Peripheral Artery Disease FINAL Flashcards
What is peripheral artery disease?
Atherosclerosis of the extremities (virtually always lower) causing ischemia.
What is Buerger’s disease?
when fingers and toes turn black in smokers
6 P’s of Arterial Insufficiency
Pain
Pulse
Paralysis
Pallor
Paresthesia
Pressure
Risk factors for PAD
HTN
Hyperlipidemia
DM
Smoking
Obesity/Sedentary lifestyle
Female/Older adults/Family hx
May be asymptomatic or cause intermittent claudication (burning, cramping, and pain in legs during exercise)
Mild PAD
May cause rest pain w/ skin atrophy, hair loss, cyanosis, ischemic ulcers, and gangrene
Severe PAD
Ankle-brachial index (ABI)
The ankle pressure is compared to the brachial pressure
Expected finding for ABI
0.9 to 1.3
ABI less than __________ in either leg is diagnostic for PAD.
0.9
What type of medication inhibits platelet aggregation and prolong bleeding time?
antiplatelet medications
Ex: Cilostazol and Pentoxifylline
General nursing implications for antiplatelet meds
-use caution in pts at risk for bleeding
-concurrent use w/ NSAIDs, heparin, thrombolytics, or warfarin may increase risk of bleeding
-teach bleeding precautions to pt and family
-monitor bleeding times throughout therapy
Side effects of Cilostazol
HA, diarrhea, GI bleeding, dizziness, flatus
Reminders for Cilostazol
-monitor for relief of intermittent claudication
-grapefruit juice inhibits metabolism
-administer on empty stomach
Procedures
- Percutaneous transluminal angioplasty and laser-assisted angioplasty
- Mechanical rotational abrasive atherectomy
- Arterial revascularization surgery
Ways to promote vasodilation & prevent vasoconstriction
-warm environment
-wear insulated socks
-never apply direct heat
-avoid exposure to cold
-avoid stress, caffeine, and nicotine
Positioning teaching for PAD pts
-avoid crossing legs
-refrain from wearing restrictive garments
-elevate legs to reduce swelling, but do not elevate above the level of the heart
Characteristics of ARTERIAL peripheral disease
Peripheral pulses: ABSENT
Cap refill: GREATER THAN 3 SEC
Ankle brachial index: LESS THAN/EQUAL TO 0.90
Edema: ABSENT UNLESS LEG CONSTANTLY IN DEPENDENT POSITION
Hair growth: LOSS OF HAIR ON LEGS, FEET, & TOES
Ulcer location: TIPS OF TOES, FOOT, OR LATERAL MALLEOLUS
Ulcer margin: ROUNDED, SMOOTH, LOOKS PUNCHED OUT
Ulcer drainage: MINIMAL
Ulcer tissue: BLACK ESCHAR OR PALE PINK GRANULATION
Pain: INTERMITTENT CLAUDICATION OR REST PAIN N FOOT; ULCER MAY OR MAY NOT BE PAINFUL
Nails: THICKENED, BRITTLE
Skin color: DEPENDENT RUBOR, ELEVATION PALLOR
Skin texture: THIN, SHINY, TAUT
Skin temp: COOL, TEMP GRADIANT DOWN LEG
Dermatitis & pruritis: RARE
