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Nur 336 > Cardiac - Unit 2 - Care of Patients with Vascular Problems > Flashcards

Cardiac - Unit 2 - Care of Patients with Vascular Problems Flashcards

1
Q

Assessment - Arterial vs. Venous Problems

A

Arterial - smooth, shiny, loss of hair, thick nails, loss of sensation, pale, cyanotic, cool.

Venous - brown pigment around ankles, edematous, warm.

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2
Q

Assessment of Peripheral Pulses - Arterial vs. Venous

A

Arterial - decreased or absent pedal pulses, ABI or = to 1

Venous = Normal pulses & ABI

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3
Q

Assessment of pain - Arterial vs. Venous

A

Arterial = intermittent claudication, rest pain, loss of movement.

Venous = achy

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4
Q

What are some diagnostics for arterial or venous problems?

A

Doppler Ultrasound, Arteriogram or Venogram

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5
Q

Arteriosclerosis - def

A

thickening or hardening of arterial wall often associated with aging.

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6
Q

Atherosclerosis - def

A

type of arteriosclerosis involving formation of plaque within the arterial wall.

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7
Q

What are some lab assessments for atherosclerosis?

A

Lipid levels, HDL, LDL, homocysteine (high levels means you can be vulnerable to plaque buildup)

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8
Q

What are some medical treatments for atherosclerosis?

A

Evaluate labs and life style changes, nutrition therapy, durg therapy (statins, fibrates [gemfibrozil - decrease triglycerides], cholesterol absorption inhibitors [ezetimibe], bile acid sequestrants, niacin)

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9
Q

What are some surgical interventions for arterial problems?

A

PTA, endarterectomy, bypass graft, thrombectomy, embolectomy, amputation

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10
Q

What are some surgical interventions for venous problems?

A

Vein ligation (they tie veins together to prevent pooling of blood), thrombectomy, debridement (removing dead tissue)

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11
Q

What is angioplasty?

A

PTA (Percutaneous Transluminal Angioplasty with stent) - they go in and open up the blockage and stent it.

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12
Q

What’s an endarterectomy?

A

They go in and basically strip the inside of the artery…

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13
Q

Pre-op procedure - assessments?

A

Vitals & Pulses

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14
Q

Post-op procedure - assessments?

A

Peripheral pulses, fluid status, coagulation status, pain, exercise & motion.

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15
Q

What are some complications for arterial procedures?

A

Graft occlusion, compartment syndrome, acute arterial occlusion and ulcer formation.

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16
Q

What are some complications for venous procedures?

A

Ulcer formation, pulmonary embolism.

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17
Q

What are ulcers like for arterial problems?

A

Painful, tops of toes/heels/feet - grayish appearance, gangrene, mottled, dry, etc.

18
Q

What are ulcers like for venous patients?

A

Lightly to non-painful, bottom third of leg, uneven edges, ruddy, superficial/wet

19
Q

How do we position extremities for these patients (tell both)?

A

Arterial - gravity flow.

Venous - elevate the extremity.

20
Q

Thrombus - def

A

Formation of a blood clot within the vascular system.

21
Q

Embolus - def

A

clot or foreign substance traveling within the vascular system.

22
Q

Embolus originating in left side of heart may travel to the brain. T/F?

A

TRUE

23
Q

What are the signs and symptoms of sudden arterial occlusion? (6 P’s)

A 
Pain - sudden & severe
Pallor - appearance is pale then white, cold and blotched - finally mottled & cyanotic.
Pulselessness - 
Paresthesia - (pens & needles)
Paralysis -
Polar or poikilothermia (temp varies)
24
Q

What is buerger’s disease?

A

Where you want Bravas all the time…

Just kidding - it’s an imflammatory & spasmotic occlusive vascular disease that happens more in Jewish men that are over the age of 40. A history of smoking is the biggest cause!

25
Q

What are symptoms of buerger’s disease?

A

Pain (intermittent claudication), paresthesia, weak pulses, ulcerations, gangrene

26
Q

What is the treatment for buerger’s disease?

A

Vasodilation, pain relief, stop smoking, buerger/allen exercises (improve circulation), dependant positioning, amputation

27
Q

What is Raynaud’s disease?

A

Bilateral intermittent cold induced digital ischemia - it usually affects fingers and can progress to necrosis and loss of tissue and it usually happens in females and is affected by smoking.

28
Q

What is Raynaud’s Phenomenon?

A

Raynaud’s secondary to another disease such as Lupus, Scleroderma, Rheumatoid Arthritis

29
Q

What are symptom’s of Raynaud’s?

A

Bilateral, intermittent pallor, cyanosis, rubor (white, then blue, then red)

Numbness, tingling, burning.

30
Q

What are the treatment options for Raynaud’s?

A

Calcium channel blockers, nitro, resperine, biofeedback, protection from cold, no smoking, if severe = regional sympathectomy (cutting of a sympathetic nerve)

31
Q

What can also induce Raynaud’s?

A

Coffee & Chocolate

32
Q

What are arterial aneurysms? The two types?

A

Abnormal dilation of an artery caused by deformity of its wall.
True = involves all three layers.
False = hematoma outside arterial wall.

Predisposing factors include family history, atherosclerosis, syphilus, HTN

33
Q

What are some symptoms of an AAA?

A

Can be asymptomatic, but also can include pulsating abdominal mass w/ bruit, pain in back, abdomen or flank, blood stools, scrotal bruising, embolus, or sudden intense back pain/shock with a rupture!

34
Q

What are symptoms of a thoracic aortic aneurysm?

A

Back pain, SOB, hoarseness, difficult swallowing, mass may be visible above suprasternal notch, sudden excruciating back or chest pain (rupture)

35
Q

What are some diagnostic tests for a TAA or an AAA?

A

CT Scan, MRI, Ultrasound, CXR

36
Q

What are some post-op nursing care things for thoracic and abdominal aneurysm’s?

A

TAA - monitor PAP pressure, chest tubes, assess LOC, assess upper extremity CSM.

AAA - assess renal function, assess abdomen, assess spinal cord function and if there’s graft occlusion.

37
Q

What is marfan’s?

A

Genetic abnormality of connective tissue usually found in tall slender men with long extremities - can cause valve prolapse and treatment depends on symptoms.

38
Q

What is a VTE?

A

Venous Thromboembolism.

39
Q

What are some assessment findings with VTE?

A

Calf or groin pain or tenderness and sudden onset of unilateral leg swelling

40
Q

What are some treatment options for VTE?

A

anticoagulation therapy, bedrest, compression stockings, surgical management

41
Q

What are varicose veins?

A

Abnormally dilated, engorged, tortuous and superficial veins - symptoms include achy legs, itching, muscle cramps, local redness and tenderness

42
Q

What is schleroptherapy?

A

Used for small varicose veins - they insert a catheter, heat it up, the vein collapses and is then removed and BAM, you’re golden!

Nur 336 (26 decks)

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