Exam 3

Question 1

1 risk factor for PVD

Answer 1

Smoking

Question 2

What is peripheral arterial disease (PAD)?

Answer 2

Progressive narrowing of the arteries of the neck, abdomen, and extremities

Question 3

PAD Risk Factors/Contributory Factors

Answer 3

Tobacco use, DM, elevated CRP (inflammation), HTN, atherosclerosis, hyperlipidemia

Family hx, gender, high triglycerides, aging, homocysteine, hyperuricemia, obesity, sedentary lifestyle, stress

Question 4

What is atherosclerosis?

Answer 4

Cholesterol/lipid deposits in arteries harden over time into plaque, decreasing vessel lumen size.

Inflammation causes plaque instability, platelet response, lesion develops/ruptures, thrombus formed, may occlude arteries

Question 5

6 P’s of PAD

Answer 5

Pain, pallor, pulselessness, parathesia, paralysis, poikilothermia (lumen same as room temp.)

Question 6

PAD Clinical Manifestations

Answer 6

6 P’s, neuropathy, prolonged cap refill, cool skin, intermittent claudication, non-healing ulcers

Question 7

Intermittent claudication

Answer 7

Classic symptom of PAD, ischemic pain due to exercise, resolves after rest period, reproducible

Question 8

Critical limb ischemia positioning

Answer 8

Keep leg level/supine

Question 9

Critical limb ischemia pt. teaching

Answer 9

Home environment must be safe, check feet every day

Question 10

PAD Diagnostic Tests

Answer 10

CT with contrast (gold standard), ankle-brachial index (ABI), Doppler imaging

Question 11

PAD Tx Goal

Answer 11

Ensure adequate tissue perfusion

Question 12

PAD Pt. Education

Answer 12

Monitor skin on extremities, modify risk factors, pt. compliance, when to seek emergency help (SOB)

Question 13

SCD use in PAD

Answer 13

SCDs contraindicated with PAD, but encouraged with venous flow problems

Question 14

Angioplasty

Answer 14

Balloon or stent

May use thrombolytics/antiplatelets

Question 15

Femoral-Popliteal Bypass

Answer 15

Native or synthetic graft, monitor distal pulse, teach antiplatelet meds for life

Improved activity tolerance immediately following surgery, call MD if results not apparent

Question 16

Chronic Venous Insufficiency Pt. Teaching

Answer 16

Wear foot protection, avoid heating pads, daily foot inspection

Question 17

DVT Diagnosis

Answer 17

D-dimer lab test, positive indicates that there may be significant thrombus formation/breakdown

Question 18

DVT Pt. Teaching: Report Immediately

Answer 18

SOB, sudden, severe pain

Question 19

VTE Tx

Answer 19

Bed rest, heparin/lovenox therapy, long term blood thinner (warfarin), IVC filter replacement, venous thrombectomy (surgical removal of clot)

Question 20

Aortic Aneurysm

Answer 20

• Weakening in artery wall that causes bulging/dilation
• susceptible to rupture
• causes: genetics, atherosclerosis, mechanical
• risk factors: make, smokers, obesity, aging, HTN, CAD, genetics

Question 21

Aortic Aneurysm mmost common location

Answer 21

Abdominal

Also: Ascending, arch, and descending

Question 22

Aortic Aneurysm most common type

Answer 22

Fusiform

Question 23

Aortic Aneurysm diagnostic tests

Answer 23

ECG to rule out MI

Question 24

Aortic Aneurysm rupture signs

Answer 24

S/Sx of hemorrhage or shock: sudden onset tachycardia, hypotension, pain, LoC, diaphoresis, suspense, weakness