peripheral vascular

Question 1

brachial artery use

Answer 1

stanard blood pressure cuff

Question 2

radial artery

Answer 2

pulse with this

Question 3

ulnar artery

Answer 3

arterial line

invasive blood pressure line

Question 4

allens test positive?

Answer 4

means patient does NOT have an adequate dual blood supply to the hand

Question 5

allens test

Answer 5

arteries of the upper extremity

make a fist then occlude

• ulnar and radial artery
• if pinks up – know have the flow

if let go of artery and does not pink up – not putting line here because if do - loss of blood supply to the area

fist - then open up hand

Question 6

arteries of the lower extremity

Answer 6

femoral artery

popliteal artery - hard to palpate

dorsalis pedis artery

posterior tibial artery

Question 7

veins - very baic

Answer 7

superficial and deep veins

have vlaves – if get back flow can go into superficial areas and get varicosities

Question 8

athrosclerosis (arteriosclerosis obliterans)

Answer 8

intermittent claudication

symptom of pain or cramping in legs during exercise that is relieved by rest within 10 minutes

usually in calf muscles

not total occlusion but some

Question 9

acute arterial occlusion?

implication

Answer 9

usually superimposed on the artersclerosis obliterans
- such as a embolism and thrombosis

weakness to area
absent or weak distal pulses

Question 10

raynaud’s disease

Answer 10

episodes of sharpley demarcated pallor of fingers aggrevated by exposure to cold

Question 11

varicosities

Answer 11

enlarged / twisted veins at the skin surface
- occurs due to malfunctioning of valves

trendelenberg test – will see blood flow out

Question 12

DVT

Answer 12

homan sign

lay flat on bed and thought had DVT
- take foot and elicit pain when flex it

Question 13

venous insufficiency

Answer 13

engorgment of blood in the veins secondary to either valve incompetency or occlusion

characterized by chronic edema, pigmentation and possibly ulceration

Question 14

edema types

Answer 14

pitting
chronic venous insufficiency
lymphoedema

Question 15

pitting edema

Answer 15

soft with pitting

results from CHF, nephrotic syndrome or malnutrition

Question 16

chronic venous insuffciency related to edema

Answer 16

soft with pitting

characterized by chronic edema, pigmentation and possibly ulceration

Question 17

lymphoedema

Answer 17

becomes indurated
non-pitting – not getting the indentations after

FIRST SOFT THEN INDURATED HARD AND NON PITTING

if took IV or blood pressure on side that has previous excision or radiation to the nodes - could develop a lymphoedema

Question 18

why laterally in the antecubetal fossa as opposed to medially?

Answer 18

concerned about anatomy

- more problomatic medial

Question 19

locations to put an IV
start?
finish?

Answer 19

dorsum of hand 
ventral forearm
lateral antecubital fossa
dorsal wrist
medial antecubital

Question 20

dosrum of hand venipuncture site?irritation ?

Answer 20

no important anatomy - but the veins DO ROLL

can cause irritation adn burning

diazepam / valium can cause burning

Question 21

ventral forearm venipuncture site?

Answer 21

no anatomy no rolling of veins

Question 22

lateral anticubital fossa venipuncture site?

Answer 22

no anatomy no rolling of veins
*joint immobilization
metal needle only

Question 23

dorsal wrist venipuncture site?

Answer 23

no anatomy
rolling of veins

*joint immobilization
metal needle only

Question 24

medial antecubital fossa venipuncture site?

Answer 24

anatomy - yes worried about structures

no rolling of veins

*joint immobilization
metal needle only

Question 25

no ___ in the IV lines

Answer 25

no air

Question 26

supine position why

Answer 26

avoid going into syncopy

but up a little so breathing isnt compromised

Question 27

angle to place IV in

Answer 27

30 degress

introducer does NOT move

catheter advances into vein

keep skin taught to help

Question 28

IM injection technique

advantages

Answer 28

rapid onset of action (15 mins)

mac clinical effect - 30 mins

more reliable absorption than oral or rectal

patient coopreation not as essential

Question 29

IM injection technique

disdvantages

Answer 29

inability to titrate
- 15 mins onset

inability to reverse drug action

prolonged duration of drug effect

injection needed
- possible injury from this

Question 30

use intramuscular route when and why

Answer 30

older adults
- cant inhale or IV routes are unavailable

disruptive pediatric patient when other routes unaffective

disruptive child or adult with disabilities in other routes not effective

Question 31

uses of the IM injection when indicated

Answer 31

premedication before IV sedation or general anesthesia in the precooperative pediatric patient or adult or peeds patient with disability

administration of antiemetics or anticholinergics

administratin of emergency drugs when IV administration is not available (like epi pen — lateral aspect of thigh)

give glucagno – in deltoid

seizure - IM versed

Question 32

vastus lateralis
perfussion in adult?
hold how much?

Answer 32

where place epi pen on lateral aspect of the thigh

perfussion is 2 - can hold 8-15 ml

Question 33

deltoid injection perfusion
adult
infant

Answer 33

1 perfussion

can hold 4 ml in adult

Question 34

gluteal / ventrogluteal injection perfusion and adult amount hold

Answer 34

3 perfussion and hold 4-8 ml