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Cardiac > Peripheral Vascular Disease > Flashcards

Peripheral Vascular Disease Flashcards

1
Q

What are PVDs?

A

A condition affecting peripheral arteries and veins interfering with normal blood flow.

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2
Q

What does peripheral arterial disease (PAD) usually result from?

A

Arteriosclerosis or atherosclerosis

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3
Q

What does Chronic venous insufficiency (CVI) usually result from?

A

Incompetent valves in the deeper veins of the legs.

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4
Q

What is PAD?

A

Peripheral Arterial Disease

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5
Q

What is CVI?

A

Chronic Venous Insufficiency

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6
Q

Why do varicose veins develop?

A

To develop a collateral circulation

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7
Q

Who are more likely to develop PAD?

A

men over the age of 50

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8
Q

What is occurring in the vessel when a patient has PAD?

A

Atherosclerotic lesions obstruct vessel lumen

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9
Q

Why would collateral circulation develop?

A

Due to inadequate blood flow to meet tissue needs

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10
Q

When does PAD manifest?

A

When the vessel is occluded by 60% or more.

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11
Q

When a patient has PAD what position do they like their legs to be in?

A

Dependent; hanging down in front of them

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12
Q

What is intermittent claudication?

A

Cramp like pains at rest in the lower legs due to poor circulation associated with atherosclerosis.

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13
Q

What are the risk factors for PAD?

A
  • Hypertension
  • Diabetes
  • Hypercholesterolemia
  • Cigarette smoking
  • Obesity
  • Physical inactivity
  • Age, genetics : African Americans
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14
Q

In a patient with PAD what is diminished?

A
  • Peripheral pulses

- Capillary refil of toes

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15
Q

When you elevate a patients legs who has PAD what typically happens?

A

Pallor occurs

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16
Q

When a patient with PAD has their legs in a dependent position what color does their affected legs turn?

A

Rubor: a dusty red/purple

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17
Q

What types of ulcerations occur in a patient with PAD?

A

-Little drainage with regular borders

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18
Q

A patient who has PAD tends to have legs and toenails that look….

A

Shiny, dry, and hairless with thickened toenails

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19
Q

What is paresthesia?

A

A numb/tingling feeling

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20
Q

What is an ankle-brachial index?

A

When the blood pressure is taken at the ankle then compared to the blood pressure taken at the brachial artery

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21
Q

What diagnostic studies are done for PAD?

A
  • Ankle-brachial index
  • Treadmill exercise arterial studies
  • Duplex ultrasound
  • Angiography
  • CT or MRI
22
Q

When a patient is undergoing treadmill exercise arterial studies how fast do they walk and for how long?

A

1.5 mph for 30 minutes

23
Q

If a patient has intermittent claudication what is lower: The blood pressure in the brachial artery or in the ankle?

A

Ankle

24
Q

What conditions does a patient need to control if they have PAD?

A

Diabetes
Cholesterol Levels
Hypertension
Weight

25
Q

What type of medications does a patient with PAD take?

A

Antiplatelet drugs like Aspirin and antilipemic drugs

26
Q

What type of angioplasty is done in patients with PAD?

A

Angioplasty with or without stenting

27
Q

Patients with PAD need to do what about smoking and exercise?

A

They need to eliminate smoking and do progressive strenuous exercise

28
Q

True or False:

A patient with PAD should not have a surgical revascularization with bypass?

A

False:

These patients benefit from revascularization with bypass

29
Q

If a patient is diabetic with PAD what is their dosage of aspirin?

A

375 mg- they need a higher dose than patients without diabetes

30
Q

How does chronic venous insufficiency or CVI normally occur?

A

From vein pathology, such as vascular incompetence, causing venous stasis and increased venous pressure in the lower extremities

31
Q

What are the three things that diagnose CVI?

A

History, physical and duplex ultrasound

32
Q

Patients with CVI tend to be at higher risk for what?

A

DVTs

33
Q

A patient who has CVI is more comfortable with their legs doing what?

A

Elevated

34
Q

If you do what you are at a higher risk for CVI?

A

Standing for a long time each day

35
Q

What gender is at a higher risk for developing CVI?

A

females

36
Q

What are the other 7 risk factors for CVI?

A 
Varicose veins
Smoking
Inactivity
Aging
Obesity
Pregnancy
Thrombophlebitits
37
Q

When a patient has CVI: What type of edema do they experience?

A

Lower extremity edema that increases with standing

38
Q

What type of leg discomfit do patients with CVI experience?

A

Itching, dull leg discomfort that increases with standing

39
Q

What type of ulcerations do patients with CVI experience?

A

Stasis ulcerations: with irregular boarders

40
Q

What type of pigmentation do patient with CVI experience?

A

Hyperpigmentation: brownish discoloration of lower leg/foot

41
Q

How would you describe a CVI patients skin appearance?

A

Thick, fibrous SQ tissue
Leathery appearance
Hyperpigmentation

42
Q

True or False:

A patient with CVI tends to have dry appearance to their skin.

A

False:

They can have weeping dermatitis

43
Q

What should patients with CVI avoid doing?

A
  • Long periods of standing or sitting
  • Crossing legs
  • Tight fitting garments
44
Q

What should patients with CVI DO?

A
  • Exercise regularly
  • Elevate legs above the level of the heart when sitting or laying down
  • Wear compression stockings
  • Good skin hygiene
  • Good nutrition
45
Q

In patients with potential PVDs what should you check on during physical examinations?

A
  • Vital Signs
  • Peripheral pulses
  • Capillary refill
  • Skin color, temperature, lesions/ulcers
  • Hair distribution
46
Q

What are the 4 diagnoses for PVD?

A
  • Ineffective Tissue Perfusion: Peripheral
  • Pain
  • Impaired Skin Integrity
  • Activity Intolerance
47
Q

What are the 6 diagnoses for CVI?

A
  • Disturbed Body Image
  • Ineffective Health Maintenance
  • Risk for Infection
  • Impaired Physical Mobility
  • Impaired Skin Integrity
  • Ineffective Tissue Perfusion: Peripheral
48
Q

What four things do you use for planning in PVD and CVI patients?

A
  • Promote wound healing
  • Manage pain
  • Promote tissue perfusion
  • Optimize activity tolerance
49
Q

What are the four implementation you should do to encourage activity in a PVD patient?

A
  • Assist with care as needed
  • Encourage gradual increases in activity, exercise
  • Provide diversional activities
  • Encourage frequent position changes
50
Q

What are the two evaluations a patient would be able to demonstrate if they have PVD?

A
  • Demonstrates positioning to promote perfusion to extremities
  • Demonstrates abstinence from tobacco products
51
Q

What are the two evaluations a patient would be able to verbalize if they have PVD?

A
  • Verbalizes appropriate wound care

- Verbalizes symptoms to report to the provider

Cardiac (13 decks)

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