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Nursing 2 > Arterial Insufficiency > Flashcards

Arterial Insufficiency Flashcards

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1
Q

plaque/artherosclerosis leads to

A

ischemia

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2
Q

ischemia is

A

reduced oxygenated blood flow to tissues or heart

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3
Q

ischemia/reduced blood flow effect on tissues

A 
less oxy and nutrients so dead tissues/necrosis
skin atrophy
delayed healing
wound infection
arterial ulcers
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4
Q

goal of peripheral arterial disease

A

inc oxygenated blood flow to lower extremities

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5
Q

goal of peripheral venous disease

A

no oxy blood problem;get deoxy blood back to heart

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6
Q

rest pain

A

no gravity flow oxy blood to lower extremity; worse at night, supine position doesn’t promote gravity flow

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7
Q

rest pain cause

A

elevated legs, supine position

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8
Q

peripheral artery disease swelling?

A

no edema b/c no oxy blood to legs/foot

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9
Q

peripheral artery disease skin temp, color?

A

temp cool; color pallor no oxy, think dead body

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10
Q

PAD wound depth?

A

deep. no oxy so break down tissue leads to depth of injury

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11
Q

PAD pain?

A

painful b/c tissue nerve damage

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12
Q

PAD wound appearance

A

even edges round, PVD moist water runs not neat

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13
Q

PAD wound drainage

A

dry, little drainage, no oxy so no fluid build up

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14
Q

PAD expected BP changes

A

normal bp legs ^ arms. PAD bp legs less than brachial

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15
Q

3 causes blood vessel obstruction

A

atherosclerosis, glucose, platelets

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16
Q

proper pulse assessment

A

bilateral

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17
Q

PAD expected pulse of affected lower extremity

A

absent or +1 vs +2 normal

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18
Q

atherosclerosis of brain arteries leads to

A

stroke/cerebrovascular accident CVA

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19
Q

atherosclerosis of brain, kidney, heart, peripheral?

A

not peripheral

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20
Q

PAD pain location

A

distal to blockage/narrowing of arteries

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21
Q

hyperhomocysteinemia

A

deficit Vit B12, B6 and folic acid

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22
Q

hyperhomocysteinemia risk

A

thrombosis if elevated level

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23
Q

cramping/ischemic pain with exercise

A

intermittent claudication pain in calf

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24
Q

intermittent claudication remedy

A

rest, resolves within 10 minutes

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25
Q

rest pain

A

supine at night no gravity flow so low arterial pressure

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26
Q

lack oxy and nutrients: 3 symptoms of lower extremities

A

no hair growth, dry skin, brittle/thick nails

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27
Q

increased lactic acid level effect on circulation

A

decrease flow of oxy and blood in arteries

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28
Q

describe PAD pain

A

shooting, sharp, stabbing, burning

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29
Q

poikilothermia

A

body temp adjust to environment/ cool on palpitation, raynaud’s

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30
Q

paresthesia

A

abnormal sensation; numbness, tingling, pins and needles b/c low oxy

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31
Q

PAD leg elevation

A

pallor color

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32
Q

PAD leg dependent position (hanging off bed)

A

rubor

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33
Q

PAD complications

A

tissue necrosis, arterial ulcer, wound infection, atrophy

34
Q

dead tissue at extremities caused by lack of blood flow or infection

A

gangrene (fingers, toes)

35
Q

nonhealing ulcers and gangrene risk

A

amputation

36
Q

term for necrosis/gangrene/ulcers

A

critical limb ischemia

37
Q

PAD ulcer bed appearance

A

pale or black, rounded and smooth margins, dry

38
Q

PAD positioning

A

dependent to get gravity/arterial pressure to leg/foot

39
Q

PVD positioning

A

elevate legs to get blood flow back to heart

40
Q

PAD treated with heat (pad) or high temp

A

not good, decreased sensation may not feel burn

41
Q

exercise benefit

A

promote blood flow, no activity: blood pool at calf

42
Q

PAD diagnostics

A

doppler ultrasound, ABI, duplex ultrasound imaging (duplex, 2 sound waves used Doppler and B-form)

43
Q

ABI calculation

A

ankle systolic BP/^ L or R brachial systolic pressure

44
Q

ABI range (ratio of BP at ankle vs BP at arm)

A

less than 1.0 indicate occlusion in lower extremity

45
Q

BP ankle vs brachial normal

A

ankle typically higher (gravity/pressure) than arm

46
Q

PAD/atherosclerosis risk factor modifications

A

stop smoking, lower BP, treat hyperlipidemia, diabetics A1C less 7

47
Q

A1C also known as

A

glycosylated hemoglobin; blood glucose attached to hgb over past 3 months

48
Q

intermittent claudication management

A

walking 30-60 min/day, 3x week

49
Q

PAD nutritional therapy

A

BMI less 25, waist size less 40 in. men, diet

50
Q

PAD pharmacologic therapy (lower BP, vasodilation)

A

ACE inhibitors Ramipril (Altace)

51
Q

ACE inhibitors Ramipril (Altace) action

A

block convert angiotensin I to II; no vasoconstriction

52
Q

PAD pharmacologic therapy - antiplatelet agents

A

aspirin, Clopidogrel (Plavix), prevent thromboemboli

53
Q

PAD pharmacologic therapy - intermittent claudication

A

Cilostazol (Pletal) no food; Pentoxifylline (Trental) food

54
Q

PAD non surgical treatment

A

Percutaneous Transluminal Angioplasty (PTA)

55
Q

Percutaneous Transluminal Angioplasty source

A

youtube nucleus medical media central georgia heart

56
Q

Arterial blockage/narrowing

A

stenosis

57
Q

wire mesh in artery to keep open

A

stent

58
Q

Percutaneous Transluminal Angioplasty Pre Op care

A

NPO, groin/femoral site shave, IV access 18/20 gauge

59
Q

Percutaneous Transluminal Angioplasty Post Op care

A

bleeding at insertion site, VS, pulse, antiplatelet med

60
Q

Percutaneous Transluminal Angioplasty with stenting process

A

stent hold artery open, balloon push plaque thru

61
Q

remove plaque by cutting or grinding, especially PVD or PAD

A

Atherectomy incision femoral artery, catheter just like PTA and PCTA but useful if vessel can’t handle stent

62
Q

PAD surgery procedure called

A

Peripheral Artery Bypass; bypass blood around lesion

63
Q

artery bypass surgery = aka

A

revascularization

64
Q

bypass graft: 2 options

A

autogenous vein (from self) or synthetic graft

65
Q

arterial bypass post op

A

24-48 hr ICU, arterial line for continuous BP, Foley

66
Q

increased pressure in body area after period of low pressure

A

compartment syndrome internal bleeding or swelling after acute trauma

67
Q

PAD surgery (1. artery bypass surgery, 2. )

A

amputation; elevate stump on 1 thin pillow

68
Q

phantom limb pain

A

feel sensations or pain in limb not there

69
Q

vasospasm/constriction of small arteries in extremities

A

Raynaud’s Phenomenon

70
Q

Raynaud’s Phenomenon characteristics

A

young female, response to cold or stress

71
Q

arteriole constriction color stages

A

white/pallor: low perfusion, blue: cyanosis, red: blood returns

72
Q

recurring inflammation arteries and veins, caps

A

Buerger’s; lead to thrombus formation, autoimmune

73
Q

Buerger’s characteristics

A

younger men, smokers, clots at tips of fingers/toes

74
Q

ankle-brachial index low level indicates

A

peripheral arterial blockage, normal about 1.0, 1.2 good

75
Q

peripheral artery disease 3 types medications

A
  1. Antihypertensive/vasodilator ACE Inhibitor
  2. Antiplatelet agents prevent formation of thromboemboli b/c narrow arteries vulnerable
  3. Intermittent Claudication treatment Cilostazol and Pentoxifylline
76
Q

all percutaneous angioplasty preop care includes

A

NPO

77
Q

critical limb ischemia revascularization or bypass surgery post op care

A 
24-48 hour ICU or step-down unit stay
arterial line for continuous BP measurement
titrate med to maintain BP
foley
neurovascular assessment
78
Q

PTA vs PCTA

A

percutaneous transluminal angioplasty (PTA) non surgical procedure to repair or unblock artery; PCTA unblock/repair coronary artery

79
Q

percutaneous transluminal angioplasty: 2 types

A

cardiac (PCTA percutaneous transluminal coronary angioplasty) and non-cardiac (PTA percutaneous transluminal angioplasty)

80
Q

PTA vs PCTA similarities

A

same process just an artery (PTA) vs coronary artery (PCTA); local anesthesia, enter via femoral artery, use catheter

81
Q

atherosclerosis vs stenosis

A

atherosclerosis is narrowing of arteries due to plaque, stenosis also narrowing but may or may not be from atherosclerosis

82
Q

gold standard for PAD diagnostics

A

invasive digital angiography

Nursing 2 (9 decks)

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