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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
rest pain
supine at night no gravity flow so low arterial pressure
26
lack oxy and nutrients: 3 symptoms of lower extremities
no hair growth, dry skin, brittle/thick nails
27
increased lactic acid level effect on circulation
decrease flow of oxy and blood in arteries
28
describe PAD pain
shooting, sharp, stabbing, burning
29
poikilothermia
body temp adjust to environment/ cool on palpitation, raynaud's
30
paresthesia
abnormal sensation; numbness, tingling, pins and needles b/c low oxy
31
PAD leg elevation
pallor color
32
PAD leg dependent position (hanging off bed)
rubor
33
PAD complications
tissue necrosis, arterial ulcer, wound infection, atrophy
34
dead tissue at extremities caused by lack of blood flow or infection
gangrene (fingers, toes)
35
nonhealing ulcers and gangrene risk
amputation
36
term for necrosis/gangrene/ulcers
critical limb ischemia
37
PAD ulcer bed appearance
pale or black, rounded and smooth margins, dry
38
PAD positioning
dependent to get gravity/arterial pressure to leg/foot
39
PVD positioning
elevate legs to get blood flow back to heart
40
PAD treated with heat (pad) or high temp
not good, decreased sensation may not feel burn
41
exercise benefit
promote blood flow, no activity: blood pool at calf
42
PAD diagnostics
doppler ultrasound, ABI, duplex ultrasound imaging (duplex, 2 sound waves used Doppler and B-form)
43
ABI calculation
ankle systolic BP/^ L or R brachial systolic pressure
44
ABI range (ratio of BP at ankle vs BP at arm)
less than 1.0 indicate occlusion in lower extremity
45
BP ankle vs brachial normal
ankle typically higher (gravity/pressure) than arm
46
PAD/atherosclerosis risk factor modifications
stop smoking, lower BP, treat hyperlipidemia, diabetics A1C less 7
47
A1C also known as
glycosylated hemoglobin; blood glucose attached to hgb over past 3 months
48
intermittent claudication management
walking 30-60 min/day, 3x week
49
PAD nutritional therapy
BMI less 25, waist size less 40 in. men, diet
50
PAD pharmacologic therapy (lower BP, vasodilation)
ACE inhibitors Ramipril (Altace)
51
ACE inhibitors Ramipril (Altace) action
block convert angiotensin I to II; no vasoconstriction
52
PAD pharmacologic therapy - antiplatelet agents
aspirin, Clopidogrel (Plavix), prevent thromboemboli
53
PAD pharmacologic therapy - intermittent claudication
Cilostazol (Pletal) no food; Pentoxifylline (Trental) food
54
PAD non surgical treatment
Percutaneous Transluminal Angioplasty (PTA)
55
Percutaneous Transluminal Angioplasty source
youtube nucleus medical media central georgia heart
56
Arterial blockage/narrowing
stenosis
57
wire mesh in artery to keep open
stent
58
Percutaneous Transluminal Angioplasty Pre Op care
NPO, groin/femoral site shave, IV access 18/20 gauge
59
Percutaneous Transluminal Angioplasty Post Op care
bleeding at insertion site, VS, pulse, antiplatelet med
60
Percutaneous Transluminal Angioplasty with stenting process
stent hold artery open, balloon push plaque thru
61
remove plaque by cutting or grinding, especially PVD or PAD
Atherectomy incision femoral artery, catheter just like PTA and PCTA but useful if vessel can't handle stent
62
PAD surgery procedure called
Peripheral Artery Bypass; bypass blood around lesion
63
artery bypass surgery = aka
revascularization
64
bypass graft: 2 options
autogenous vein (from self) or synthetic graft
65
arterial bypass post op
24-48 hr ICU, arterial line for continuous BP, Foley
66
increased pressure in body area after period of low pressure
compartment syndrome internal bleeding or swelling after acute trauma
67
PAD surgery (1. artery bypass surgery, 2. )
amputation; elevate stump on 1 thin pillow
68
phantom limb pain
feel sensations or pain in limb not there
69
vasospasm/constriction of small arteries in extremities
Raynaud's Phenomenon
70
Raynaud's Phenomenon characteristics
young female, response to cold or stress
71
arteriole constriction color stages
white/pallor: low perfusion, blue: cyanosis, red: blood returns
72
recurring inflammation arteries and veins, caps
Buerger's; lead to thrombus formation, autoimmune
73
Buerger's characteristics
younger men, smokers, clots at tips of fingers/toes
74
ankle-brachial index low level indicates
peripheral arterial blockage, normal about 1.0, 1.2 good
75
peripheral artery disease 3 types medications
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
all percutaneous angioplasty preop care includes
NPO
77
critical limb ischemia revascularization or bypass surgery post op care
``` 24-48 hour ICU or step-down unit stay arterial line for continuous BP measurement titrate med to maintain BP foley neurovascular assessment ```
78
PTA vs PCTA
percutaneous transluminal angioplasty (PTA) non surgical procedure to repair or unblock artery; PCTA unblock/repair coronary artery
79
percutaneous transluminal angioplasty: 2 types
cardiac (PCTA percutaneous transluminal coronary angioplasty) and non-cardiac (PTA percutaneous transluminal angioplasty)
80
PTA vs PCTA similarities
same process just an artery (PTA) vs coronary artery (PCTA); local anesthesia, enter via femoral artery, use catheter
81
atherosclerosis vs stenosis
atherosclerosis is narrowing of arteries due to plaque, stenosis also narrowing but may or may not be from atherosclerosis
82
gold standard for PAD diagnostics
invasive digital angiography

Nursing 2 (9 decks)

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