Cardiovascular System (Exam Two) Flashcards
What is peripheral artery disease (PAD)?
- Progressive narrowing of arteries
- Degeneration of arteries
What is considered the leading cause of peripheral artery disease (PAD)?
Atherosclerosis
List the common sites of atherosclerotic lesions.
- Iliac artery
- Femoral artery
- Popliteal artery
- Tibial artery
- Peroneal artery
What are the risk factors for developing peripheral artery disease?
- Tobacco use
- Over age 60
- African American
- Women
- Diabetes mellitus
What are the clinical manifestations of peripheral artery disease (PAD)?
- Intermittent claudication
- Thin, shiny, taut skin
- Diminished/absent pulses
- Paresthesia
- Loss of hair on lower legs
Describe intermittent claudication.
- Ischemic muscle pain caused by exercise
- Resolves in 10 minutes or less with rest
- Reproducible
A nurse caring for a patient diagnosed with peripheral artery disease (PAD) would expect the capillary refill in the lower extremities to be what?
Prolonged
The nurse knows that the most serious complication(s) of peripheral artery disease (PAD) is/are what?
- Nonhealing Arterial ulcers
- Gangrene
Arterial ulcers most commonly occur over bony prominences on the: (SATA)
A. Lower legs B. Hands C. Upper legs D. Toes E. Feet
A, D, E
List the medications commonly prescribed for a patient diagnosed with peripheral artery disease (PAD).
- Statins
- ACE inhibitors
- Anti-platelet agents
- Cilostazol (Pletal)
Why are anti-platelet agents not prescribed, or given concurrently, with omeprazole?
Omeprazole will reduce absorption of the anti-platelet
T/F: Compression stockings or TED hose are NOT utilized in patients with peripheral artery disease (PAD).
True
What education should the nurse provide to a patient with peripheral artery disease (PAD)?
- Avoid knee-flexed positions
- Do not cross legs
- Turn and reposition frequently
- Avoid using heating-pads
- Avoid compression stockings
What are the characteristics of critical limb ischemia?
- Chronic ischemic rest pain that lasts more than two weeks
- Nonhealing arterial leg ulcers
- Gangrene of the leg
What is considered the cure for critical limb ischemia?
Revascularization via bypass surgery
What is the priority nursing intervention for a patient who is post-operative from a percutaneous transluminal angioplasty (PTA) due to critical limb ischemia?
Assess vital signs for changes
What is an aneurysm?
Outpouching of arterial wall
What is the most common location for an aortic aneurysm to occur?
Abdominal aorta
List the signs and symptoms of a thoracic aortic aneurysm.
- Difficulty swallowing
- Hoarseness
- Chest pain
What is the highest risk factor for aortic aneurysm rupture?
Hypertension
In order for an aortic aneurysm to be surgical repaired, it must be greater than ______ in diameter.
5 cm
What is the priority nursing management for a patient with an aortic aneurysm?
- Monitor intake and output
- Daily weights
- Avoid severe hypertension
- Frequent neuromuscular assessment
Describe an aortic dissection.
- Tear occurs in inner layer of aorta
- Middle layer is stripped from the inner layer
- Results in “dissection”
List the signs and symptoms of a Type A: Acute ascending aortic dissection.
- Severe, sudden onset
- Excruciating chest/back pain
- Radiates to neck and shoulders
List the signs and symptoms of a Type B: Acute ascending aortic dissection.
- More likely to report pain in back
- Abdomen
- Legs
- Pain described as sharp, worst ever, tearing, ripping
If the nurse is suspicious of a acute ascending aortic dissection, what is the priority intervention?
- Assess blood pressure
- Assess heart rate
What is the target heart rate for a patient who is being treated for an aortic dissection? What medication is often utilized to reach this target heart rate?
- 60 bpm or less
- Morphine
Which type of aortic dissection is considered a surgical emergency?
Type A: Acute ascending aortic dissection
What are the priority nursing intervention(s) for a patient following surgical repair of an aortic aneurysm?
- Cardiac monitor
- Monitor intake/output
- Neurovascular assessment
What is the most common disorder of the veins?
Venous thrombosis
Venous thrombosis can result in what other disorders?
- Pulmonary embolism (PE)
- Deep vein thrombosis (DVT)
List the risk factors for developing deep vein thrombosis (DVT).
- Pregnancy
- Surgery
- Contraceptives
- Prolonged sitting
- Prolonged standing
- Obesity
What are the signs and symptoms of deep vein thrombosis?
- Unilateral leg edema
- Systemic temperature >100.4
- Fullness in thigh or calf
- Paresthesia
- Warm skin
- Redness
What is/are an uncommon, but severe form of deep vein thrombosis (DVT)?
- Phlegmasia cerulea dolens
- Phlegmasia alba dolens
A patient is admitted to the ED with phlegmasia cerulea dolens and/or phlegmasia alba dolens. The nurse knows this patient will require what type of treatment?
Revascularization surgery
What is considered the therapeutic range for INR?
2 - 3
