Exam 3- Peripheral Vascular Disorders Flashcards
The symptoms of peripheral
arterial disease
Decreased or absent pulses Cap refill > 3 secs ABI < 0.75 Edema – none Hair – none Ulcer – toe tips, lateral ankle; Pale white Skin color – rubor, pallor with elevation Skin texture – thin, shiny, cool
The symptoms of peripheral venous disease
Pulses present Cap refill < 3 secs ABI > 0.90 Edema – + Hair – present Ulcer – medial ankle; Beefy Red Skin color – brown Varicose veins Skin texture – thick, tough, dark, warm
Nursing assessment of patient that had a stent placement
Monitor tissue perfusion
(cap refill, pulses, temp, color, movement, baseline?)
Monitor for bleeding
(check groin for hematoma and bruising, check dressing, hgb & hct)
Reocclusion
(sudden change, pain)
Acute arterial occlusion symptoms
Embolis or thrombosis; maybe acute trauma 6 P's S&S Pulselessness Pain Pallor Paresthesias: tingling Parlysis Poikilothermia (cold)
Cause, diagnosis, symptoms, and treatment of Raynaud’s syndrome.
Spasms of distal arteries
No test to dx
Pallor, cyanosis, then rubor
CCB, smoking cessation, keep core and hands warm
Types of amputations
Flap (Closed): take bone back further and leave skin to pull over.
Guillotine (open): require 2nd surgery, left open because of infection.
AKA
BKA
Cause, diagnosis, symptoms, and treatment of Buerger’s syndrome.
Vasculitis of small and medium-sized veins and arteries
Cause unknown-ETOH, more often in men?
Manifestations: Pain arches feet especially, Digital ulcers
Temperature and color changes hands & feet
Treatment: Vasodilators, Pain management, Smoking cessation
What is Arterial Occlusive Disease (PAD)
Narrowing of the arterial lunmen; lining damage
Stenosis or occlusion
Usually affects lower extremities and areas with bifurcations
Decreased blood flow
Risk factor Arterial Disease
Atherosclerosis embolism Thrombosis - Platlet buildup trauma spasm inflammation obesity smoking
Manifestations of PAD
Claudication: pain with walking cramps/pain at night Dependent rubor: red extremities when down, blanched on elevation cool extremity weak or absent pulse Paresthesias: tingling
Patho of PAD
The diameter of vessel decreases. As demands increase the tissues become ischemic. The anaerobic response where the muscles release lactic acid which is what causes the pain.
Antiplatelet Agents
Prevent platelet aggregation; they don’t break up existing clots, they top new from forming
- Aspirin
- Ticlodipine (Ticlid)
- Clopidogrel (Plavix)
- Cilostazol (Pletal) also vasodilates (avoid grapefruit juics)
Clients that should not exercise include those with:
- ulcers
- Deep vein thrombosis
- pain at rest
- cellulitis
- gangrene
Bypass Grafts
Synthetic arteries or veins (eg saphenous vein) taken from other areas and are surgically connected to bypass the occluded area.
Raynaud’s Syndrome
Arterial Spasm
- Intermittent spasm afftecting digital arteries caused by nicotine, cold, caffeine, stress
- pallor of hands followed by cyanosis then rubor
Treatment: Calcium channel blockers, alpha blockers
Similar feeling like frostbite
