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adult health nursing > Lecture 9 Vascular Disorders > Flashcards

Lecture 9 Vascular Disorders Flashcards

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1
Q

what is peripheral vascular disease?

A

disorders that alter natural blood flow outside of the brain and heart

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2
Q

what is the path of blood flow by vessel type?

A

arteries > arterioles > capillaries > venules > veins

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3
Q

oxygenation VS circulation VS perfusion

A

oxygenation = supplying with oxygen

circulation = movement of blood through vessels

perfusion = forcing a fluid through an organ or tissue via the blood vessels

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4
Q

vascular assessment

A

CSMT = color, sensation, motion, temperature
skin inspection
palpation of peripheral pulses
pain - will occur distal to diseased vessel r/t poor perfusion. pain is cellular death from lack of oxygen

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5
Q

how can peripheral vascular disease be diagnosed?

A

doppler
ankle brachial index
exercise testing
ultrasound
CT scan
angiography

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6
Q

risk factors for PAD (similar to CAD)

A

smoking
diet
HLD
HTN
diabetes
stress
obesity and sedentary lifestyle
age
female gender
genetics

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7
Q

intermittent claudication

A

muscle aching, cramping d/t lack of blood during exercise
pain distal to occlusion - legs, thighs, butt
pain worse with exercise, relieved with rest

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8
Q

ischemic rest pain

A

arterial insufficiency severe, pain also present at rest
persistent, aching, piercing
usually worse at night

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9
Q

general signs and symptoms of PAD in lower extremities

A

cool extremities
palor
dependent rubor
diminished or unequal pulses
hair loss distal to occlusion
thick opaque nails
numbness, tingling
poor healing

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10
Q

signs and symptoms of PAD in upper extremities

A

less severe symptoms
arm fatigue and pain with exercise
coolness, pallor
difference in BP between arms

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11
Q

treatment for PAD

A

walking
aspirin, plavix, statins
angioplasty
stenting
surgery - endarterectomy or bypass
foot care

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12
Q

6 Ps of arterial embolism and thrombosis

A

pain (severe, shooting)
pallor
pulseless
poikilothermia - coolness
paresthesia
paralysis

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12
Q

6 Ps of arterial embolism and thrombosis

A

pain (severe, shooting)
pallor
pulseless
poikilothermia - coolness
paresthesia
paralysis

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13
Q

acute arterial occlusion treatment

A

embolectomy
IV heparin

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14
Q

nursing management for PAD

A

CSMTs, pulses, cap refill
avoid crossing legs
monitor IOs, VS, mental status, and monitor incision

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15
Q

abdominal aortic aneurysm

A

asymptomatic, only symptomatic 40% of the time
affects men 2-6X more than women
more prevalent after 65 years

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16
Q

how deadly is abdominal aortic aneurysm rupture?

A

80% mortality

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17
Q

signs and symptoms of abdominal aortic aneurysm

A

heart beat in abdomen
throbbing mass

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18
Q

signs and symptoms of impending abdominal aortic aneurysm rupture

A

severe low back pain
abdominal pain - middle lower, left of midline
low BP

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19
Q

managing abdominal aortic aneurysm

A

stable = 5.5 cm or less
BP control with BB, CCB, ACE, ARB, diuretics
ultrasound every 6 months for monitoring

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20
Q

surgical management of AAA

A

open repair or endovascular aortic repair
ICU after repair
6 hours bedrest after EVAR
check groin site, VS, CSMTs

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21
Q

what is Raynaud phenomenon?

A

intermittent arteriolar vasoconstriction
causes coldness, pain, pallor in fingers or toes

22
Q

Raynaud triggers

A

stress
cold
smoking

23
Q

common locations for arterial ulcers

A

tips of toes
webs of toes
medial side of foot
lateral pinkie toe

24
Q

describe arterial ulcers

A

painful
small and deep
circular
pale

25
Q

what causes venous vascular disease?

A

difficulty for blood to get back to heart from legs

26
Q

what are varicose veins?

A

incompetent valves in the legs

27
Q

what can cause varicose veins?

A

pregnancy
prolonged standing

28
Q

signs and symptoms of varicose veins

A

dull ache
muscle cramps
ankle edema

29
Q

preventing varicose veins

A

avoid prolonged standing
walk regularly
avoid crossing legs

30
Q

treating varicose veins

A

thermal ablation
ligation and stripping
schlerotherapy

31
Q

what is hemosiderin?

A

brown staining of the legs seen with chronic venous insufficiency
occurs from RBC breakdown byproducts leaving the capillaries

32
Q

nursing management of chronic venous insufficiency

A

elevate legs for venous return
TED hose (thrombo-embolic deterrent hose)
ambulation (muscles act like pumps)
ROM and PT
ulcer prevention

33
Q

why is venous insufficiency a risk for DVT and PE?

A

stagnant blood can clot more easily, small piece can break off and travel

34
Q

what is virchow’s triad of thrombosis?

A

stasis
vessel wall injury
hypercoagulability

35
Q

signs and symptoms of DVT

A

swelling and pain in leg

36
Q

signs and symptoms of PE

A

severe SOB and chest pain

37
Q

how are DVT and PE diagnosed?

A

ultrasound
CT

38
Q

medical/surgical management of DVT and PE

A

heparin or lovenox
warfarin
thrombectomy
Inferior Vena Cava filter
elevate legs
control pain
movement

39
Q

describe venous ulcers

A

dull pain if superficial, worse pain if deeper
pain worse with dependency
usually around ankle
large and irregular shape
itching
cellulitis

40
Q

difference in ulcer drainage?

A

venous has moderate-high drainage
arterial has very little drainage

41
Q

wound care of arterial vs venous ulcers

A

arterial - keep dry, may require amputation
venous - surgical debridement, wet-to-dry dressing

pain control, emotional support, education across the board

42
Q

what is an unna boot?

A

cast-like dressing on foot and lower leg
used to reduce edema and help heal venous ulcers
changed weekly, should be kept dry in the shower

43
Q

what are the causes of amputations and their frequency?

A

54% secondary to vascular disease and diabetes
45% due to trauma

44
Q

nursing management for amputations

A

pain control
emotional support and coping
stump care and skin care
rehab

45
Q

complications of amputation

A

hemorrhage
infection
skin breakdown
phantom limb pain
joint contracture

46
Q

what is lymphedema

A

localized fluid retention because it is stuck in the tissue and unable to re-enter bloodstream

47
Q

what can cause lymphedema?

A

infection
blockage
radiation and cancer growth can block drainage

48
Q

where is lymphedema common and why

A

axillary and arms s/p mastectomy
legs s/p prostate or gyn cancer surgery

49
Q

lymphedema treatment

A

compression sleeves or stockings
massage

50
Q

nursing considerations for lymphedema

A

no BP or IV on affected extremity
affected extremity at increased risk for infection from trauma

51
Q

what is the most common infectious cause of limb swelling?

A

cellulitis

52
Q

what are the signs and symptoms of cellulitis?

A

swelling
redness
warmth
pain
fever, chills, sweating

53
Q

how is cellulitis treated?

A

oral antibiotics for mild, IV antibiotics if severe

adult health nursing (10 decks)

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