch

17

What is Horner's Syndrome?

drooping eyelid, constricted pupil and dry skin on one side of face associated with TAA

18

Post-op care for Aneurysm resection?

NGT and Strict NPO

Control pain (epidural catheter)

Arterial Line (manage HTN and hypotension)

Neuro Assessment

Renal Function (UOP hourly)

HOB less than 45 degrees

19

Drug therapy for Raynaud's?

Nifedipine

Cyclandelate

Phenoxybenzamine

20

Target Cholesterol level?

less than 200 mg/dL

21

Target HDL level?

Men: 35-65 mg/dL

Women: 35-80 mg/dL

22

Target LDL level?

less than 130 mg/dL

***even less if they have high risk of CAD

23

Target VLDL level?

7-32 mg/dL

24

Target HDL:LDL ratio?

3:1

25

Target Triglycerides level?

Men: 40-160 mg/dL

Women: 35-135 mg/dL

26

Which vessel is mostly affected by an Anterior MI?

Left Anterior Descending (LAD) Artery

27

Which leads will show the Anterior MI?

V3-V4

28

Which vessel is mostly affected by an Inferior MI?

Right Coronary Artery (RCA)

29

Which leads will show an Inferior MI?

II, III, aVf

30

Normal Troponin T levels?

less than 0.02 mg/L

31

When do Troponin T levels return to normal?

14-21 days

***T = Two - Three wks

32

--- is an oxygen carrying protein found in cardiac and skeletal muscle.

Myoglobin

**normal is less than 90 mcg/L

**return to normal in 24 hrs

33

Anticoagulation:

--- decreases platelet aggregation.

--- prevents re-occlusion.

ASA

Heparin

34

Immediate Treatment for MI:

M
O
N
A

Morphine (2-10 mg q 5-15 mins)

Oxygen

Nitroglycerine

ASA (or Plavix)

35

Which meds can prevent Ventricular Remodeling?

ACE Inhibitors (-pril)

ARBs (-sartan)

36

What are S/S of Cardiogenic Shock?

SBP less than 90

Weak, thready pulse

HR greater than 100

S3 and S4

Tachypnea

UOP less than 30 mL/hr

Decreased CO and CI

Increased CVP and PAWP

JVD

Increased SVR (compensatory)

37

What is the DOC to increase contractility of vessles during Cardiogenic Shock?

DA