Peripheral vascular disease Flashcards
What is peripheral vascular disease – PVD
Umbrella term for peripheral vascular insufficiency & peripheral arterial disease
Risk factors for PVD – both diseases
+50 to 70 years
+ hypertension
+ Male sex
+ family history
+ diabetes mellitus
+ increased lipids
+ sedentary
+ smoker
Disease process of PVD/PVI
+ NOT an oxygen problem
+ Narrow veins
+ blood cannot get back to heart
+ voluptuous pulses – warm feet
+ edema – increased wound drainage
+ dull pain
+ yellow/brown ankles – stasis dermatitis
+ irregular shaped sores
+ venous stasis ulcers
Positioning for PVD/PVI
+ ⬆️ Bi lateral extremities
+ Elevation of veins helps blood returned a heart
Acronym for PVD/PVI to remember signs and symptoms
VEINY
- V: voluptuous pulses
- E: edema
- I: irregular shaped sores
- N: no sharp pain — DULL
- Y: yellow/brown ankles
Disease process of PAD
+ Oxygen problem – ischemia!
+ Narrow arteries
+ blood cannot flow down to extremities (bilateral issue)
+ absent pulses Dash cold feet
+ round red sores – decreased drainage
+ toes/feet pale – black eschar ➡️ gangrene due to lack of blood flow
+ pale, dry/scaly, thin skin
+ sharp calf pain
+ intermittent claudication
+ NO EDEMA – lack of blood in extremities
What is claudication?
+ cramping pain in leg induced by exercise
+ typically caused by obstruction of the arteries
Positioning of patient with PAD
+ extremities ⬇️ bilaterally
+ dangle to help blood circulate
What is priority for PAD – Peripheral Arterial Disease
Oxygenation
GOALS of treatment for PVD/PVI & PAD
+ Get vessels open
+ Get blood moving
+ clot prevention
Treatments for all PVD (PVD/PVI/PAD)
+ thin blood: ASA, clopidogrel
+ lower cholesterol: statins
+ lower blood pressure: calcium channel blockers
+ lower BP: vasodilators
+ surgery — bypass, angioplasty, endarterectomy
+ avoid OTC - cold remedies/pseudoephedrine
Patient education on all PVDs — physical/external
+ No crossing legs
+ no constructive clothing
+ no cigarettes
+ no caffeine
+ no cold temps
+ no cutting toenails – podiatrist only
Patient teaching on all PVDs — diet
+ Adequate proteins
+ vitamin/mineral: C, A, zinc, iron
+ ⬇️ trans/saturated fats
+ ⬇️ salt intake
+ ⬆️ water intake
+ ⬇️ weight
+ no smoking or alcohol
+ healthy diet
Priority intervention when patient has bypass graft on lower extremities for PVDs
+ 6 Ps
+ blood flow/pulse should be better after surgery
+ may be swelling
+ if patient has pain after bypass — bypass probably did it work ➡️ vein could be collapsed on bypass
+ check pedal pulses before and after and every shift
+ CALL SURGEON RIGHT AWAY if no pulses
