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Nursing 281 > 10 minute topic vascular disease > Flashcards

10 minute topic vascular disease Flashcards

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1
Q

Vascular diseases

A

PVD (peripheral vascular disease) and PAD (peripheral arterial disease)
both have interference of normal blood flow

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2
Q

PAD (peripheral arterial disease)

A

results from atherosclerosis usually the lower extremities

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3
Q

Atherosclerosis

A

gradual thickening of the intima and media of the arteries, ultimately resulting in the progressive narrowing of the vessel lumen

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4
Q

Classifications of PAD

A

Inflow (distal aorta and iliac arteries)

Outflow – femoral, popliteal & tibial artery

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5
Q

subtypes of PAD

A

Buerger’s, subclavian steal, thoracic outlet syndrome, Raynaud’s, popliteal entrapment

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6
Q

PAD risk factors

A

HTN, hyperlipidemia, DM, Smoker, Obesity, sedentary lifestyle, familial predisposition, age

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7
Q

PAD s/sx

A 
Burning pain during exercise (intermittent claudication)
Pain while in bed
< cap refill
< distal pulse
Loss of hair on calf
Dry, scaly skin
thick toenails
muscle atrophy
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8
Q

PAD diagnostic tests

A

Arteriography
Exercise tolerance test
Plethysmography

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9
Q

PAD Arteriography

A

arterial injection of contrast medium, under fluoroscopy

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10
Q

PAD Arteriography nursing actions

A

(same as with cardiac cath) Observe for bleeding and hemorrhage. Palpate pedal pulses to identify possible post-procedure occlusions

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11
Q

PAD Exercise tolerance test

A

used to evaluate claudication during exercise

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12
Q

PAD Plethysmography

A

used to determine the variations of blood passing through an artery, thus identifying abnormal arterial flow in the affected limb

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13
Q

PAD nursing care

A

encourage exercise
avoid crossing legs
elevate the legs but not above the heart
promote vasodilation and reduce vasoconstriction

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14
Q

Medications for PAD

A

ASA, clopidogrel (Plavix) Pentoxifylline (Trental)
give with meals
need several weeks to take effect
Antiplatelets

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15
Q

Anti-platelet teaching

A

take with food
monitor for signs of bleeding
meds take weeks for effect

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16
Q

PAD surgical interventions

A

Percutaneous transluminal angioplasty

Arterial revascularization

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17
Q

Percutaneous transluminal angioplasty

A

balloon or stint them open

will be on anti-platelet therapy for 1-3 months

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18
Q

Arterial revascularization

A

used for severe claudication and/or limb pain at rest

bypass graft around occlusion

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19
Q

Arterial revascularization post procedure nursing actions

A

monitor BP, hypotension increases risk of clot or graft collapse
limit hip and knee bending
pain may be severe when reestablishing blood flow

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20
Q

Arterial revascularization PT teaching

A

avoid crossing legs
loose clothing
no smoking or cold due to vasoconstriction
foot care

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21
Q

Arterial revascularization complications

A

Graft occlusion

Compartment syndrome

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22
Q

Compartment syndrome

A

Tissue pressure within a confined body space can restrict blood flow and the resulting ischemia can lead to irreversible tissue damage

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23
Q

Examples of PVD’s

A 
venous thromboembolism (VTE)
venous insufficiency
varicose veins
24
Q

venous thromboembolism (VTE)

A

blood clot formed as a result of venous stasis, endothelial injury, or hypercoagulability (hypercoagulation)

25
Q

Thrombophlebitis

A

thrombus that is associated with inflammation

26
Q

Venous insufficiency

A

occurs secondary to incompetent valves in the deeper veins of the lower extremities

27
Q

Varicose veins

A

enlarged, twisted and superficial veins

28
Q

VTE risk factors

A 
Hip surgery, total-knee replacement, open prostate surgery
Heart failure 
Immobility
Pregnancy
Oral contraceptives
29
Q

Venus insufficiency risk factors

A

Sitting or standing in one position over a long time
Obesity
Pregnancy
Thrombophlebitis

30
Q

Varicose veins risk factors

A 
A person over 30yrs with standing occupation
Pregnancy
Obesity
Systemic diseases
Family history
31
Q

VTE s/sx

A 
Can be asymptomatic 
Calf or groin pain – classic sign
Tenderness – classic sign
Sudden onset of swelling – classic sign
 assess for SOB & chest pain (feeling of impending doom)
32
Q

Venus insufficiency s/sx

A

Pain
Stasis ulcers -typically found around ankles
Stasis dermatitis (brown discoloration around ankles that can extend up the calf relative to the level of insufficiency)
Edema

33
Q

Varicose veins s/sx

A

Aching pain (dull)
Distended superficial veins (visible just below the skin)
Tortuous in nature

34
Q

D-dimer diagnostic test

A

measures fibrin degradation products present in the blood produced from fibrinolysis.
indicates thrombus formation has possibly occurred

35
Q

Venous duplex ultrasonography diagnostic test

A

uses high-frequency sound waves to provide picture of the blood flow through a blood vessel.

36
Q

Impetus plesmography

A

determine the variations of blood passing through a vein, thus identifying abnormal venous flow in the affected limb

37
Q

Venogram

A

if other tests are negative but they still suspect a DVT

they put a contrast medium material into the vein and use x-ray and fluoroscopy to see it

38
Q

Trendelenburg test

A

used for varicose veins
If they fill proximally there are varicose veins
If they fill distally there are none (normal)

39
Q

DVT & thromblophlebitis nursing care

A 
encourage rest
elevate extremity
no massage
warm compress
compression or antiembolism stockings
40
Q

Venous Insufficiency nursing care

A

Elevate legs several times a day for at least 15 to 30 min
Elevate feet at least 6 inches at night
Avoid crossing legs and constrictive clothing or stockings
TED hose – after the legs have been elevated and when swelling is at a minimum.

41
Q

Therapeutic procedures for varicose veins

A

sclerotherapy
Vein Stripping
Endovenous Laser Treatment
Radiofrequency Energy application

42
Q

sclerotherapy

A

chemical solution is injected into the varicose vein to produce localized inflammation which will, close the lumen of the vessel over time and it will collapse on itself

43
Q

Vein Stripping

A

moval of large varicose veins that cannot be treated with less-invasive procedures

44
Q

Vein Stripping post procedure

A

keep legs elevated
encourage ROM
need compression stockings

45
Q

Radiofrequency Energy application

A

electrode will scar the dilated vein causing it to close down on itself

46
Q

Endovenous Laser Treatment

A

heat from a laser is used to close the dilated vein.

47
Q

Aneurysms

A

weakness in a section of a dilated artery that causes widening or ballooning in the wall of the blood vessel

48
Q

Aneurysm forms

A

Saccular (only affecting one side of the artery)

Fusiform (involving the complete circumference of the artery)

49
Q

abdominal aortic aneurysms

A

account for 75% of aneurysms

50
Q

Aneurysm prevention

A

no smoking
decrease WT
healthy diet/exercise
control BP (#1)

51
Q

Aneurysm risk factors

A

Atherosclerosis

Age (arterial stiffening occurs)

52
Q

Aneurysm s/sx

A

none initially

53
Q

Abdominal aortic aneurysm (AAA) s/sx

A 
Abdominal pain
pulsating abdominal mass (no not palpate)
> BP
Aortic dissections (likely fatal)
54
Q

Thoracic aortic aneurysm s/sx

A

Coolness or cyanosis below
Severe back pain
Hoarseness, cough, shortness of breath, and difficulty swallowing
Decrease in urinary output

55
Q

Aneurysm diagnosis

A

x-ray

CT and ultrasound to assess location and size

56
Q

Percutaneous aneurysm repair

A

Insertion of endothelial stent grafts

typically used for aortic aneurysms, but can be used to repair a thoracic aortic aneurysm

57
Q

Thoracic aortic repair

A

similar to open heart surgery

Nursing 281 (34 decks)

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