CAD and PAD

Question 1

major cause of coronary artery disease:

Answer 1

atherosclerosis

Question 2

common causes for endothelial injury

Answer 2

• tobacco use or smoking
• diabetes
• hypertension
• hyperlipidemia

Question 3

non modifiable risk factors

Answer 3

• increasing age
• gender – men more susceptible
• ethnicity – incidence greater in white men
• family history

Question 4

modifiable risk factors

Answer 4

• tobacco use
• high serum lipids
• physical inactivity
• hypertension
• weight – obesity
• diabetes control

Question 5

peripheral artery disease

Answer 5

• thickening of the artery walls into the peripheries
• caused by atherosclerosis
• can involve more than one artery and multiple locations
• classic symptom is intermittent claudication – put legs down

Question 6

diagnostics for PAD

Answer 6

• doppler ultrasound
• segmental BP
• angiography and MRA – location and extent of PAD
• ABI (ankle brachial index) – screening of BP in upper and lower limbs

Question 7

peripheral pulses

Answer 7

• arterial = decreased or absent
• venous = present or hard to palpable due to edema

Question 8

capillary refill

Answer 8

• arterial = greater than 3 seconds
• venous = less than 3 seconds

Question 9

ABI

Answer 9

• arterial = less than or equal to 0.9
• venous = greater than or equal to 0.9

Question 10

edema

Answer 10

• arterial = absent
• venous = lower leg edema

Question 11

hair

Answer 11

• arterial = loss of hair
• venous = hair is present

Question 12

ulcer location

Answer 12

• arterial = tips of toes, feet, lateral malleolus
• venous = near the medial malleolus

Question 13

ulcer margin

Answer 13

• arterial = rounded, smooth, punched out
• venous = irregularly shaped

Question 14

ulcer drainage

Answer 14

• arterial = minimal drainage
• venous = moderate to large amounts

Question 15

ulcer tissues

Answer 15

• arterial = black, eschar, pale pink granulation
• venous = yellow slough or dark red ruddy granulation

Question 16

pain

Answer 16

• arterial = intermittent claudication
• venous = dull ache or heaviness

Question 17

nails

Answer 17

• arterial = thin and brittle
• venous = normal

Question 18

skin color

Answer 18

• arterial = pallor
• venous = bronze or brown pigmentation

Question 19

skin texture

Answer 19

• arterial = thin, shiny taut
• venous = thick, hardened

Question 20

skin temperature

Answer 20

• arterial = cool
• venous = warm

Question 21

dermatitis

Answer 21

• arterial = rare
• venous = often

Question 22

pruritis

Answer 22

• arterial = rare
• venous = often

Question 23

Treatment for PAD

Answer 23

• risk factor modification
• medications – statins, ACE inhibitors
• supervised exercise program
• nutritional therapy
• re-vascularization

Question 24

post procedure assessment

Answer 24

• vitals Q 15 minutes
• groin site – hematoma
• RLL color
• temperature
• capillary refill
• pulses
• sensation
• movement

Question 25

6 Ps

Answer 25

• pulses
• pallor
• pain
• paresthesia
• paralysis
• pokilothermia – adaptation of limb to environmental temperature

Question 26

patho of chronic venous insufficiency

Answer 26

improper functioning of the valves in the lower legs inhibiting venous return

Question 27

risk factors of chronic venous insufficiency

Answer 27

• age
• genetics
• gender = most likely in females
• pregnancy
• sedentary lifestyle
• obesity
• history of DVT
• tall people

Question 28

S/S of chronic venous insufficiency

Answer 28

• persistent edema
• varicose veins
• brown color
• irregular shaped ulcers
• lift legs up

Question 29

treatment of chronic venous insufficiency

Answer 29

• surgery
• lifestyle changes – compression stockings, skin care, elevation of legs, avoid sitting or standing for long periods of time, lose weight, exercise