8: PVD and Infections Flashcards
If a patient’s distal popliteal and tibial arteries are affected, what should you suspect?
Arterial peripheral vascular disease (aPVD)
What are the most common infections in DM?
- Respiratory:
- CAP
- TB
- Urinary Tract:
- UTI
- Pyelonephritis
- Skin and soft tissue
Name 3 risk factors for foot infections.
- Neuropathies
- PVD
- Impaired immune function
Name 3 causes of altered immunity.
- Depressed polymorphonuclear leukocyte function
- Impaired leukocyte adherence, chemotaxis, phagocytosis
- T-cell function depressed
T/F Diabetics are at increased risk for infections, but risk for bacteremia remains the same.
False. Increased risk for bacteremia, too.
What are 9 signs and symptoms of arterial peripheral vascular disease (PVD)?
- Intermittent claudication (calf pain when walking but disappears at rest)
- Impotence
- Pain in distal foot when supine (rest pain)
- Decreased/absent pulses
- Pallor on elevation of feet
- Rubor on dependency of feet
- Thickened toenails
- Loss of toe and foot hair
- Smooth, shiny, atrophic skin
What is a sign of advanced PVD?
Ulcers
Which organisms are most common in diabetics with foot infections?
- Gram + cocci
- Staph aureus
- Strep
What are 3 complications of foot infections?
- Osteomyelitis
- Amputation
- Death
Which 3 organisms are most common in diabetics with UTIs?
- E. coli
- Proteus species
- Fungi
How would you expect a foot ulcer in PVD to look?
Sharply defined, dry, “punched out”
Where are 3 common locations for foot ulcers?
- Plantar surface of foot
- Over 1st and 5th metatarsals
- Tips of toes, heels, malleoli
What are the mechanisms of injury in foot ulcers?
- Shear
- Mechanical stress
Why should diabetics receive Pneumovax injection?
Increased risk of CAP caused by S. pneumoniae
Which organism is most common in diabetics with pyelonephritis?
E. coli
