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Med Surg > Chapter 18 > Flashcards

Chapter 18 Flashcards

1
Q

what are two types peripheral vascular disease?

A
  • arterial vascular disease
  • venous vascular disease
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1
Q

what kind of symptoms would you see in arterial vascular disease?

A
  • diminished, weak, or absent pulse
  • pallor skin, thin, dry, shiny cool skin
  • absent or mild edema
  • ulcers on toes or at pressure points on feet
  • intermittent claudication when walking (sharp, stabbing, gnawing)
  • thick brittle nails, hair loss
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2
Q

what kind of symptoms would you see in venous vascular disease?

A
  • strong, symmetric pulses
  • legs or feet bluish when dependent
  • visible veins, warm at ankle, dermatitis
  • brown pigmentation at ankles
  • edema is present (particularly around ankle and in foot)
  • ulcers at bones of ankle
  • aching, cramping, particularly when dependent
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3
Q

what would you recommend for a px with peripheral venous disease?

A
  • elevating the legs
  • do not dangle them
  • use elastic stockings
  • no standing or sitting for a long time
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4
Q

what would you recommend for a px with peripheral arterial disease ?

A
  • promote walking and exercise
    -no elastic stockings
  • dangle feet off of leg
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5
Q

what is primary hypertension?

A
  • essential hypertension
  • unidentified causes
  • genetic
  • environmental
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6
Q

what is secondary hypertension?

A
  • can identify the cause
  • CKD
  • renal artery disease
  • sleep apnea
  • pregnancy
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7
Q

what is a risk factor of hypertension?

A

atherosclerotic heart disease

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8
Q

what are some nonmodifiable factors of cardiovascular disease ?

A
  • heredity, race, sex, age
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9
Q

what are some modifiable risk factors?

A
  • obesity, hypertension, high cholesterol
  • diabetes, smoking, stress
  • excess alcohol intake
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10
Q

s/s of hypertension

A
  • headache, dizziness, blurred vision, blackouts
  • dyspnea, fatigue, retinal changes
  • heart failure, kidney damage
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11
Q

hypertension treatment

A
  • weight reduction, exercise
  • DASH diet, low fat diet
  • alcohol and sodium restriction
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12
Q

nursing managment/ interventions of hypertension?

A
  • assess for potential symptoms of target organ action
  • monitor for angina, SOB, altered speech, altered visions, nose bleeds, nocturia
  • cardiovas: orthostatic htn, apical and peripheral
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13
Q

potential complications of hypertension?

A
  • retinal hemorrhage
  • stroke, CVA
  • heart attack, TIA
  • myocardial infarction
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14
Q

what is Thromboangiitis obliterans (Burgers Disease)

A

rare disease where smaller blood vessels especially in hands or feet become blocked by clots
- clots form due to inflammation and swelling

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15
Q

what are some risk factors of Burgers Disease

A
  • more common around age 35
  • more common in people who smoke
16
Q

s/s of Burgers disease?

A
  • numbness and tingling of toes in cold weather
  • pain in feet, intermittent claudication
  • pain is intense
  • ulcerations and gangrene may occur
17
Q

what is Raynauds disease?

A

vasospasms in some areas of the body, primarily where there are smaller blood vessels
- spasms cause px to have issues receiving adequate blood flow

18
Q

treatment of Burgers disease

A

stop smoking completely

19
Q

s/s of raynauds disease

A
  • fingers and toes may display a series of color changes from white to blue to red
  • experience numbness or prickly sensation
  • decreased sensory perception
  • edema may be present
  • discomfort in extremity
20
Q

treatment of raynauds disease?

A
  • alpha blockers
  • stress control
  • avoid exposure to cold
  • vasodilators
  • calcium channel blockers
  • stop smoking
21
Q

what are some nursing interventions/ teachings of Raynaud’s disease?

A
  • caffeine intake limited
  • protect extremities, prevent injury
  • dress warmly, nonrestrictive clothing
  • avoid cold temperatures
22
Q

what is venous thrombosis

A

veins become inflamed
- cause thrombosis (can be superficial or deep veins)

23
Q

what are the three types of venous thrombosis

A
  1. phlebitis - inflammation of the vein wall
  2. thrombophlebitis - clot has formed at the site of inflammation within a vein
    - deep vein thrombosis- clot in deep vein rather than in superficial vessels
24
Q

risk factors of venous thrombosis

A
  • immobility, obesity
  • hx of venous insufficiency
  • oral contraceptives, smoking
25
Q

what are some symptoms of venous thrombosis problems

A
  • redness and tenderness along the course of the vein
  • swelling, (pain dependent)
26
Q

treatment of venous thrombosis?

A
  • anticoagulants or anti-thrombolytics or both
  • surgically remove the clot
  • monitor clots for movement
  • possibly best rest but bed rest is also a risk for the clots so carefully
27
Q

what are some nursing interventions of venous thrombosis

A
  • early ambulation after procedures, if unable do frequent ROM
  • ensure proper hydration
  • apply elastic stocking
28
Q

what is varicose veins?

A

when veins become dilated with weak valves, so blood stays in periphery
- occurs most commonly in lower extremities and trunk

29
Q

risk factors of varicose veins?

A
  • long periods of standing on the feet like nursing or being a cashier
  • family hx of varicose veins
  • obesity, tight-fitting clothing of frequent crossing of legs
30
Q

s/s of varicose veins

A
  • dilated, twisting, discolored veins usually on legs
  • easy fatigue of legs
  • cramping especially at night
  • heaviness in legs
  • dependent edema
31
Q

management/treatment of varicose veins?

A
  • analgesics
  • frequent ambulation
  • facilitate venous return with compression stockings, SCD’s
  • avoid constrictive clothing
  • avoid prolonged standing or sitting
32
Q

what is chronic venous insufficiency?

A

obstruction of venous valves
- causing reflux of blood through valves

33
Q

s/s of chronic venous insufficiency?

A
  • chronic venous stasis
  • edema
  • superficial vein become dilated
  • dry itchy skin with cracks
34
Q

what are some complications of chronic venous insufficiency?

A
  • ulcerations (brownish in color)
    -cellulitis, dermatitis
35
Q

nursing managment/ interventions

A
  • reduce venous stasis, increase blood flow, compress superficial veins
  • elevate legs, avoid dangling legs over side of bed
  • do not place pressure on popliteal area
  • decreases edema, keep skin clean, dry, and soft
  • protect from trauma

Med Surg (12 decks)

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