NUR 240 ch 26 PVD Flashcards
functions of the vascular system
include supplying the circulatory needs of tissue
maintaining blood flow and blood pressure providing capillary filtration and reabsorption hemodynamic resistance
intermittent claudication
a muscular, cramplike pain or fatigue in the extremities consistently reproduced with the same degree of exercise or activity and relieved by rest
rest pain
persistent pain the the foot or digits when the patient is resting, indicating a severe degree of arterial insufficiency and critical state of ischemia
rubor
reddish-blue discoloration of the extremities; indicative of severe peripheral arterial damage in vessels that remain dilated and unable to constrict
atherosclerosis
Filling of the vessel with cholesterol, lipids, fats, plaque = small lumen and diameter
inflammatory process involving the accusation of lipids, calcium, blood components, carbs, and fibrous tissue on the intimal layer of a large or medium sized artery
arteriosclerosis
hardening of the arteries - loose elasticity
diffuse process where the muscle fibers thicken and the endothelial lining of the walls of SMALL arteries and arterioles become thickened
what is the driving force that moves blood through the vascular system
contraction
intermittent claudication is caused by
the inability of the arterial system to provide adequate blood flow to the tissues when there is increased demands for nutrients and oxygen during exercise
intermittent claudication is relieved by
rest (decrease in metabolic needs)
assessing the ____ is important in assessing the status of peripheral arterial circulation
presence or absence and the quality of peripheral pulses
absence of peripheral pulses may indicate
stenosis (narrowing or constriction)
aging adult considerations for changes in vessels
aging produces changes in the walls of the blood vessels that affect the transport of oxygen and nutrients to the tissues
can cause vessels to stiffen and results in:
increased peripheral resistance
impaired blood flow
increased left ventricular workload
physical assessment findings of an impaired vascular system
skin (cool, pale, pallor, rubor (red color),
loss of hair,
brittle nails,
dry or scaling skin,
atrophy,
ulcerations (shallow, circular, pale, not a lot of drainage)
pulses=weak
Ankle-brachial index (ABI)
take BP on arm, take BP on leg, compare the values
looking for a 1:1 ratio
major goals for someone with peripheral vascular problems
increase arterial blood supply
decrease in venous congestion
promotion of vasodilation and prevention of vascular compression
relief of pain
maintenance of tissue integrity
how to improve peripheral arterial circulation
position strategies- dangle the feet (increases blood flow)
exercise- walking, graded isometric exercises
temperature effects of heat and cold (poor circulation- cold=vasoconstriction)
discourage nicotine use- vasoconstrictor
stress reduction (fight or flight pulls all the blood from distal and bring it to trunk)
different types of arterial disorders
arteriosclerosis
atherosclerosis
peripheral artery disease
Aneurysms
arterial embolism and arterial thrombosis
raynauds phenomenon
risk factors for atherosclerosis and PAD
nicotine use
diabetes
HTN
Hyperlipidemia
diet
stress
sedentary lifestyle
C-ractive protein
hyperhomocysteinemia
increased age
family genes
hallmark symptoms for Peripheral artery disease (PAD)
intermittent claudication (relieved with rest)
ischemic rest pain is usually worse at
night and often wakes the patient up
pharm therapy for PAD
phosphodiesterase III inhibitor
anti platelet (Aspirin)
statins
For patients with PAD, blood flow to the lower extremities needs to be enhanced; therefore, the nurse encourages keeping the lower extremities in a neutral or dependent position. In contrast, for patients with venous insufficiency, blood return to the heart needs to be enhanced, so the lower extremities are elevated. Exercise can be prescribed to aid in the development of collateral circulation. Some pain is associated with PAD.
Aneurysm
localized sac or dilation formed at a weak point in the wall of the artery
classified by its shape or form
most common forms of aneurysms are
saccular and fusiform
saccular aneurysm
projects from only one side of the vessel
fusiform aneurysm
entire arterial segment becomes dilated
raynauds phenomenon
intermittent arterial vas occlusion (spasm), usually of the finger or toes
associated with underlying diseases such as scleroderma
signs and symptoms of raynauds
sudden vasoconstriction results in color changes, numbness, tingling, and burning pain
poor circulation to fingers, put spo2 on earlobe
raynauds episodes are triggered by
cold weather or stress
venous disorder types
venous thromboembolism condition (DVT and PE)
chronic venous insufficiency/post-thrombotic syndrome
leg ulcers
varicose veins
difference between leg ulcers in venous and atrial circulation disorders
arterial:
shallow, circular, pale, not a lot of drainage
venous:
more fluid and drainage, larger, red, odor, normal on the gaiter region (behind the ankle, medial)
