Exam 3 Flashcards
1 risk factor for PVD
Smoking
What is peripheral arterial disease (PAD)?
Progressive narrowing of the arteries of the neck, abdomen, and extremities
PAD Risk Factors/Contributory Factors
Tobacco use, DM, elevated CRP (inflammation), HTN, atherosclerosis, hyperlipidemia
Family hx, gender, high triglycerides, aging, homocysteine, hyperuricemia, obesity, sedentary lifestyle, stress
What is atherosclerosis?
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
6 P’s of PAD
Pain, pallor, pulselessness, parathesia, paralysis, poikilothermia (lumen same as room temp.)
PAD Clinical Manifestations
6 P’s, neuropathy, prolonged cap refill, cool skin, intermittent claudication, non-healing ulcers
Intermittent claudication
Classic symptom of PAD, ischemic pain due to exercise, resolves after rest period, reproducible
Critical limb ischemia positioning
Keep leg level/supine
Critical limb ischemia pt. teaching
Home environment must be safe, check feet every day
PAD Diagnostic Tests
CT with contrast (gold standard), ankle-brachial index (ABI), Doppler imaging
PAD Tx Goal
Ensure adequate tissue perfusion
PAD Pt. Education
Monitor skin on extremities, modify risk factors, pt. compliance, when to seek emergency help (SOB)
SCD use in PAD
SCDs contraindicated with PAD, but encouraged with venous flow problems
Angioplasty
Balloon or stent
May use thrombolytics/antiplatelets
Femoral-Popliteal Bypass
Native or synthetic graft, monitor distal pulse, teach antiplatelet meds for life
Improved activity tolerance immediately following surgery, call MD if results not apparent
Chronic Venous Insufficiency Pt. Teaching
Wear foot protection, avoid heating pads, daily foot inspection
DVT Diagnosis
D-dimer lab test, positive indicates that there may be significant thrombus formation/breakdown
DVT Pt. Teaching: Report Immediately
SOB, sudden, severe pain
VTE Tx
Bed rest, heparin/lovenox therapy, long term blood thinner (warfarin), IVC filter replacement, venous thrombectomy (surgical removal of clot)
Aortic Aneurysm
- Weakening in artery wall that causes bulging/dilation
- susceptible to rupture
- causes: genetics, atherosclerosis, mechanical
- risk factors: make, smokers, obesity, aging, HTN, CAD, genetics
Aortic Aneurysm mmost common location
Abdominal
Also: Ascending, arch, and descending
Aortic Aneurysm most common type
Fusiform
Aortic Aneurysm diagnostic tests
ECG to rule out MI
Aortic Aneurysm rupture signs
S/Sx of hemorrhage or shock: sudden onset tachycardia, hypotension, pain, LoC, diaphoresis, suspense, weakness
