week 4 module 13 peripheral vasculature

Question 1

vascular disease HPI

Answer 1

pain or cramps
swollen extremities
extremity fatigue, restless
non-healing wounds
erectile dysfunction 
travel or immobilization 
high altitude 
hypercoagulable state
recent injury or surgery

Question 2

PMH vascular disease

Answer 2

meds
- CCB
- oral contraceptive 
cardiac or peripheral disease
vasculitis or vasospastic
chronic illnesses
- clotting disease
- heart disease
- dyslipidemia
- aortic aneurysm

Question 3

FH vascular disease

Answer 3

peripheral vascular disease

abdominal aortic aneurysm

Question 4

leg pain/cramps HPI

Answer 4

onset and duration: with activity or rest?
cont. burning in toes, pain in thighs/butt
skin changes: cold, pallor, darkened, redness/warmth
swelling
limping

Question 5

vascular disease infants and children

Answer 5

hemophilia
sickle cell
renal disease
coarctation of the aorta
leg cramps during exercise

Question 6

vascular disease and preg

Answer 6

Blood pressure
- preeclampsia
– HA, vision changes, N/V, epigastric pain, RUQ pain
– oliguria, rapid onset edema, hyperreflexia, proteinuria,
Legs
- edema, varicosities, pain or discomfort

Question 7

risk factors for preeclampsia

Answer 7

older than 40 
first preg
preexisting HTN
renal disease
DM
multifetal gestation 
FH of preeclampsia 
previous preeclampsia 
obesity

Question 8

vascular disease and older adults

Answer 8

leg edema: pattern, freq. time of day
interference with ADL 
ability of pt and family to cope 
claudication: area involved, uni/bilateral, distance one can walk before onset, sensation, length of time required for relief 
medications

Question 9

vascular disease and personal/social hx

Answer 9

employment
tabacco use
wt
exercise
age
standing/sitting for long periods

Question 10

inspection of extremities

Answer 10

pallor, cyanosis, or erythema
collapsed or engorgement of superficial veins
atrophied skin/nails and loss of hair

Question 11

palpate arterial pulses

Answer 11

amplitude

• 4: bounding
• 3: full, increased
• 2: expected
• 1: diminished, barely palpable
• 0: absent, not palpable

Question 12

PAD

Answer 12

dull ache with muscle fatigue/cramps with sustained exercise.

• walking/stairs
• a few minutes of rest relieves it

Question 13

occulsion 3 P’s

Answer 13

pain
pallor
pulselessness

Question 14

types of PAD

Answer 14

stenosis or atherosclerosis
aneurysm
vasculitis
vasospastic
raynauds

Question 15

claudication

Answer 15

pain that results from muscle ischemia

Question 16

arterial disease and location of pain calf

Answer 16

superficial femoral artery

Question 17

arterial disease and location of pain thigh

Answer 17

C femoral, external iliac

Question 18

arterial disease and location of pain buttock

Answer 18

C iliac or distal aortic

Question 19

Arterial disease S/S

Answer 19

pain
diminished pulses
ulcers
skin color/temp: cool and pale
dec. cap refill time

Question 20

3 type of veins

Answer 20

superficial
deep
penetrating: connects superficial and deep

Question 21

venous inspection of sufficiency

Answer 21

color
temperature: warmth
skin texture
nail changes
presence of hair
muscular atrophy 
edema or swelling: pitting
varicose veins
venous ulcers

Question 22

venous obstruction Homans sign

Answer 22

cal pain with dorsiflexion of the foot

Question 23

older adults

Answer 23

arteries calcify
arterial walls lose elasticity and tone
superficial vessels become more prominent
inc. peripheral vascular resistance -> inc. BP
dec. perfusion

Question 24

infants bounding pulse

Answer 24

associated with a large left to right shunt

- PDA

Question 25

coarctation of aorta vasculature findings

Answer 25

difference noted in pulse amplitude between the upper extremities or between the femoral and radial pulses or femoral pulses absent

Question 26

infant weak pulse

Answer 26

cardiac output may be diminished or peripheral vasoconstriction may be present