Perioheral Vascular disorders

Question 1

How many layers does an artery have? and what does the middle layer consist of?

Answer 1

3; media consist of smooth muscle and elastic fibers which help with the contraction of the arteries

Question 2

c-reactive protein, hemostatic markers-D dimer and Hyperhomocysteinemia are used for what?

Answer 2

Atherosclerosis. D-dimer is a tracker that is injected into you, with hyperhomocysteinemia, they will have clotting problems and the c-reactive protein determines the extent of atherosclerosis

Question 3

s/s of an embolism

Answer 3

painful, pale, cool, distal pulses absent, paresthesia, cyanosis or mottling, muscle spasms, line of dematcation (finger tips are blue)

Question 4

Buergers disease

Answer 4

recurring inflammation

Question 5

s/s of PAD

Answer 5

Intermittent claudication, pain numbness, heaviness, cramping in legs, weak or absent pulses, delayed healing on lower extremities, color changes (pale, cyanosis, rubor), poor nail/hair growth, E.D

Question 6

Why is Plavix (clopidogrel) & ASA used to treat PAD?

Answer 6

they reduce the risk of clots

Question 7

Why is Pletal (cilostazol) used to treat PAD?

Answer 7

it has a vasodialator property (so don’t use with heart failure!)

Question 8

Why is Trental (pentoxifylliune) used to treat PAD?

Answer 8

it decreases blood viscosity by decreasing fibrogen and it increases RBC flexability so it can get thru the smaller vessels and so youll have increased blood flow

Question 9

Why are Parental prostaglandins used to treat PAD?

Answer 9

help reduce pain and increase healing

Question 10

When a patient has severe PAD and they have balloon angioplasty, what do you need to do for them after the surgery?

Answer 10

bedrest for 6-24 hrs, monitor site for bleeding, monitor circulation, teach them: no lifting at home, avoid baths until site is healed

Question 11

Is Buergers Disease an artery or veinous issue? and what is the treatment?

Answer 11

artery; Stop smoking!, keep extremities warm, manage stress

Question 12

Cardizem (diltiazem) and Isoptin (verapamil) are used to treat?

Answer 12

Buergers disease

Question 13

What is the treatment goal for buergers disease?

Answer 13

provide relief of vasoconstriction and intermittent claudication

Question 14

What do buerger-Allen Exercises do?

Answer 14

help promote circulation

Question 15

Raynauds disease

Answer 15

intermittent attacks of pallor followed by cyanosis. extremities will turn white then blue then red once they get into warm environment

Question 16

Raynauds disease treatment

Answer 16

keep hands warm, avoid smoking, vasodilators (Procardia (nifedipine), Norvasc (amlodipine), Transdermal NTG

Question 17

What does venous return depend on?

Answer 17

skeletal muscle contraction and pressure changes

Question 18

What 3 things will you have in order to put you at risk for a DVT

Answer 18

Venous stasis, hypercoagulation & vascular injury

Question 19

Venous stasis

Answer 19

blood pooling in extremity

Question 20

Hypercoagulation

Answer 20

due to infection, IV drug use, any access procedure (IV), due to neoplasm, dehydration, cancer, valves prevent backward flow

Question 21

Vascular injury

Answer 21

injury to vessel related to trauma, surgery, contrast dye

Question 22

s/s of dvt

Answer 22

limb pain, heaviness, ankle engorgement, increased surface temperature, tenderness, redness

Question 23

management of dvt

Answer 23

bedrest, TEDS on unaffected leg, antibiotics, surgery

Question 24

DVT prophylaxis

Answer 24

early mobilization, foot/leg exercises, elevating foot of bed with knees slightly flexed, use of LMWH for pre/post op ( Coumadin, Plavix)

Question 25

lymphangitis cellulitis treatment

Answer 25

elevate limbs, teds, pressure devices, good skin care, restrict sodium , antibiotics, antifungal, diuretics, albumin, surgery