Arterial Insufficiency

Question 1

Arterial insufficiency ulcer
Onset
Cause

Answer 1

Sudden development of wound
s/s of the arterial insufficiency present for a while though
Imbalance of supply and demand

Question 2

Risk factors for an arterial insufficiency ulcer

Answer 2

Hyperlipidemia
Smoking
Hypertension
DM
Age
Trauma

Question 3

Acute ischemia - causes

Answer 3

Embolism (five Ps)
Thrombosis
Acute dissection 
Trauma
Compression
Intra-arterial injections
Cold injury 
Severe vasospasm

Question 4

Acute ischemia - cause - embolism - what are the 5 Ps to identify an embolism

Answer 4

Pain
Pallor
Paresthesia
Pulselessness 
Paralysis

Question 5

Arterial insufficiency ulcer - characteristics 
Shape
Depth
Location
Pain
Wound bed
Exudate
Surrounding skin

Answer 5

Regular symmetrical wound margins
Moderate depth - might expose underlying soft tissue structures
Distal locations (dorsum toes/foot, ant shin)
Pain might be significant!
Pale wound bed - might have severe necrotic tissues
Mild exudate or no exudate
Surrounding skin is shiny, hairless, rubor

Question 6

Chronic Ischemia

Answer 6

Worsening arteriosclerosis may eventually lead to cell death
Often s/s have been present for significant period of time

Question 7

Arterial insufficiency ulcer - general treatment guidelines

Answer 7

Stop smoking, limit alcohol
Control of diabetes, hypertension, lipid levels
Foot and skin care (proper shoes/washing)
NO COMPRESSION
Revascularization procedure might be needed for pt with low ABIs
Limit use of body part - consider AD
Aerobic exercise
Gentle warming
Dressing to promote moisture

Question 8

Arterial insufficiency ulcer - general treatment guidelines - no sharp debridement for who?

Answer 8

ABIs of 0.5 or less

SIGNIFICANT caution at 0.8

Question 9

Most typical patient will present with

Answer 9

Combination of venous and arterial insufficiency

Question 10

Vasculitis

Answer 10

Vascular inflammation as result of CT disorder
Often result in loss of integumentary integrity
Most pt on heavy dose corticosteroid

Question 11

Calciphylaxis is what

Answer 11

Syndrome associated with renal disease
Vascular calcification and skin necrosis
Dermal calcification may occur
Uncommon to rare

Question 12

Calciphylaxis risk factors

Answer 12

DM increase risk

end stage liver disease will increase risk