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NU318 Exam 5 > Peipheral arterial diease and venous insufficiency > Flashcards

Peipheral arterial diease and venous insufficiency Flashcards

1
Q

risk factors for atherosclerosis and PAD

A 
nicotine
diabetes
diet
HTN
obesity
stress
sedentary lifestyle
high cholesterol
age > 60
gender
familial predisposition
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2
Q

intermittent claudication

A

pain with walking

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3
Q

pain in arterial insufficiency

A

intermittent claudication to sharp, unrelenting constant

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4
Q

pain in venous insufficiency

A

aching, throbbing, cramping

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5
Q

pulses in arterial insufficiency

A

absent or diminished

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6
Q

pulses in venous insufficiency

A

present, but may be difficult to palpate through edem

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7
Q

skin in arterial insufficiency

A

dependent rubor; elevation pallor of foot; shiny skin; cool/cold temperature; loss of hair over toes and foot; nails thickened

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8
Q

skin in venous insufficiency

A

pigmentation in gaiter area; skin thickened and tough; may be reddish blue (dermatitis)

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9
Q

location of ulcer in arterial insufficiency

A

tips of toes, toe webs, heel or other pressure areas if confined to bed

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10
Q

location of ulcer in venous insufficiency

A

medial malleolus, lateral malleolus, or anterior tibial area

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11
Q

pain of ulcer in arterial insufficiency

A

very painful

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12
Q

pain of ulcer in venous insufficiency

A

minimal pain if superficial or may be very painful

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13
Q

depth of ulcer in arterial insufficiency

A

deep, often involving joint space

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14
Q

depth of ulcer in venous insufficiency

A

superficial

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15
Q

shape of ulcer in arterial insufficiency

A

circular

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16
Q

shape of ulcer in venous insufficiency

A

irregular border

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17
Q

ulcer base in arterial insufficiency

A

pale to black and dry gangrene

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18
Q

ulcer base in venous insufficiency

A

beefy red to yellow fibrinous in chronic long-term ulcer

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19
Q

leg edema in arterial insufficiency

A

minimal unless extremity kept in dependent position constantly to relieve pain

20
Q

leg edema in venous insufficiency

A

moderate to severe

21
Q

ankle-brachial index

A

taking BP in two places and getting a ratio; in PAD there’s a large decrease in BP

22
Q

nicotine causes

A

vasoconstriction and potential endothelial damage

23
Q

ways to prevent PAD

A 
smoking cessation
diet, weight management, and exercise
lipid modification and statin therapy
prevention and management of diabetes
prevention and management of HTN
antiplatelet therapy
24
Q

clinical manifestations of PAD

A 
intermittent claudication
changes in peripheral pulses
signs and symptoms of perfusion and atrophy
bruit
wounds
25
Q

signs and symptoms of perfusion and atrophy

A 
temperature intolerance (cold)
color changes 
skin, hair, and nail changes
26
Q

consequences of PAD

A

limb ischemia - can lead to wounds and amputations

27
Q

pharm goals of PAD

A

symptom management and risk reduction

28
Q

symptom management of PAD

A

vasodilator/antiplatelet (cilostazol) – for intermittent claudication
antiplatelets (aspirin, clopidogrel)
HMG-COA reductase inhibitors (statin)

29
Q

angioplasty and stents

A

tube goes into femoral artery (opposite)
monitor perfusion lower than stent
make sure there’s no hematoma

30
Q

bypass surgery

A 
if stent doesn't work
monitor BP (low BP can collapse graft)
31
Q

nursing management for PAD

A 
increased arterial blood supply
promotion of vasodilation
prevention of vascular compression
relief of pain
maintenance of tissue integrity
adherence to self-care
32
Q

assessment and monitoring of PAD

A

round shape, dry, necrotic, uniform
rubor (blood starting to flow with gravity); pt will be sitting with feet up because there’s a lot of burning pain with feet down (want them in a dependent position)

33
Q

maintaining tissue integrity in PAD

A

prevention - wear sturdy shoes, don’t wear compression stockings

limit cause of vasoconstriction (cold, caffeine, chocolate)

don’t put feet directly on heating pad

regular inspection of extremities and f/u

good nutrition, low-fat diet

weight reduction

34
Q

encourage activity in PAD

A

supervised exercise program (walking) offered to people with intermittent claudication; 2 hours of supervised exercise a week for 3 months; encourage exercise to point of pain

35
Q

exercise increases ________ ________

A

collateral circulation

36
Q

chronic venous insufficiency is a result of

A

incompetent valves or venous obstruction

37
Q

venous insufficiency leads to

A

edema, tissue congestion, tissue impairment

38
Q

goal of venous stasis wounds

A

get the fluid out of the legs

39
Q

risk factors of venous insufficiency

A 
DVT
varicose veins
obesity
pregnancy
smoking
extended periods of sitting or standing
female 
age > 50
40
Q

clinical manifestations of venous insufficiency

A 
edema (bilateral)
pain, aching
hyperpigmentation
skin atrophy
stasis dermatitis (brown thickness)
venous ulcers
41
Q

management of venous insufficiency

A 
avoid long periods of sitting/standing
regular exercise (walking)
maintain BMI
position legs (elevation)
compression therapy 
practice skin hygiene
improved diet for wound healing
42
Q

restoring skin integrity in venous insufficiency

A 
cleansing wound
compression therapy
avoiding trauma and injury
positioning 
wounds are not uniform, draining, macerated
43
Q

improving physical mobility

A

activity is usually restricted to promote healing
gradual progression of activity
activity to promote blood flow in bed and exercise upper extremities
diversional activities
pain med before activities

44
Q

promoting adequate nutrition

A 
protein
vit C and A
iron
zinc
iron intake for anemic patients
45
Q

improving peripheral arterial circulation

A 
exercises (walking), isometric 
positioning - feet down during day
temp - cold feet
stop smoking
stress reduction
limit caffeine
rubor, wound is round and uniform
need aspirin to prevent blood clots 
most likely to see gangrene
46
Q

improving peripheral vascular circulation

A 
compression stockings
elevate dependent limbs 
weight loss
nutrition
dermatitis stasis - brown coloring
pulses should be present 
risks for DVT
47
Q

risks for DVT

A 
post-op
women
overweight
any type of stasis
DVT can travel to lungs (pulmonary embolism)

NU318 Exam 5 (4 decks)

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