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N102 > Arterial Vascular Disorders > Flashcards

Arterial Vascular Disorders Flashcards

1
Q

PAD

A

Peripheral Arterial Disease

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2
Q

PAD

A

Progressive narrowing & degeneration of arteries

ALL Extremities, but more frequent in all

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3
Q

Leading cause of PAD

A

Atherosclerosis

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4
Q

Risk increases w/ age
Typically appears at ages 60-80
= in men & woman
Strongly r/t other CV diseases

A

PAD

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5
Q

Risk Factors for PAD

A

Cigarette smoking
Hyperlipidemia
HTN
DM

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6
Q

(PAD): Atherosclerosis - Commonly affected arteries:

A 
More commonly affects certain portions of arterial tree
Coronary 
Carotid 
Iliac 
Femoral 
Popliteal 
Tibial
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7
Q

S/s of arterial disease begin when

A

occlusion 60-75%

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8
Q

PAD in Diabetics

A

primarily affects:
Anterior and Posterior Tibials
Peroneal

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9
Q

PAD in non-diabetics

A

Femoral & popliteal

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10
Q

Intermittent claudication

A

Pain with exercise
Resolves with rest
Reproducible
(10% of pt)

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11
Q

PAD Manifestation

A

Intermittent claudication
Impotence
Paresthesia
Neuropathy

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12
Q

PAD: Complications

A

Decreased arterial blood flow
Non-healing ulcers over bony prominence
Gangrene then amputation

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13
Q

PAD - Diagnostic Testing—Non Invasive

A

Doppler ultrasound
Duplex imaging
Segmental blood pressures
Ankle-brachial index (ABI)

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14
Q

Ankle-brachial index (ABI)

A

Use highest brachial and then use highest L.E –> LOWER/UPPER

LOWER THE #–> WORSE OFF THE EXTREMITY

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15
Q

PAD: Diagnostic Studies–Invasive

A

Angiography and MRA

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16
Q

Angiogram

A

Contrast dye injected into a catheter in vessel

Pictures taken as dye is dispersed into system

17
Q

Angiogram Complications:

A 
Bleeding
Thrombosis
Arterial dissection
Emboli
Hematoma (cath sz)
Allergic reaction
Renal failure (dye hard on kidneys)
18
Q

Pre-Angiography

A 
Inform of contrast/dye side effects ( allergies?)
NPO after MN prior to procedure
Document pulses prior to procedure
Labs
Pre op medications
Follow facility protocol
Informed consent
19
Q

Pre-Angiography Labs

A

PT, PTT, INR, BUN, Creatinine (kidney/dye clearance)

20
Q

Post Angiography

A 
Assess q 15 min x4, q30 min x 2, then hourly x 4:
Pressure dressing 
Access site 
Distal pulses 
Bedrest
IV fluids as ordered
21
Q

Modifiable Risk Factor PAD

A

Smoking cessation
Tx hyperlipidemia
BP maintained <7.0%

22
Q

Drug therapy PAD

A

Antiplatelet

Ace Inhibitors

23
Q

Antiplatelet agents

A 
Aspirin
Clopidogrel (Plavix)
24
Q

ACE inhibitors

A

Ramipril (Altace)

25
Q

Ramipril (Altace)

A

↓ cardiovascular morbidity and mortality
↑ peripheral blood flow
↑ walking distance

26
Q

Treatment of intermittent claudication (DRUGS)

A

Cilostazol (Pletal)

Pentoxifylline (Trental)

27
Q

Cilostazol (Pletal)

A

↑ vasodilation
↓ platelet aggregation
↑ walking distance

28
Q

Pentoxifylline (Trental)

A

↑ erythrocyte flexibility

↓ blood viscosity

29
Q

Critical limb ischemia

A

Rest pain for 2 weeks
Arterial ulcers
Gangrene in affected leg

30
Q

Critical limb ischemia Conservative goals:

A

Protect extremity from trauma
Decrease Pain
Prevent or control infection
Maximize arterial perfusion

31
Q

Percutaneous Transluminal Balloon Angioplasty (PTBA)

A

Balloon-tipped catheter inserted through femoral artery to site of obstruction–>Inflated at narrowing
–>Cracks atherosclerotic plaque and stretches media

32
Q

Best sites for Percutaneous Transluminal Balloon Angioplasty (PTBA)

A

iliac, femoral

33
Q

Endarterectomy

A

Sx opening of an artery & removing the (“fatty plaque scrapple”…)

34
Q

Patch Graft Angioplasty

A

Open artery, Remove Plaque, Apply patch to

Cover ulceration –> Widen artery lumen

35
Q

Amputation used for

A

Gangrene
Osteomyelitis
All major arteries in limb are occluded
preserve as much of limb as possible–>last resort!

36
Q

Post-op emergency

A

Absent pulses, decreased ABI’s, dramatic pain, cool/pale/blue skin, numbness/tingling

N102 (13 decks)

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