T1 Blueprint - Vascular Disease (Josh)

Question 1

What is the definition of HTN?

Answer 1

140/90 or greater in people without DM

Question 2

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

Answer 2

less than 200 mg/dL

Question 3

With PAD, where would pain be for INFLOW DISEASE?

Answer 3

lower back, buttocks, and thighs

Question 4

With PAD, where would pain be for OUTFLOW DISEASE?

Answer 4

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

Question 5

What are the 6 P’s of PAD?

Answer 5

Pain

Pallor

Pulselessness

Paresthesia

Paralysis

Pokilothermia (coolness)

Question 6

PAD:

How is the pain alleviated?

Answer 6

when the lower extremity is placed in dependent postion

Question 7

PAD:

When does pallor occur?

Answer 7

when the extremity is raised above heart level

Question 8

What are the Stages of Chronic PAD?

Answer 8

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

Question 9

What is postop nursing responsibility for Bypass for PAD?

Answer 9

Deep breathing q 1-2 hr

Monitor for graft occlusion (emergency)

Monitor for compartment syndrome

Assess for infection

Question 10

PAD Postop:

What is the most common type of graft occlusion?

Answer 10

embolis

***Most common in lower extremities

Question 11

What is Buerger’s Disease?

Answer 11

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

**eventually become gangrenous

Question 12

What is associated with Buerger’s Disease?

Answer 12

tobacco smoking

Question 13

What are S/S of Buerger’s Disease?

Answer 13

Claudication

Aching pain

Sensitivity to cold

Diminished pulse

Cool, red, or cyanotic extremities

Question 14

How do you manage Buerger’s Disease?

Answer 14

Avoid all forms of tobacco

Avoid exposure to cold

Vasodilators

Question 15

Where would pain from an Abdominal Aortic Aneurysm be located?

Answer 15

abdomen

flank

back

Question 16

S/S of Thoracic Aneurysm?

Answer 16

Coughing / Wheezing

Horner’s Syndrome

Hoarse Voice

Difficulty swallowing

Back pain

Mass visible above suprasternal notch

Question 17

What is Horner’s Syndrome?

Answer 17

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

Question 18

Post-op care for Aneurysm resection?

Answer 18

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

Question 19

Drug therapy for Raynaud’s?

Answer 19

Nifedipine

Cyclandelate

Phenoxybenzamine

Question 20

Target Cholesterol level?

Answer 20

less than 200 mg/dL

Question 21

Target HDL level?

Answer 21

Men: 35-65 mg/dL

Women: 35-80 mg/dL

Question 22

Target LDL level?

Answer 22

less than 130 mg/dL

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

Question 23

Target VLDL level?

Answer 23

7-32 mg/dL

Question 24

Target HDL:LDL ratio?

Answer 24

3:1

Question 25

Target Triglycerides level?

Answer 25

Men: 40-160 mg/dL Women: 35-135 mg/dL

Question 26

Which vessel is mostly affected by an Anterior MI?

Answer 26

Left Anterior Descending (LAD) Artery

Question 27

Which leads will show the Anterior MI?

Answer 27

V3-V4

Question 28

Which vessel is mostly affected by an Inferior MI?

Answer 28

Right Coronary Artery (RCA)

Question 29

Which leads will show an Inferior MI?

Answer 29

II, III, aVf

Question 30

Normal Troponin T levels?

Answer 30

less than 0.02 mg/L

Question 31

When do Troponin T levels return to normal?

Answer 31

14-21 days ***T = Two - Three wks

Question 32

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

Answer 32

Myoglobin **normal is less than 90 mcg/L **return to normal in 24 hrs

Question 33

Anticoagulation: --- decreases platelet aggregation. --- prevents re-occlusion.

Answer 33

ASA Heparin

Question 34

Immediate Treatment for MI: M O N A

Answer 34

Morphine (2-10 mg q 5-15 mins) Oxygen Nitroglycerine ASA (or Plavix)

Question 35

Which meds can prevent Ventricular Remodeling?

Answer 35

ACE Inhibitors (-pril) ARBs (-sartan)

Question 36

What are S/S of Cardiogenic Shock?

Answer 36

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)

Question 37

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

Answer 37

DA