VD and Problems w/Peripheral Circulation

Question 1

Peripheral artery disease is a result of?

Answer 1

• atherosclerotic plaque
• thromboemboli
• trauma
• infections
• inflammation
• vasospastic disorders
• congenital

Question 2

Peripheral artery disease is a manifestation of?

Answer 2

atherosclerosis

Question 3

What is atherosclerosis?

Answer 3

a thickening/hardening of arteries

Question 4

Atherosclerosis is a slow process that begins?

Answer 4

in early adulthood, most people do not know they have it

Question 5

Assessment considerations for PAD?

Answer 5

• brain
• heart
• kidneys
• mesentery
• limbs
• frequently seen in DM and elderly patients

Question 6

PAD causes:

Answer 6

• partial or totally obstruction
• lumen narrows
• infraction
• accusation of: lipid, calcium deposits, fibrous tissue, stenosis, thrombosis

Question 7

Who is at risk for PAD?

Answer 7

• tabacco * big factor
• family
• age 70
• obesity
• HTN
• HLD
• DM

Question 8

PAD asymptomatic/ symptomatic manifestations:

Answer 8

• pain in distal muscle groups: worse when walking
• ulcers
• numbness/tingling
• hairloss
• pallor
• cool to touch
• no pulse
• paralysis

Question 9

PAD structural changes:

Answer 9

• hair loss distal to the occlusion
• thick opaque nails
• shiny dry skin
• skeletal muscle atrophy

Question 10

PAD skin color changes:

Answer 10

• pallor with elevation

- dependent rubor

Question 11

PAD pulse changes:

Answer 11

• diminished or absent blew area of stenosis/obstruction

- cool extremity distal to occlusion

Question 12

PAD sensation changes:

Answer 12

• paresthesia: numbness/tingling
• ulcerations
• gangrene

Question 13

With rubor the blood vessel cannot?

Answer 13

constrict they stay dilated.

Question 14

Intermittent claudication is a hallmark symptom for PAD and is?

Answer 14

limping pain

Question 15

What is it when the arterial occlusions develop gradually, and there is less risk of sudden death b/c this ______ ______ may develop.

Answer 15

collateral circulation

Question 16

Over time with collateral circulation continued decreased perfusion results in?

Answer 16

ischemia and tissue death

Question 17

DX of PAD:

Answer 17

• doppler
• ultrasonography
• magnetic resonance angiography (MRA)
• CT

Question 18

An MRA is able to?

Answer 18

isolate blood vessels and vein in 3D

Question 19

Treatment of PAD:

Answer 19

• thrombolysis
• percutaneous
• cilostazeol (aspirin)
• bypass graft

Question 20

What is thrombolysis?

Answer 20

a thrombolytic agent injected directly into thrombosis to lyse the clot

Question 21

What is percutaneous?

Answer 21

• angioplasty: balloon expanded stenosis
• stent placement: assess perfusion/pain
• bypass graft: rerouting blood flow

Question 22

Nursing management of PAD:

Answer 22

• pain relief
• maintain tissue integrity
• tabacco cessation
• stress reduction
• avoid hot temperature
• avoid constrictive clothing
• avoid crossing legs

Question 23

Six P’s for acute arterial occlusion:

Answer 23

• pain
• pallor
• pulselessness
• poiikilothermia (cool temp)
• paresthesia
• paralysis

Question 24

_______ is vasospasm causing vasoconstriction, and occurs with cold or stress?

Answer 24

raynauds syndrome

Question 25

_____ _____ is when blood vessel become inflamed, swell, and become blocked (thrombi).

Answer 25

buergers disease

Question 26

Burgers disease puts you at risk for?

Answer 26

- infection | - gangrene

Question 27

Abdominal aortic aneurysm (AAA) is a?

Answer 27

localized out pouching sac dilation formed on the arterial wall.

Question 28

AAA is a result of?

Answer 28

- atherosclerotic plaque - trauma - disease - congenital

Question 29

Risk factors for AAA:

Answer 29

- genetic basis | - HTN

Question 30

AAA grows an average of?

Answer 30

0.4 cm/year

Question 31

Clinical manifestations of AAA:

Answer 31

- some people may not have any - feeling there heart beat in their abdomen when lying down - report feeling an abdominal mass or abdominal throbbing - mottling of toes - IMPENDING RUPTURE: severe pain pain or abdominal pain, persistent of intermittent, often midline - Rupturing anerysm: constant, intense back pain, falling BP, decreasing hematocrit - MOST IMPORTANT INDICATION: pulsating mass in the abdomen, also systolic bruit may be heard of mass

Question 32

What is the MOST IMPORTANT indication for AAA:

Answer 32

pulsating mass in the abdomen.

Question 33

DX of AAA:

Answer 33

- ultrasonography | - CT

Question 34

Treatment of AAA:

Answer 34

- observation - monitor BP - education - anti-hypertensives - surgery

Question 35

AAA can be confused with?

Answer 35

MI

Question 36

For AAA ultrasound every 6 months and monitor BP is small but if larger than?

Answer 36

5.5 cm or significantly enlarging surgical intervention is required.

Question 37

Nursing management for AAA:

Answer 37

- education r/t diet, smoking, meds

Question 38

Postop considerations for AAA:

Answer 38

bleeding, circulation, neuro changes, pain management

Question 39

Venous thrombosis is?

Answer 39

formation of blood clot in the venous system

Question 40

People at risk for DVT:

Answer 40

- stasis of blood - vessel wall injury - hormone therapy - smoking - dehydration - varicose veins

Question 41

Manifestations of DVT:

Answer 41

- pain - swelling/edema - increase in tempature - larger leg - gray brown skin

Question 42

DX of DVT:

Answer 42

- D dimer - ultrasonography - MRA

Question 43

a d dimer that is positive:

Answer 43

clots when lyse

Question 44

Treatment of DVT:

Answer 44

- heparin - warfarin - thrombotic therapy - surgery

Question 45

Goal for patients with DVT of warfarin:

Answer 45

- INR 2 to 3 - with heart valve INR 2.5 to 3.5 - check INR every month

Question 46

heparin does not dissolve a clot that is?

Answer 46

already formed.

Question 47

aPTT for heparin:

Answer 47

21 - 35 sec

Question 48

Venous Ulceration complication:

Answer 48

cellulitis/dermatitis may complicate healing

Question 49

Venus ulcers develop as a result of?

Answer 49

increased venous pressure or external trauma

Question 50

Venous ulcerations cause the skin to be?

Answer 50

dry, cracked and pruritic

Question 51

Treatment of venous ulceration?

Answer 51

- dressing for debridement - hyperbaric oxygenation - compression

Question 52

With PAD venous ulceration develops as a result of

Answer 52

ischemia and may lead to gangrene

Question 53

Treatment of ulceration

Answer 53

keep dry and usually not debriefed until revascularization procedures are performed.