Arterial Ulcers

Question 1

what causes ischemic / arterial ulcers?

Answer 1

arterial insufficiency/ vessel stenosis or occlusion which results in inadequate blood supply to meet demand causing necrosis.

Question 2

True or false

Boderline blood flow may be asymptomatic?

Answer 2

true

Question 3

what is the primary cause of arterial insufficiency? and what is this? what is the most common form?
what causes it?

Answer 3

arteriosclerosis
thickening and hardening of the arterial walls
atherosclerosis
fatty material deposited on arterial walls

Question 4

what is Angiopathy?

Macro vs micro?

Answer 4

poor perfusion of blood supply, nutrients, and oxygen for wound healing

macro=large vessels disease, typically bilateral lower extremities

micro=small vessel disease with possible sclerosis

Question 5

Microangiopathy is often seen in what population?

Answer 5

diabetics

Question 6

Risk factors for arterial ulcers (50 HATS)

Answer 6

arteriosclerosis
diabetes
hyperlipidemia
thrombosis
smoking
more common in males over 50

Question 7

arterial ulcers are usually found?

cold or hot?
painful or painless?
wet or dry?

appearance?

Answer 7

distal third of lower extremity, pretrial or dorsal of the foot

cold
painful
dry

punched out shape with smooth edges, pale wound bed with likely necrotic tissue, full thickness loss

Question 8

what two arteries are used to take pulse?

Answer 8

dorsalis pedis and posterior tibialis

Question 9

what are the sounds of doppler?

Answer 9

monophasic, biphasic, and triphasic

Question 10

explain the rubor of dependency arterial test and what people it is used for?

Answer 10

supine
bring leg to 60 degrees for 1 min
bring leg down
assess color on top of foot
dark red, indication of severely impaired circulation
fair skin people only

Question 11

explain the venous filling time test

Answer 11

supine
bring leg to 45-60 degrees
hold foot until blanched (1 min)
bring leg down
note time it takes being to re-distend on dorsum of foot
normal is 15…15-40 moderate insufficiency…over 40 indicated severe ischemia

Question 12

ABI is no reliable in _____ patient due to their arteries being ______ open leading to non compressibility of the arteries. ______ pressures are more reliable

Answer 12

diabetics
sclerosed
toe

Question 13

what is an arteriogram or angiogram?

Answer 13

a dye injected into the blood vessels to make the vessels appear on an X-ray to identify blockages, sclerosis r aneurysms

Question 14

Plan of care for arterial ulcer?

Answer 14

improve blood flow to wound w/ systematic or local treatment
exercise or walking program
conservative wound care (ace wrap)
avoid compression and debridement until circulation imporves

Question 15

ambulate to _______, not to _______

Answer 15

tolerance, claudication

Question 16

patient education

Answer 16

avoid vasoconstrictives
other leg exercise to promote circulation
control hypertension, cholesterol, and diabetes
no smoking
foot care

Question 17

true or false

if arterial supply shown by testing is inadequate for healing, then the eschar can be debrided

Answer 17

false

Question 18

what should you do if a patients wound is cool, dusky blue-purple, and no pulse

Answer 18

refer immediately

Question 19

what is not indicated for mixed vascular ulcers

Answer 19

high compression

Question 20

Thromoangiitis Obliterans-Beurger’s Disease

Answer 20

rare disease in which blood vessels of the distal extremities are obstructed
painful,blue, pale, and cool
no cure
must stop smoking and stay away from the cold

Question 21

raynauds disease

Answer 21

narrowing of smaller arteries in hands, feet, nose, and ears
numbness and cool and color changes
response to cool temps and stress
vasodilation meds sometimes used for treatment

Question 22

long term goals of wound healing vascular insufficency

Answer 22

pain is decreased
protection of a body part is increased
sense of well being is increased
soft tissue swelling, inflammation, or restriction is reduced
tolerance to positions and activities are increased