TOPIC 5 - peripheral vascular diseases Flashcards
(25 cards)
disorders of peripheral arterial disease
intermittent claudication
neuropathy
arterial ulcers
disorders of peripheral venous disease
venous thromboembolism
venous ulcers
medications for PVD
aspirin
clopidogrel
warfarin
heparin
analgesics
risk factors for PAD
tobacco, CKD, diabetes, HTN, hypercholesterolemia, african americans, females, elevated C reactive protein, family hx, hypertriglyceridemia, aging
manifestations of PAD
intermittent claudication, parasthesia, elevation pallor, dependent rubor, critical limb ischemia
6 P’s assessment
paralysis
paresthesia
pallor
pulse
pain
poikilothermic
diagnostic testing and labs
ABI
doppler ultrasound
duplex imaging
angiography
magnetic resonance angiography
complications of PAD - arterial ulcer
a wound caused by impaired arterial blood flow to the lower leg and foot. impairment in blood flow results in tissue ischemia and necrosis
associated skin characteristics of arterial ulcers
cool temp
thin, shiny skin
decreased or absent skin hair
pain
decrease pulse strength
nursing diagnosis
ineffective peripheral tissue perfusion
activity intolerance
chronic pain
ineffective health management
medications
antiplatelets - ASA, clopidogrel, platelet aggregation inhibitor
phosphodiesterase inhibitors - cilostazol
exercise therapy for PVD
exercise 30-45 min a day at least 3 times a week for a minimum of 3 months
nutritional therapy
maintain waist circumference less than 40 for men and less than 35 for women
interventions
protect limb from injury
decrease ischemic pain
prevent and control infection
improve perfusion
meds : antiplatelets, NSAID, anticoagulants
lifestyle and diet modifications
diseases associated with chronic venous diseases
phlebitis
venous thrombosis
superficial vein thrombosis
venous thromboembolism
venous leg ulcers
venous thromboembolism can lead to ___
pulmonary embolism (life threatening)
risk factors for venous stasis
advanced age, a fib, bed rest, chronic heart failure, fractured leg or hip, long trips without adequate exercise, obesity, orthopedic surgery, pregnancy, stroke, prolonged immobility, spinal cord injury or limb paralysis
risk factors for endothelial damage
abdominal and pelvic surgery, caustic or hypertonic IV drugs, fractures of the lower extremities, history of previous venous thromboembolism, indwelling peripherally inserted central vein catheter, IV drug abuse, trauma
risk factors for hyper-coagulability of blood
dehydration or malnutrition, erythropoiesis stimulating drugs, high altitudes, hormone therapy, cancer, oral contraceptives, polycythemia vera, pregnancy, sepsis, severe anemias, tobacco use
prevention for those with a history of VTE
avoid oral contraceptives
drink fluids
exercise during periods of bed rest
prevention for those at risk for VTE
patient education
leg exercises
early ambulation after procedure
compression stockings
anticoagulation therapy
hydration
venous ulcer + associated characteristics
a wound caused by a decrease of blood flow return from the lower extremities to the heart
hyperpigmentation, firm skin, dry scaly skin, edema
care for venous insufficiency
compression stockings
moist dressings
nutrition for venous insufficiency
high protein, vitamin A and C and zinc
