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Adults Exam 2 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

describe the SA node

A

primary pacemaker of the heart (60-100)

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2
Q

describe the AV node

A

secondary pacemaker of the heart (40-60)

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3
Q

describe the role of the Bundle of HIS (AV bundle)

A

helps w left ventricular contraction; less than or equal to 20 bpm

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4
Q

describe the role of the purkinje fibers

A

ventricular contraction; 15-40 bpm

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5
Q

describe the single chamber conductor

A

electrical impulses to right ventricle

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6
Q

describe the dual chamber conductor

A

electrical impulses to right atrium & ventricle to control contractions between these two chambers

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7
Q

describe the biventricular conductor

A

(called cardiac resynchronization therapy; Stimulates right and left ventricles to help heart beat more efficiently.
(seen commonly for HF or abnormal electrical systems)

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8
Q

what is cardiac output? what is the normal range?

A

Amount of blood ejected by the left ventricle in liters / minute.
Normal = 4-6 L/min

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9
Q

what is stroke volume? what is the normal range?

A

Amount of blood ejected from the left ventricles per heartbeat
Normal = 60-130 ml

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10
Q

how to calculate cardiac output

A

stroke volume X HR

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11
Q

what is preload?

A

ventricular stretch at the end of diastole

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12
Q

what is afterload?

A

resistance to ejection

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13
Q

describe the Frank-Starling Law of the Heart

A

As preload increases, muscle stretch increases resulting in strong contractions and subsequent greater stroke volume

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14
Q

which stretch receptors deal w orthostatic hypotension & correspond to BP?

A

baroreceptors

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15
Q

list 4 causes of orthostatic hypotension

A
  1. dehydration
  2. heart problems
  3. endocrine problems
  4. NS disorders
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16
Q

list 4 risk factors for orthostatic hypotension

A
  1. age
  2. meds
  3. diseases
  4. bed rest
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17
Q

list 3 complications of orthostatic hypotension

A
  1. falls
  2. stroke
  3. CV diseases
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18
Q

what is ejection fraction? what is the normal range?

A

end diastolic blood volume ejected w each heart beat (left ventricle)
normal: 55%-65%

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19
Q

what can an ejection fraction be helpful in determining? which specific procedure is done?

A

HF (echo is done)

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20
Q

how does the heart change as we age? (list 4)

A
  1. slower HR
  2. larger heart
  3. valves stiffen (unable to close properly)
  4. decreased compensation (unable to adapt to metabolic changes & postural changes)
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21
Q

which 2 cardiac diseases could CP indicate?

A

coronary artery disease & MI

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22
Q

which 4 pulmonary disorders could CP indicate?

A

pneumonia, PE, pulmonary HTN, asthma

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23
Q

which 3 esophageal disorders could CP indicate?

A

GERD, peptic ulcers, Hiatal hernia

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24
Q

which musculoskeletal / neuro disorder could CP indicate?

A

muscle strain / shingles

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25
Q

list 8 risk factors for developing any cardiovascular disease

A
  1. smoking
  2. HTN
  3. physical inactivity
  4. Hyperlipidemia
  5. Overweight / obese
  6. poor diet
  7. alcoholism
  8. diabetes
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26
Q

describe an electrocardiogram (ECG / EKG)
- what does it reveal & detect?

A

electrical activity of the heart; detects arrhythmias
12-lead for testing (10 electrodes)
accurate & quick

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27
Q

describe an echocardiogram
what is it & what does it assess?

A
  • sound waves to produce images of the heart
  • assess for heart conditions & ejection fraction for determination of stage of CHF
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28
Q

describe a cardiac stress test
what is it & what does it detect?

A

if heart is under stress when exercise induced; detects arrhythmias

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29
Q

what is a cardiac monitor?
what does it show?

A

bedside monitoring; shows full VS (except temp) & a 2-view of the heart

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30
Q

list & describe the 3 cardiac biomarkers
what is the goal value? (normal range)

A
  1. CK: indication of an MI
  2. CK-MB: detects an acute MI or other damage to the heart
  3. Troponin; serial troponins / high-sensitivity: indication of MI or damage to the heart
    goal value: 0.0-0.10
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31
Q

what does a BTNP cardiac biomarker detect?
list the normal levels & ranges for HF

A

detects HF & cardiac dysfunction
normal levels: <125 (0-74 y/o)
<450 (75-99 y/o)
if pt. has HF:
>450 (under 50 y/o)
>900 (50 y/o & older)

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32
Q

what does a lipid profile measure?
what is the normal level & normal triglyceride level?

A

measures cholesterol (normal: <200)
normal triglyceride level: <150

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33
Q

what is HF?

A

heart can no longer keep up w demands of your body

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34
Q

when kidneys do not get what they want, what do they initiate? how does this deal w HF?

A

the RAS system; vasoconstriction (vessels get stronger) & aldosterone increase reabsorption of water & blood volume leading to blood congestion

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35
Q

what is a symptom of blood congestion?

A

lots of coughing; trying to clear out fluid

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36
Q

what is the most common cause of right sided HF?

A

left sided HF

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37
Q

list 8 causes of left sided HF (star which one is most common)

A
  1. CAD (vessels of heart become damaged)
  2. MI
  3. valvular problems
  4. renal failure
  5. HTN
  6. cardiomyopathy
  7. diabetes
  8. sleep apnea
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38
Q

list 5 causes of right sided HF (star which one is most common)

A
  1. left-sided HF
  2. valvular problems (Tricuspid)
  3. HTN; pulmonary HTN
  4. CAD
  5. lung disease
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39
Q

list 5 s/sx of how a client would present w HF

A
  1. SOB / activity intolerance (lungs having a difficult time exchanging O2)
  2. CP
  3. crackles in lungs; cough; progressing to respiratory distress (from fluid in lungs)
  4. peripheral edema; pitting edema (gravity) to lower extremities
  5. palpitations / arrhythmias (A. fibb)
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40
Q

list & describe 6 labs / diagnostics for HF & what they detect (star important ones)

A
  1. BNP: beta nateric peptide (should be <300)
  2. CBC: standard to look at kidney function
  3. chest x-ray: can detect wall thickening leading to a cardiac meropathy
  4. CT scan: looks at blood vessels in the heart (do not eat or drink anything day of exam!!) check for shellfish or iodine allergy
  5. Echocardiogram (ECHO): noninvasive, warm jelly on chest, ultrasound, can show heart valves & regurgitation
  6. Electrocardiogram (EKG)
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41
Q

how does an ACE-I help w HF? list an example med
what is a common side effect?

A

blocks vasoconstriction & extra fluid; Lisinopril (dry cough is a common AE)

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42
Q

how do beta blocker meds help w HF? list an example med

A

decrease HR & create a better force of contraction; Metoprolol

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43
Q

how do diuretics help w HF? list an example med

A

decrease fluid overload; Furosemide (look at K+ levels before giving)

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44
Q

how do anticoagulants help w HF? give an example med

A

because A fib creates blood clots!
warfarin

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45
Q

how do antiarrhythmics help w HF? give an example med

A

decrease HR & prevent arrthymias!
Metoprolol

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46
Q

list an example med of a cardiac glycoside used to tx HF

A

digoxin

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47
Q

list an acute intervention for a pt. w HF; how does this help?

A

Bipap: forces oxygen down & opens airways so the patient can breathe

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48
Q

list 2 complications of HF

A
  1. flash pulmonary edema
  2. death
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49
Q

list 13 nursing care / considerations for a pt. w HF

A
  1. group activities
  2. elevate HOB
  3. daily weights
  4. supplemental O2 (<93%)
  5. reduce Na in diet
  6. stop smoking / drinking
  7. doctor-guided exercise; weight loss
  8. medication compliance
  9. restrict fluids (still need to drink though)
  10. control DM
  11. repair valves
  12. treat sleep apnea
  13. pneumonia / flu vaccinations
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50
Q

what is a HF diet?

A

low Na+ fat

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51
Q

describe the physiology of CV disease (9)

A
  1. arterial damage
  2. cholesterol / fats / lipids infiltrate
  3. atheroma
  4. block / narrow arterial wall
  5. plaque rupture
  6. blood clot / cholesterol embolus
  7. blockage of coronary vessels (MI)
  8. blockage of cerebral vessels (CVA)
  9. permanent damage (Atherosclerosis)
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52
Q

list 7 causes of CAD

A
  1. hyperlipidemia
  2. HTN: damages coronary arteries & allows plaque & lipids to collect
  3. Smoking
  4. DM: microvascular & macrovascular disease
  5. sedentary lifestyle; obesity
  6. Genetic predisposition
  7. metabolic syndrome: high blood glucose, big waist, high BP, low blood high density lipopoien, high blood triclycerides (if pt. has 3 or more of these symptoms)
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53
Q

list 3 s/sx a client w CAD will present with

A
  1. Angina
  2. Activity intolerance
  3. Myocardial infarction
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54
Q

how is stable angina described relating to CAD?

A

very predictable

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55
Q

how is unstable angina described relating to CAD?

A

not predictable; blockage getting worse

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56
Q

what is intractable / refractory angina indicate?

A

MI; get to hospital immediately!

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57
Q

what are variant / prinzemtals angina caused by?

A

vasospasms

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58
Q

describe silent ischemia angina

A

inverted T waves found on EKG (unknown heart attack)

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59
Q

list 5 s/sx found to indicate an MI

A
  1. back / shoulder / jaw / left or right arm pain
  2. N/V indigestion
  3. general malaise / SOB / dizzy
  4. diaphoresis
  5. CP
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60
Q

list & describe 7 labs / diagnostics used for CAD

A
  1. CBC, BMP
  2. troponin (serial / high sensitivity): released by the heart everytime there is an insult or injury
  3. D-Dimer: detects blood clots; if +, CT scan must be done
  4. EKG: tells if & where a pt. is having a heart attack
  5. echo
  6. stress test: IV or walking on treadmill
  7. coronary angiogram: part of the cardiac catheterization (places dye in heart to show where blockage is)
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61
Q

how do statins help w CAD? list an example med

A

helps control of cholesterol, circulating lipids
EX: atorvastatin

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62
Q

how does aspirin help w CAD?

A

thins the blood; reduces risk of blood clots from forming

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63
Q

how do beta blockers help w CAD? list an example med

A

lowers HR; metoprolol

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64
Q

how do calcium channel blockers help w CAD? list an example med

A

vasodilate to improve blood flow; diltiazem

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65
Q

how does nitroglycerin help w CAD?
what route is it given in? what should you educate your pt. on?
how often should it be given?

A

tx for angina, potent vasodilator! reduces preload
- given sublingual
- educate pt. to expect HA & burning
- given once every 5 min. (HR & BP must be checked prior to admin)

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66
Q

how do ACE-I’s help w CAD? give an example med

A

prevents vasoconstriction
EX: lisinopril

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67
Q

list 6 acute interventions for CAD acute care

A
  1. line / labs
  2. EKG
  3. nitro / baby aspirin 324 mg: take at home if pt. thinks they’re having an MI / Heparin
  4. chest x-ray: shows enlarged heart if they have a MI
  5. cardiac monitor
  6. possible cardiac catheterization
68
Q

list 6 complications of CAD

A
  1. MI
  2. NSTEMI & STEMI
  3. HF
  4. arrhythmias
  5. CVA
  6. death
69
Q

describe the difference between an NSTEMI & STEMI

A

NSTEMI: non ST elevation myocardial infarction; ST depression seen (patients have mini strokes)
STEMI: ST elevated myocardial infarction

70
Q

describe the difference between a Hemorrhagic & Ischemic stroke

A

Hemorrhagic: rupture of blood vessels; leakage of blood
Ischemic: blockage of blood vessels; lack of blood flow to affected area

71
Q

list 5 nursing care / considerations for CAD

A
  1. quit smoking
  2. medication compliance (HTN, hyperlipidemia, DM)
  3. monitor diet (low fat & Na)
  4. monitor weight
  5. reduce stress
72
Q

describe what happens in a valvular disorder

A

valve balloons into left atria & no longer seals properly (mitral valve regurgitation / aortic valve regurgitation)

73
Q

list 3 s/sx of how a client will present in the beginning of a valvular disorder

A
  1. asymptomatic
  2. arrhythmia
  3. dizzy / lightheaded
74
Q

list 3 s/sx of how a client will present later on (worse) of a valvular disorder

A
  1. SOB / dyspnea
  2. fatigue
  3. hemoptysis
75
Q

what is a Corrigan pulse? what does it indicate?

A

(water hammers pulse) indicates aortic regurgitation

76
Q

what can a heart murmur indicate? what does it sound like?

A

can indicate a valvular disorder; swish sound

77
Q

list 6 causes of valvular disorders

A
  1. weakened papillary muscles / chordae tendinea: help to close & open heart valves
  2. viral / bacterial infections: strep throat can cause damage to heart valves if untreated (bad oral care can cause damage to the heart as well)
  3. CAD
  4. autoimmune disorders: Ra (rheumatoid arthritis)
  5. Congenital malformations
  6. age related changes
78
Q

list 7 labs / diagnostics used for valvular disorders

A
  1. BNP
  2. CBC, BMP
  3. Echo
  4. EKG
  5. Stress test
  6. coronary angiogram
  7. strep culture
79
Q

list 5 meds used for valvular disorders

A
  1. beta blockers (metoprolol)
  2. diuretics (furosemide)
  3. ACE-I (lisinopril)
  4. blood thinners (ASA, warfarin)
  5. antiarrhythmics (Sotalol, amiodarone, flecainide)
80
Q

what are surgical interventions for valvular disorders?

A

valve replacement

81
Q

what are surgical interventions for valvular disorders?

A

valve replacement

82
Q

which procedure is used for valve repair?

A

ROSS procedure

83
Q

what type of valve is replaced in younger patients? why? which med must these patients be on & why?

A

mechanical valve; they last longer! patients must be on warfarin to prevent blood clots around the device (must have INR checked)

84
Q

which type of valve is used on older patients? where does it come from? should they be on a med?

A

tissue valve; biological valve from a pig or cow; only need warfarin to a certain amount rather than continuous

85
Q

what kind of sound does a mechanical valve make?

A

clicking sound

86
Q

how long does a bioprosthetic valve typically last? what med & how much is possibly given?

A

<60 = 5-10 years; >70 = 15-20 years
possible daily ASA of 81 mg

87
Q

what does hypertrophic cardiomyopathy affect? due to what 4 things?

A

diastolic function
due to:
1. thickened wall (ventricular wall)
2. decreased filling
3. reduced cardiac output
4. CHF

88
Q

what does dilated cardiomyopathy affect? due to what 4 things?

A

affects systolic function (contractility of the heart)
due to:
1. large ventricle
2. decreased contraction
3. reduced cardiac output
4. CHF

89
Q

restricted cardiomyopathy

A

rare - seen in athletes

90
Q

list 10 causes of a fib (star most common cause)

A
  1. heart abnormalities or heart damage
  2. CAD / MI
  3. metabolic imbalance
  4. stimulants
  5. lung diseases
  6. viral infections
  7. sleep apnea
  8. sick sinus syndrome
  9. can be idiopathic
91
Q

what is happening in atrial fibrillation? list 5 other things that happen

A

heart beating irregularly; chaos in atria (ectopy; ectopic)
1. atria quiver
2. fewer impulses to ventricle
3. poor cardiac output
4. agitation leads to clots
5. stroke & HF

92
Q

what loses control in a fib? what happens?

A

SA node loses control; cardiac cell initiates a beat over the SA node

93
Q

a fib is also known as absence of which wave?

A

the P wave (most common irregular heart beat)

94
Q

list 8 s/sx of how a client will present w A fib (star the most common ones)

A
  1. heart palpitations: racing heart, fish flopping; butterflies
  2. SOB
  3. reduced cardiac output
  4. weakness / fatigue / activity intolerance
  5. intermittent or continuous
  6. confusion
  7. CP
  8. anxiety
95
Q

list the 7 labs / diagnostics for a fib

A
  1. Holter monitor: continuous EKG of the heart; worn for 3 days (dropped off at cardiologist)
  2. Coag’s: check INR (2-3 to be therapeutic)
  3. CBC, BMP
  4. Troponin: shows if the heart has been damaged or if there has been a heart attack
  5. BNP (if concern)
  6. chest x-ray
  7. echo
96
Q

what is the overall goal for a fib meds?

A

rhythm control

97
Q

list the 4 meds for tx of a fib (list examples)

A
  1. Anticoagulants: warfarin, clopidogrel
  2. Antiarrythmics: Amiodarone, flecainide, sotalol
  3. Beta-blockers: metoprolol, propranolol, atenolol
  4. Calcium channel blockers: diltiazem, verapamil
98
Q

how do calcium channel blockers specifically work for tx of a fib?

A

slows conduction between the SA node & AV node

99
Q

what is an acute intervention for a fib?

A

A. Fibb w RVR (rapid ventricular rate)
heart monitor?

100
Q

list 2 surgical interventions for a fib

A
  1. catheter ablation
  2. maze procedure
101
Q

what is extremely important to do w a heart rate monitor?

A

synch it! syncing peak at QRS will get to a normal rhythm - if not synced, you can kill the patient!!!

102
Q

list 7 nursing care / considerations for a fib

A
  1. triggers
  2. OTC cough medicine / caffeine (stimulants)
  3. sleep deprivation / physical illness
  4. emotional stress
  5. dehydration
  6. hormones (menstrual cycle females)
  7. smoking
103
Q

what is considered the “silent killer” and what most people don’t know that they have?

A

hypertension

104
Q

list 8 causes of hypertension (indicate primary & secondary causes)

A
  1. primary (idiopathic) - unknown cause
  2. secondary (renal diseases due to blood volume increasing)
  3. dyslipidemia
  4. obesity / sedentary lifestyle
  5. DM
  6. OSA, HF, CAD, SCA
  7. medications
  8. illegal drugs
105
Q

list 2 s/sx of hypertension that a client will present with (star most common)

A
  1. asymptomatic (“silent killer”)
  2. headaches? nosebleeds?
106
Q

list 2 complications of HTN

A
  1. CVA
  2. MI
107
Q

what is the main nonpharmacalogic tx for HTN?

A

lifestyle changes - healthy diet & exercise!

108
Q

list 6 meds & examples for tx of HTN

A
  1. thiasize diuretics (hydrochlorothiazide)
    controls fluid volume & pressure exerted on arterial wall
  2. ACE-I (lisinopril)
  3. ARBs (Losartan) usually given if patients have a cough
  4. calcium channel blockers (amlodipine, diltiazem)
  5. beta blockers (metoprolol) decrease HR
  6. combo meds (antillipidemic)
    - Losartan & HCTZ
    - one med for compliance
109
Q

which 2 med classes should NEVER be combined for tx of HTN?

A

ACE’s & ARBs!!!

110
Q

list 4 nursing care / considerations for HTN

A
  1. prevention
  2. diet & exercise
  3. monitor BP at home (same time everyday, not multiple times, AHA recommends against wrist cuffs - need brachial artery!)
  4. Medication compliance (side effects? try another)
111
Q

what type of blood do arteries carry & in which direction?

A

oxygenated blood AWAY from the heart (aorta to body)

112
Q

what type of blood do veins carry & in which direction?

A

deoxygenated blood BACK to the heart (returns via the inferior & superior vena cava)

113
Q

what 3 roles does the lymphatic system have?

A
  1. fluid / waste removal
  2. absorption of fatty acids & fats to circulatory system
  3. produce immune cells (lymphocytes, monocytes, plasma cells (make antibodies)
114
Q

what are vascular disorders?

A

disorder of natural flow of blood

115
Q

list the 2 arterial disorders

A
  1. Raynaud’s
  2. Intermittent Claudication
116
Q

if you have peripheral artery disease, you must also have ___

A

CAD

117
Q

list 5 risk factors for arterial disorders

A
  1. smoking
  2. DM
  3. stress
  4. HTN
  5. hyperlipidemia
118
Q

what is the venous disorder called?

A

chronic venous insufficiency

119
Q

describe the color of a patient’s skin w an arterial disorder

A

red

120
Q

describe the color of a patient’s skin w a venous disorder

A

rutty, purply browny coloring (increase pressure of fluid overload breaking tiny capillaries causing bleeding & bruising)

121
Q

what is the cause of PAD?

A

atherosclerosis (plaquey buildup in lower leg)

122
Q

describe the physiology of intermittent claudication - which 3 things are occurring?

A
  1. narrowing of arteries feeding leg
  2. reduce blood flow to leg
  3. ischemia = limb necrosis
123
Q

list 5 s/sx of how a client will present w intermittent claudication

A
  1. intermittent leg pain (increased w exercise or walking)
  2. erythema to legs / feet (inflammation to open up arteries of the legs)
  3. wounds (difficult to heal)
  4. progressing to pain at rest
  5. cool skin
124
Q

list 4 labs / diagnostics for intermittent claudication

A
  1. CBC, BMP, D-dimer
  2. CT / MRI
  3. vascular ultrasound
  4. Angiography (looks at blood vessels to show where there is reduced blood flow)
125
Q

list 2 acute interventions for intermittent claudication

A
  1. rest legs (dependent position)
  2. warm compressions (vasodilate)
126
Q

list 2 surgical interventions for PAD intermittent claudication

A
  1. Angioplasty
  2. vascular surgery (bypass)
127
Q

list 3 complications of intermittent claudication

A
  1. limb ischemia
  2. pain at rest & walking
  3. hard to heal ulcers (DRY) - key to intermittent claudication (bad eating away at foot)
128
Q

which type’s of patients feet should always be inspected? why?

A

Diabetic patients! make sure they are always wearing shoes (nerves on their feet are damaged)

129
Q

list 7 nursing care / considerations for intermittent claudication

A
  1. frequent breaks
  2. dependent position
  3. warm compresses
  4. inspect & protect legs / feet
  5. medication compliance
  6. control DM
  7. if in bed = sit upright & dangle
    **same prevention as CAD (healthy diet, exercise, meds, watch BP)
130
Q

list 4 causes of Raynaud’s disease

A
  1. cold
  2. stress
  3. smoking
  4. idiopathic
131
Q

what is happening in Raynaud’s disease?

A

smaller arteries to skin = narrow
limits blood flow via vasospasm

132
Q

list 2 s/sx of how a client will present w Raynaud’s disease

A
  1. N/T in fingers or toes
  2. skin pale / blue / reddened
133
Q

list 2 meds & examples for tx of Raynaud’s disease

A
  1. calcium channel blockers (Amlodipine)
  2. Vasodilators (Nitro)
134
Q

list 6 nursing care / considerations for Raynaud’s disease

A
  1. gradual warming
  2. pain relievers / CCBs
  3. avoid cold temps
  4. quit smoking
  5. avoid emotional stress
  6. wounds
135
Q

which 2 things are used for DVT & PE prevention?

A
  1. Heparin SQ (5,000 units)
  2. Enoxaprin SQ (weight based)
136
Q

list 4 causes of VTE

A
  1. Virchow’s triad: endothelial damage, venous stasis, altered coagulation
  2. immobility
  3. major surgery / injury
  4. pregnancy: increases blood volume (clots can form)
137
Q

list 4 things that happen in VTE

A
  1. asymptomatic
  2. redness possible to calf
  3. tenderness / pain
  4. edema
138
Q

list 3 labs / diagnostics for VTE

A
  1. CBC, BMP
  2. D-dimer: detects blood clots
  3. Venous doppler US: noninvasive, warm jelly; detects blood clots
139
Q

which med class is used to tx VTE? give examples of meds

A

anticoagulants (Apaxiban, enoxaparin)

140
Q

list 2 acute interventions for VTE

A
  1. TPA ONLY if PE (life threatening)
  2. Thrombectomy (vena cava filter… collects clot fragments (causes scarring)
141
Q

list 3 complications of VTE

A
  1. PE
  2. CVA
  3. post thrombotic syndrome - can cause a vericose vein
142
Q

what is chronic venous insufficiency? (CVI)

A

too much fluid in lower legs & struggles to get back into the heart

143
Q

list 10 nursing care / considerations for VTE

A
  1. watchful waiting
  2. anticoagulants
  3. early ambulation
  4. SCD’s / ted / enoxaparin / heparin (VTE prophylaxis)
  5. stay active (lifestyle changes)
  6. discuss risks of birth control
  7. discuss HTN meds & treatment
  8. discuss symptoms of PE
  9. post thrombotic syndrome (PTS)
  10. follow up for US to monitor
144
Q

list 7 causes of CVI (star most common)

A
  1. varicose veins: veins get too stretched out causing valve insufficiency preventing the backflow of blood)
  2. age
  3. extended sitting or standing
  4. reduced mobility
  5. PTS
  6. smoking (causes vasoconstriction & damage to veins)
  7. trauma to leg
145
Q

list 6 things that are happening w CVI

A
  1. venous vales incompetent
  2. stretching = improper closing of valves
  3. pooling of blood in veins
  4. increased pressure = increased stretch
  5. capillaries rupture (red/brown/purple skin)
  6. tissue swelling / inflammation
146
Q

list 6 s/sx of how a client w CVI will present

A
  1. swelling to lower extremities
  2. arching / fatigue in legs
  3. varicose veins
  4. change in color of legs
  5. flaking / itchy skin
  6. venous status ulcers (WET)
147
Q

list 5 labs / diagnostics for CVI

A
  1. CBC, BMP
  2. D-Dimer
  3. vascular US
  4. CT
  5. X-ray
148
Q

which meds are used to tx CVI?

A

antibiotics (if infection present)

149
Q

list 2 complications of CVI

A
  1. cellulitis (infection of the skin tissue)
  2. difficult to heal ulcers
150
Q

list 10 nursing care / considerations for CVI

A
  1. support hose; sit breaks
  2. avoid prolong sitting / standing
  3. catch early!
  4. surgical options
  5. elevate legs when sitting
  6. exercise
  7. good hygiene - take care of legs
  8. wound care
  9. quit smoking
  10. Hyperbaric therapy (HBO) - collects new blood vessels, time intensive
151
Q

list the main cause of lymphedema

A

removal / damage of lymph node; happens typically w cancer treatment

152
Q

list 4 things that are happening in Lymphedema

A
  1. swelling unilateral or bilateral
  2. lymph system blocked
  3. lack of drainage
  4. tissue swelling / edema
153
Q

list 7 s/sx of how a client will present w lymphedema (star important one)

A
  1. swelling in one or both arm / leg
  2. heaviness / tightness in affected
  3. decreased ROM
  4. aching
  5. infections
  6. fibrosis (late finding)
  7. stages
154
Q

list 2 labs / diagnostics for lymphedema

A
  1. CT scan
  2. Doppler US
155
Q

what are meds that can tx lymphedema?

A

antibiotics (for infection)
- no preventative meds! can’t do much at this point

156
Q

list 3 treatments for lymphedema (star important one)

A
  1. compression
  2. decongestive therapy (1st two stages) - manual machine
  3. surgery (as stages progress) - helps relieve fluid & pressure (may cause more damage than good) - very rare that it works
157
Q

what is a complication of Lymphedema?

A

cellulitis

158
Q

list 10 nursing care / considerations for lymphedema (star important one)

A
  1. protect from injury
  2. after CA treatment care
  3. avoid ice / heat
  4. elevate
  5. avoid tight fitting clothes
  6. exercise!
  7. compression dressing
  8. massage
  9. wound care for ulcerations
  10. CDT
159
Q

list 5 causes of cellulitis

A
  1. injury
  2. skin conditions (eczema for ex)
  3. lymphedema
  4. animal bites (cat scratches)
  5. immunocompromised
160
Q

list 3 things that are happening in cellulitis

A
  1. infection in tissue
  2. spreading through blood / lymph
  3. can be life-threatening; Sepsis
161
Q

list 4 s/sx of how client will present w cellulitis

A
  1. redness & swelling (continuous pattern)
  2. pain & tenderness
  3. warmth
  4. progress to S & S of infection
162
Q

list 4 labs / diagnostics for cellulitis

A
  1. CBC, BMP
  2. blood cultures (caused by bacteria)
  3. outline w marker (line around area of redness)
  4. CT (see depth of it)
163
Q

list 3 meds that can tx cellulitis; what form of admin?

A

antibiotics:
1. vanc
2. penicillin
3. Clindamycin (primary for outpatient)
oral first, no response through IV dependent on severity!

164
Q

list 3 complications of cellulitis

A
  1. Sepsis
  2. Lymphedema
  3. necrotizing Fasciltis (eating skin away)
165
Q

list 10 nursing care / considerations for cellulitis

A
  1. proper wound care (clean, dry, protected)
  2. protect skin
  3. DM special care (more prone to cellular infections)
  4. treat skin infections
  5. if redness exceeds line, go to ED!
  6. elevate (helps blood flow back to the heart)
  7. cool damp cloth
  8. take entire course of antibiotics
  9. analgesics
  10. protect area!

Adults Exam 2 (4 decks)

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