10 minute topic vascular disease Flashcards
Vascular diseases
PVD (peripheral vascular disease) and PAD (peripheral arterial disease)
both have interference of normal blood flow
PAD (peripheral arterial disease)
results from atherosclerosis usually the lower extremities
Atherosclerosis
gradual thickening of the intima and media of the arteries, ultimately resulting in the progressive narrowing of the vessel lumen
Classifications of PAD
Inflow (distal aorta and iliac arteries)
Outflow – femoral, popliteal & tibial artery
subtypes of PAD
Buerger’s, subclavian steal, thoracic outlet syndrome, Raynaud’s, popliteal entrapment
PAD risk factors
HTN, hyperlipidemia, DM, Smoker, Obesity, sedentary lifestyle, familial predisposition, age
PAD s/sx
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
PAD diagnostic tests
Arteriography
Exercise tolerance test
Plethysmography
PAD Arteriography
arterial injection of contrast medium, under fluoroscopy
PAD Arteriography nursing actions
(same as with cardiac cath) Observe for bleeding and hemorrhage. Palpate pedal pulses to identify possible post-procedure occlusions
PAD Exercise tolerance test
used to evaluate claudication during exercise
PAD Plethysmography
used to determine the variations of blood passing through an artery, thus identifying abnormal arterial flow in the affected limb
PAD nursing care
encourage exercise
avoid crossing legs
elevate the legs but not above the heart
promote vasodilation and reduce vasoconstriction
Medications for PAD
ASA, clopidogrel (Plavix) Pentoxifylline (Trental)
give with meals
need several weeks to take effect
Antiplatelets
Anti-platelet teaching
take with food
monitor for signs of bleeding
meds take weeks for effect
PAD surgical interventions
Percutaneous transluminal angioplasty
Arterial revascularization
Percutaneous transluminal angioplasty
balloon or stint them open
will be on anti-platelet therapy for 1-3 months
Arterial revascularization
used for severe claudication and/or limb pain at rest
bypass graft around occlusion
Arterial revascularization post procedure nursing actions
monitor BP, hypotension increases risk of clot or graft collapse
limit hip and knee bending
pain may be severe when reestablishing blood flow
Arterial revascularization PT teaching
avoid crossing legs
loose clothing
no smoking or cold due to vasoconstriction
foot care
Arterial revascularization complications
Graft occlusion
Compartment syndrome
Compartment syndrome
Tissue pressure within a confined body space can restrict blood flow and the resulting ischemia can lead to irreversible tissue damage