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From Flashcardlet > Vascular Disorders > Flashcards

Vascular Disorders Flashcards

1
Q

Does ischemia occur in the arterial or venous system?

A

Arterial

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2
Q

What can increase blood viscosity and cause ischemia?

A

BC in young women

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3
Q

Is peripheral arterial disease chronic?

A

Yes

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4
Q

What are the risks for peripheral arterial disease similar to?

A

CAD/Stroke

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5
Q

With peripheral arterial disease how much of an occlusion is there before there are symptoms?

A

Usually 50%

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6
Q

What does peripheral arterial disease result in?

A

Lack of blood flow to an area

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7
Q

What is usually the first sign of peripheral arterial disease?

A

Leg cramps

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8
Q

When do symptoms of peripheral arterial disease become so severe that they seek treatment?

A

When there is a 75% occlusion

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9
Q

What happens with intermittent claudication?

A

Walking causes lower extremity pain that gets better with rest

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10
Q

What happens to the skin and nails on the legs and feet with peripheral arterial disease?

A
  • Sparse hair
  • Dry, scaly skin
  • Slow growing thick toenails
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11
Q

When is there pain with peripheral arterial disease (PAD)?

A

At rest

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12
Q

What happens to pulses with PAD?

A

Decreased

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13
Q

What happens when the extremity is in a dependent position with PAD?

A

Redness/rubor

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14
Q

What happens to motor function with PAD?

A

Decreased

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15
Q

How do the extremities look and feel with PAD?

A

Cool and Pale

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16
Q

What is the Ankle Brachial Index (ABI) range?

A

-0.5-.95

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17
Q

What is one way you can measure ABI?

A

Blood Pressure

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18
Q

Why do we check for red areas on the skin with PAD?

A

PAD can cause ulceration

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19
Q

Where are ulcerations with PAD usually seen?

A

On toes or points of trauma

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20
Q

What can also cause leg cramps?

A

Electrolyte imbalances

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21
Q

How do you diagnose an arterial occlusion?

A
  • Doppler
  • ABI
  • MRI
  • Arteriogram
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22
Q

What is an arteriogram?

A

Inject dye into periphery to detect occlusion

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23
Q

What do people with PAD often have a history of?

A

CAD, Stroke, HTN

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24
Q

What medications do you use to treat an occlusion?

A
  • Vasodilators
  • Antiplatelets
  • CCBs
  • Thrombolytics
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25
Q

What are the non-pharmacological treatments for an occlusion?

A
  • Angioplasty/Stent
  • Atherectomy
  • Embolectomy
  • Bypass
  • Amputation
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26
Q

Why are CCBs used to treat occlusions?

A

Treat spasms

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27
Q

What is another name for Buerger’s Disease?

A

Thromboangiitis obliterans

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28
Q

What happens with Buerger’s Disease?

A

Inflammation and spasms in the extremities

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29
Q

Who is Buerger’s Disease most common in?

A

Young males who smoke

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30
Q

What increases the risk of Buerger’s Disease?

A

Smoking

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31
Q

What arteries does Buerger’s Disease effect?

A

Small and Medium

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32
Q

How does Buerger’s Disease progress?

A
  • Fibrotic areas
  • Gangrene
  • Necrosis
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33
Q

What drug do you not use with Buerger’s Disease?

A

Vasodilators

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34
Q

What are some treatments for Buerger’s Disease?

A
  • Quit smoking
  • Avoid cold
  • Amputation
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35
Q

What is vasospasm of the small arteries?

A

Raynaud’s Disease

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36
Q

Which gender is more likely to have Raynaud’s?

A

Females

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37
Q

What other diseases is Raynaud’s often associated with?

A

Autoimmune Disorder

  • SLE
  • Rheumatoid Arthritis
  • Trauma
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38
Q

What can aggravate Raynaud’s Disease?

A
  • Cold
  • Smoking
  • Stress
  • Caffeine
39
Q

What happens to the skin when there is a spasm with Raynaud’s?

A

It blanches white wherever the spasm occurs

40
Q

Which disease has more amputations: Raynaud’s or Buerger’s?

A

Buerger’s

41
Q

What happens as the vessels dilate and blood flow returns with Raynaud’s?

A

Fingers turn blue then red

42
Q

Is Raynaud’s usually bilateral?

A

Yes

43
Q

Why are the radial and ulnar pulses intact with Raynaud’s?

A

Because the spasms are in the small periphery

44
Q

How do you prevent spasms with Raynaud’s?

A
  • Avoid cold and stimulants
  • Layer clothes
  • Use mittens not gloves
  • Reduce stress
45
Q

What are some stimulants that could trigger Raynaud’s?

A

Diet Pills and Power Drinks

46
Q

What are the 6 P’s of circulation?

A
  • Pain
  • Paresthesia
  • Paralysis
  • Pulse
  • Pallor
  • Poikilothermia
47
Q

What is poikilothermia?

A

Extremity is the same temperature as the room

48
Q

What is the pre-op care for revascularization?

A
  • Record pre-op circulation

- Pre-op teaching

49
Q

What is the post-op care for revascularization?

A
  • Assess circulation (pulses)
  • TCDB
  • Wound care
  • Watch for bleeding
50
Q

When is there a greater operative risk with revasularization?

A

If the aorta is involved

51
Q

What are the types of venous disorders?

A
  • DVT
  • Varicose veins
  • Venous stasis ulcers
52
Q

What happens with age that causes a risk for DVT?

A

Lose elastin

53
Q

Which gender is more at risk for DVT?

A

Females

54
Q

What are the other risks for DVT?

A
  • Hypercoagulation
  • Immobility
  • Vessel damage
  • Sickle cell
  • Trauma
  • BC
  • COPD
  • Heart disease
55
Q

What are the usual sites for a DVT?

A

Pelvis and Lower extremities

56
Q

What are the symptoms of DVTs?

A
  • Cord-like
  • Tenderness
  • Unilateral swelling
  • Fever
57
Q

How many DVTs are asymptomatic?

A

50%

58
Q

Should you still check for Homan’s sign?

A

No it can cause a clot to break off

59
Q

What is a test that can check for DVTs?

A

Ultrasound

60
Q

What is the treatment for DVTs?

A
  • Heparin
  • Warfarin
  • Thrombolytics
61
Q

What is the IV Heparin dose?

A

8 units/kg/hr for 5 days

62
Q

What is the loading dose of IV Heparin?

A

100U/kg

63
Q

What can you use instead of IV Heparin?

A

Low Molecular Weight Heparin (LMWH)

64
Q

What do you watch for with LMWH?

A

Heparin induced thrombocytopenia

65
Q

What do you monitor with Heparin?

A

aPTT and platelets

66
Q

What reverses heparin?

A

Protamine sulfate

67
Q

What do you monitor with Warfarin?

A

INR and PT

68
Q

What is therapeutic INR?

A

2-3X normal

69
Q

What reverses Warfarin?

A

Vitamin K

70
Q

What are the non-pharmacological interventions for DVT?

A
  • TEDs
  • Compression stockings
  • External pneumatic compression
  • Early ambulation
  • Vena cava filter
71
Q

When can a patient with a DVT not ambulate?

A

If they are still in pain

72
Q

What does a vena cava filter do?

A

Catches clots

73
Q

What is one complication you watch for with DVTs?

A

Pulmonary embolism

74
Q

What are signs of a pulmonary embolism?

A

SOB, pain, decreased O2 sats, increased HR

75
Q

What are the Coumadin restrictions?

A
  • Soft toothbrush
  • Careful with aspirin
  • Avoid alcohol
76
Q

What foods do you avoid with Coumadin?

A

Greens

77
Q

What is their activity level if they are on IV heparin?

A

Bedrest

78
Q

What disease has increased pressure in the veins and failing valves?

A

Varicose veins

79
Q

What increases the risk for varicose veins?

A
  • Obesity
  • Prolonged standing
  • Pregnancy
  • Increased intra-abdominal pressure (Ascites, hepatic disease)
80
Q

How do you manage varicose veins?

A
  • Regular exercise
  • Elevate extremity
  • Support stockings
  • Sclerotherapy
  • Weight loss
  • Teach s/s infection
81
Q

How many stasis ulcers are venous?

A

85%

82
Q

What are the risks for venous stasis ulcers?

A
  • Venous HTN
  • Infection
  • DM
  • Malignancy
  • Connective tissue disorder
  • Trauma
  • Pressure
  • Insect Bites
83
Q

Why do venous stasis ulcers occur?

A
  • Venous stasis
  • Poor venous return
  • Edema
84
Q

What is the treatment for venous stasis ulcers?

A
  • Compression
  • Elevation
  • Topical wound care
  • Vein removal
85
Q

How many venous stasis ulcers will reoccur after vein removal?

A

70-80%

86
Q

Which vascular disease has pain?

A

Arterial

87
Q

Which vascular disease has normal pulses unless there is edema?

A

Venous

88
Q

What color is the extremity with arterial disease?

A
  • Pale if elevated

- Red if dependent

89
Q

What color is the extremity with venous disease?

A

Normal or may bronze

90
Q

What is the extremity temperature with venous and arterial disease?

A
  • Venous: normal

- Arterial: cool

91
Q

Which vascular disorder has edema?

A

Venous

92
Q

Where are the ulcers with arterial disease?

A

On toes or points of trauma

93
Q

Where are ulcers with venous disease?

A

Medial side

94
Q

Which vascular disorder has a risk of gangrene?

A

Arterial

From Flashcardlet (107 decks)

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