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Med Surg Exam 3 > Chapter 35 > Flashcards

Chapter 35 Flashcards

1
Q

Usually forms in the heart, but a roughened atheromatous plaque in any artery also can lead to thrombus formation

If a thrombus breaks loose, it becomes an embolus and travels through the circulatory system until it lodges in a vessel, blocking blood flow distal to the occlusion

Thrombi from the right side of the heart lodges in the lungs causing a PE

Thrombi from the left side of the heart usually affects the legs

A

Arterial emboli

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2
Q

Signs and symptoms of arterial emboli

A

Severe, acute pain
Gradual loss of sensory and motor function in the affected areas
Pain aggravated by movement or pressure
Absent distal pulses
Pallor and mottling (irregular discoloration)
Sharp line of color and temperature demarcation: tissue beyond the obstruction is pale and cool

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3
Q

Medical and surgical treatment for arterial emboli

A

Intravenous anticoagulants and thrombolytic agents

Embolectomy

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4
Q

When should anticoagulant not be used

A 
Active internal bleeding
Cardiovascular accident
Recent major surgery
Uncontrolled hypertension
pregnancy
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5
Q

Arterial embolism dx/intervention

A 
Inadequate tissue perfusion
Stress
Immobility
Skin breakdown
Inadequate self care
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6
Q

common sites of occlusion for peripheral arterial disease

A

Common sites for arterial occlusion are the distal superficial femoral and the popliteal arteries

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7
Q

Hypoxia affects all tissues distal to the occlusion in what condition

A

Peripheral arterial disease

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8
Q

Signs and symptoms of peripheral artery disease

A

Intermittent claudication (classic sign)
Absence of peripheral pulses below occlusive area
Rest pain (persistent and aching)
Shiny, scaly skin
Pale color
Hairlessness
Ulcers with a gray or yellowish hue (tips of toes, foot, lateral malleolus)

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9
Q

Medical diagnosis of peripheral artery disease

A

Plethysmography
Duplex imaging
Angiography (if surgery is indicated)

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10
Q

Medical treatment for peripheral artery disease

A

Lifestyle changes
Smoking cessation
exercise
weight management

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11
Q

Drugs for claudification

A

cilostazol and Plavix are anticoagulant

pentoxifylline which is a blood viscosity reducing agent

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12
Q

Nursing diagnosis of peripheral artery disease

A 
Impaired activity tolerance
Pain
Skin breakdown
Altered body image
Inadequate peripheral circulation
Inadequate self-care management
Potential infection
Inadequate cardiac output
Inadequate peripheral circulation
Impaired physical mobility
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13
Q

Inflammatory thrombotic disorder of arteries and veins in lower and upper extremities

A

Thromboangiitis Obliterans aka(Buerger Disease)

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14
Q

intermittent claudication, rest pain, skin color/temperature changes in affected areas, cold sensitivity, abnormal sensation, ulceration, gangrene

A

Signs and symptoms of Thromboangiitis Obliterans

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15
Q

What is the most important treatment for Thromboangiitis Obliterans

A

Most important treatment is smoking cessation

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16
Q

affects hands primarily.

Can also affect tips of nose toes

A

Raynaurds disease

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17
Q

Signs and symptoms of Raynaud disease

A

Chronically cold hands, numbness, tingling, and pallor
Finger involvement is not symmetric and the thumb is typicall not involved
During an arterial spasm, the skin color changes from pallor to cyanosis to redness

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18
Q

Based on the signs and symptoms and on the absence of evidence of occlusive vascular disease

A

Raynaurd disease

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19
Q

Nursing diagnosis of Raynaud disease

A

Pain
Inadequate peripheral tissue oxygenation
stress

20
Q

A dilated segment of an artery caused by weakness and stretching of the arterial wall

A

Aneurysm

21
Q

Most common type of aneurysm

A

Atherosclerosis

22
Q

Most common site of aneurysm

A

Abdominal aorta

23
Q

Sign and symptoms of aneurysm

A

Thoracic aneurysms usually have no symptoms, though some report deep, diffuse chest pain
If aneurysm puts pressure on the recurrent laryngeal nerve, patient may complain of hoarseness
Pressure on the coronary arteries can cause angina
Pressure on the esophagus may cause dysphagia
Pressure on the superior vena cava may have edema of the head and arms
Pressure on the pulmonary structures may cause airway obstruction

24
Q

Aneurysm post operative care

A

Mark the pedal pulses
Critical care unit for 24-48 hours
Monitor vital signs, hemodynamic status, renal function, and fluid balance
Inspect and palpate the extremities for color, warmth, and peripheral pulses

25
Q

A small tear in the intima permits blood to escape into the space between the intima and the media
Blood accumulates between the layers, causing the media to split lengthwise

A

Aortic dissection

26
Q

Varicosities are dilated, tortuous, superficial veins, often the saphenous veins in the lower extremities

A

Varicose vein

27
Q

Dilation of the vessels results from incompetent valves in the veins

A

Varicose vein

28
Q

Avoid restrictive garments, prolonged standing or sitting, crossing the legs or knees, and injury to compromised areas
Weight reduction
Support stockings
Sclerotherapy, light therapy, or laser therapy
Ligation and stripping

A

Varicose vein

29
Q

Virchow’s triad

A

Stasis of the blood
Damage to the vessel walls
Hypercoagulability

30
Q

Pain, redness, warmth, or tenderness in the affected area vein that fells firm and cordlike when palpated
Area around the vein may be warm, red, and tender.

A

SVT

31
Q

Edema, pain, warmth, and tenderness at the area of compromise
May have slight elevation in the systemic temperature

A

DVT

32
Q

Medical treatment for venous thrombosis

A

Anticoagulant or thrombolytic therapy, or both

33
Q 
Skin breakdown
Pain
Anxiety
Inability to tolerate activity
Inadequate peripheral tissue oxygenation
Impaired pulmonary oxygenation
Inadequate self care
A

Nursing diagnosis of venous thrombosis

34
Q

Culmination of long-standing pressure that stretches the veins and damages the valves

A

Patho of chronic venous insufficiency

35
Q

Edema around the lower legs, pain, brownish skin discoloration (stasis dermatitis), and stasis ulcerations
Heaviness or dull ache in the calf or thigh
Skin temperature is warm, and nails are normal
Feet and ankles often cyanotic when in a dependent position
Peripheral pulses are present, but due to edema, they may be difficult to palpate

A

Signs and symptoms of chronic venous insufficiency

36
Q

Nursing diagnosis of chronic venous insufficiency

A

Inadequate peripheral tissue oxygenation
Impaired self concept
Potential infection
Skin breakdown

37
Q

Acute inflammation of the lymphatic channels

The inflammation is the result of an infectious process, usually caused by streptococcus

A

Lymphangitis

38
Q

Enlargement of the lymph nodes along the lymphatic channel
Tenderness as these nodes are assessed
Red streak from the infected wound extends up the extremity along the path of the lymphatics
Elevated temperature and chills

A

Signs and symptoms of lymphangitis

39
Q

Diagnosis of lymphangitis

A

Wound culture and Lymphangiography

40
Q

Antimicrobials
Abscess is incised to drain the suppurative material
Rest and elevation of the limb; warm, wet dressings; and elastic support hose

A

Surgical treatment of lymphangitis

41
Q

Analgesics, antimicrobials, and elevation of the extremity to reduce lymphedema
Application of warm, moist soaks to the infected areas
Elastic support hose

A

Interventions of lymphangitis

42
Q

Systolic: <120 mm Hg; diastolic <80 mm Hg

A

Normal Blood Pressure

43
Q

Systolic between 120 and 139; diastolic between 80 and 89

A

Prehypertension

44
Q

140-159 SBP and 90-99 DBP

A

Stage 1

45
Q

≥160 over ≥ 100

A

Stage 2

Med Surg Exam 3 (6 decks)

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