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Integumentary 1 - Midterm > Arterial Injuries - Class 4 > Flashcards

Arterial Injuries - Class 4 Flashcards

1
Q

arterial ulcers are d/t

A

arterial insufficiency of large and small vessels

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2
Q

how do arterial ulcers present

A

gangrene

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3
Q

gangrene

A

dry, dark, cold and mummified

wet gangrene = infection

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4
Q

when does ulceration occur –> gangrene

A

when gangrene is sloughed off or debrided

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5
Q

where do arterial ulcers usually occur

A

toes

interdigital spaces

foot

lateral malleolus

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6
Q

arterial ulcer wound base

A

dry

deep

pale

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7
Q

arterial ulcers will have

A

necrotic, lacking granulating tissue

wound edges usually rough and steep

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8
Q

surrounding skin of arterial ulcers

A

may be cyanotic or gangrenous

demarcation of viable and nonviable tissues

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9
Q

arterial ulcers are

A

very painful to pt

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10
Q

acute arterial ulcers

A

thrombosis

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11
Q

chronic arterial ulcers

A

arteriosclerosis obliterans

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12
Q

arterial insufficiency presents w/

A

intermittent claudication

pain and pallor on elevation

rubor on dependency

trophic changes of skin

decreased pulses

slow nail growth

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13
Q

predisposing factors of arterial insufficiency

A

smoking

DM

hyperlipoproteinemia

hypertension

advancing age

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14
Q

those with atherosclerosis –>arterial insufficiency

A

60-70% of pts have at least 2 RFs

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15
Q

how is arterial insufficiency dx

A

angiogram

arterial dopler

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16
Q

rubor of dependency

A

assesses arterial flow by evaluating skin color during elevation and dependency

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17
Q

venous filling time

A

assesses arterial flow by evaluating time for veins to refill after emptying

18
Q

capillary refill

A

assesses patency of the capillaries in small vessel dz

19
Q

arterial doppler

A

assesses relative flow of blood

movement of blood cells
–>causes shift in signal frequency which is audible to the examiner

20
Q

arterial doppler –> normal

A

sound pulsatile

21
Q

pulse volume recording

A

used w/ arterial doppler

visualize waveforms of segmental pressures at different sites of the extremity

22
Q

pulse volume recording asseses

A

the site of blockage

23
Q

ankle/brachial index

A

detects and quantifies arterial dz

can determine tx course of action

24
Q

ABI ratio

A

systolic pressure of posterior tibial artery to brachial artery

25
Q

< 0.5 ABI

A

tissue necrosis

26
Q

0.5-0.8 ABI

A

ischemic rest pain

27
Q

0.8-1.0 ABI

A

minimal sxs

28
Q

> 1.0 ABI

A

no arterial occlusive dz

29
Q

medical therapy for arterial insufficiency

A

reducing RFS for dz and resultant MI, stroke and vascular death

improving sxs

30
Q

improving sxs

A

stop smoking

control of DM

anti-platelet therapy

trental –> reduces blood viscosity

pletal

walking exercise program

31
Q

indications for surgical therapy –> arterial insufficiency

A

progressive and limiting intermittent claudication

rest pain

gangrene

32
Q

conservative management

A

bed rest (for acute occlusion)

limb protection is paramount

decreased –> NWB when ambulating if ulcerative

local wound care

skin protection

reflexive vasodilation

light exercise

33
Q

bed rest

A

avoid excessive muscular activity

HOB raised slightly for increased perfusion to feet

34
Q

local wound care

A

determine ABI

sharps, enzymatic debridement if indicated

moisture wound dressings (hydrogels)

cultures –> antibiotics if infected

35
Q

skin protection

A

w/ petrolatum bases moisturizers

36
Q

light exercise

A

preulcerative pt

37
Q

surgical management

A

vascular studies

imaging

cultures

surgery

38
Q

vascular studies

A

dopplers

ABI

angiogram

MRA

tcPO2

39
Q

imaging

A

xrays

CT scans

bone scans

MRIs

40
Q

surgery

A

angioplasties/stents

bypass surgeries

serial debridement

amputations

Integumentary 1 - Midterm (23 decks)

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