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Peripheral Vascular Disease Flashcards

1
Q

What is peripheral vascular disease?

A

Any condition that affects your circulatory system. Divided by arterial and venous diseases/conditions.

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2
Q

What is PAD?

A

Peripheral Arterial Disease

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3
Q

Leading cause of PAD

A

Atherosclerosis - lipid accumulation and thickening of the arterial walls, causes progressive narrowing of arteries. Symptoms typically occur at 60-75% occlusion.

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4
Q

Risk factors for PAD:

A

Smoking #1 (tobacco is a vasoconstrictor)
diabetes
hyperlipidemia
HTN
older age >60
family history

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5
Q

PAD symptoms:

A

Claudication
Paresthesia
Resting pain

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6
Q

Claudication:

A

Pain experienced with ambulation, a result of imbalanced supply and demand. Pain increases with more movement.

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7
Q

Paresthesia:

A

described as numbness or tingling

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8
Q

Patients will experience pain in the muscle group _______ the level of stenosis.

A

below

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9
Q

PAD exam findings

A

Lower extremities changes; color, warmth, tissue loss
Assess for motor function and sensation
Pulse exam - decreased pulses
Thick nails, smooth hairless skin

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10
Q

Treatment of PAD

A

PTA - Percutaneous transluminal angioplasty, stents, atherectomy

Surgical: Lower extremity bypass or endarterectomy (plaque is cleaned out)

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11
Q

Acute nursing care for patients with PAD:

A

check lower extremities for color, temp, pulses, cap refill, sensation, movement, pain

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12
Q

Pharmacologic treatment for PAD:

A

Antiplatelets: aspirin or plavix are used to treat intermittent claudication. Statins used to manage hyperlipidemia and prevent worsening atherosclerosis
NSAIDs can also be used for pain management

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13
Q

Health promotion for PAD

A

Risk factor modifications - stop smoking
Exercise
BP control
BG control
Diet modifications
Proper foot care

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14
Q

Acute Arterial Ischemia

A

Sudden interruption in the arterial blood supply to a tissue, organ or extremity

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15
Q

Causes of AAI:

A

embolism, thrombus, or trauma

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16
Q

Clinical manifestations of AAI

A

6 Ps: pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

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17
Q

What is a thrombosis?

A

Complete blockage of the blood vessel from platelets and or fibrin

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18
Q

What is an embolism?

A

Dislodged mass that has traveled through the bloodstream to cause a blockage (ex. from aFib)

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19
Q

AAI nursing care:

A

Notify provider immediately
Anticoagulation therapy: IV unfractionated heparin

Treatment options:
Thrombectomy
Catheter
Bypass
Amputation if limb can’t be salvaged

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20
Q

What is an aneurysm?

A

A permanent localized outpouching or dilation of vessel wall

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21
Q

Aortic Aneurysm

A

Can occur in abdominal aorta or thoracic, an abdominal aorta >3cm is considered an aneurysm. The larger the size the greater risk for rupture.

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22
Q

Aortic Aneurysm Risk Factors:

A

male
coronary artery disease
carotid artery disease
previous stroke
race/ethnicity

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23
Q

Causes of Aortic Aneurysms:

A

Degenerative - atherosclerosis
Congenital - family tendencies
Mechanical - trauma
Inflammatory/infection

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24
Q

What are the two types of aneurysms?

A

True aneurysm - walls of artery forms the aneurysm.
False aneurysm (pseudoaneurysm) - disruption of all layers of arterial wall

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25
Thoracic aortic aneurysm clinical manifestations:
often asymptomatic deep, diffuse chest pain hoarseness, dysphagia, JVD, edema
26
Abdominal aortic aneurysm clinical manifestations:
often asymptomatic mass palpable bruits, back pain, epigastric discomfort, blue toe syndrome
27
Aortic aneurysm diagnostic studies:
Chest and abdominal x-rays ECG ultrasound CT MRI Angiography
28
Aortic Aneurysm Rupture manifestations
severe back pain back or flank ecchymosis hypovolemic shock
29
Aortic aneurysm surgical therapy:
EVAR or open repair of aneurysm
30
What is an aortic dissection?
When a tear develops in the inner layer of the aorta and blood surges into the middle layer creating a false lumen. Can be fatal if blood ruptures outside of the aortic wall.
31
Aortic dissection risk factors:
male aortitis trauma congenital heart disease connective tissue disorders drug use hypertension pregnancy
32
Clinical manifestations of Type A: acute ascending aorta and arch
abrupt onset of chest or back pain altered LOC, weakened carotid pulses, dizziness, syncope
33
Clinical manifestations of Type B: acute descending aorta
sharp tearing pain, in back, abdomen or legs malperfusion to lower extremities
34
Aortic dissection diagnosis:
ECG Chest x-ray CT scan TEE MRI
35
Aortic dissection complications:
cardiac tamponade aortic rupture occlusion of blood supply to vital organs
36
What is cardiac tamponade?
blood from the dissection leaks into the pericardial sac manifests as hypotension, JVD, muffled heart sounds LIFE THREATENING
37
Aortic dissection treatment:
IV beta-blockers, calcium channel blockers, ace inhibitors Surgical: endovascular dissection repair, surgical aortic resection and repair
38
What is carotid artery disease?
plaque build up within the carotid artery, can be symptomatic or asymptomatic
39
Clinical manifestations of CAD:
Amaurosis fugax (visual disturbance/shade over one eye) speech deficits hx of strokes asymmetry in strength carotid bruit
40
Risk factors for CAD:
HTN, HLD, DM, smoking
41
Diagnostic studies for CAD:
Ultrasound can measure the velocity of blood as it travels thru the carotid arteries CT angiography provides rapid high resolution images of the carotid arteries
42
Nursing care for CAD:
Neuro checks BP management Headache monitoring Prevention education
43
Surgical treatment for CAD:
Carotid endarterectomy (scoop it out), PTA (stenting)
44
Peripheral venous disease
affects the venous return of blood to the heart
45
Venous thrombosis
formation of thrombus and inflammation of a vein
46
Superficial vein thrombosis
usually occurs in the greater or lesser saphenous vein
47
Deep vein thrombosis (DVT)
Most commonly occurs in the iliac and femoral veins
48
Venous thromboembolism (VTE)
represents spectrum of pathology from DVT to PE
49
Post thrombotic syndrome (PTS)
a venous stress disorder that develops from long-term effects from a previous deep vein thrombosis
50
Virchow's triad
endothelial injury venous stasis hypercoagulability
51
VTE risk factors:
women postoperative state - bed rest central venous catheter immobilization pregnancy/post-partum smoking family history estrogen therapy
52
VTE diagnosis:
ultrasound blood work - d-dimer (indicates clot) CT venography MR venography
53
Superficial venous thrombosis manifestations:
palpable, firm, cordlike surrounding area may be itchy, tender, painful to touch
54
Deep vein thrombosis manifestations:
unilateral leg pain, edema, tenderness, warm skin, erythema diagnosed via ultrasound of affected limb
55
Post-thrombotic syndrome (PTS) manifestations:
persistent edema, pain, aching, heaviness, venous dilation, itching, tingling, increased pigmentation
56
VTE pharmacologic treatment:
Vitamin K antagonists (warfarin) Thrombin inhibitors (Heparin, lovenox, pradaxa) Factor Xa inhibitors (xarelto, eliquis) The goal is to limit formation of new clot, not use thrombolytics WARNING THESE MEDS INCREASE RISK FOR BLEEDING
57
VTE management:
anticoagulation medications IVC filter if anticoagulants are contraindicated (catches clots like a net) surgical: open venous thrombectomy vena cava filter device IR procedures
58
VTE nursing care:
MOBILITY hydration compression devices medication education monitor for bleeding vitals fall risk
59
What is phlebitis?
Acute inflammation of the walls of small cannulated vein of hands or arms
60
Risk factors for phlebitis include
mechanical infiltration from catheter, infusion or irritating medication, catheter location
61
Phlebitis symptoms:
Pain, tenderness, warmth, erythema, swelling, palpable cord
62
Phlebitis nursing care:
remove catheter, elevate extremity, apply warm moist heat, administer NSAIDs to relieve pain and inflammation
63
What are varicose veins?
Dilated, tortuous subcutaneous veins commonly found in the saphenous vein (superficial) system that result from increased venous pressure.
64
Risk factors for varicose veins:
family history weakness of vein structure female use of oral contraceptives tobacco use increasing age obesity pregnancy history of VTE occupations that require long periods of standing or sitting
65
Venous disease manifests commonly in what 4 ways?
Varicose veins Swollen legs (edema) Skin changes (redness) Skin ulcers (from blood pooling)
66
Care for venous leg ulcers:
compression moist dressings leg elevation balanced diet to promote healing antibiotics if infection is present

NURS5050 (5 decks)

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