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N3 Cardiac > Peripheral Vascular Disease (PVD) > Flashcards

Peripheral Vascular Disease (PVD) Flashcards

1
Q

What does PVD affect?

A

Both Arteries and Veins

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2
Q

What is Arteriosclerosis?

A

The thickening, loss of elasticity and calcification of arterial walls
It is the most chronic arterial disorder
PAD is caused by arteriosclerosis

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3
Q

Peripheral Vascular Disease (PVD) include:

A

Peripheral Arterial Disease (PAD) &

Peripheral Venous Disorders.

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4
Q

PAD affects…?

Peripheral Venous Disease affects…?

A

Arterials - Vessels carrying blood Away from heart (to the periphery.)
Veins - Vessels carrying blood to the heart

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5
Q

What is Atherosclerosis?

A

Gradual thickening of the intima & media of the arteries, ultimately narrowing the vessel lumen. Plaques form on the wall.

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6
Q

Progressive arteriosclerosis (stiffening) & progressive atherosclerosis (narrowing) causes what?

A

Decreased blood supply to the peripheral tissues & increased resistance to blood flow

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7
Q

Where does tissue damage usually occur?

A

Below the arterial obstruction

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8
Q

What are some Risk Factors for PAD?

A 
HTN
Hyperlipidemia
DM
Cigarette Smoking
Obesity
Sedentary Lifestyle
Familial Predisposition
Age
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9
Q

What are some main Chief Complaints from a pt. with PAD?

A

Burning, Cramping Pain in the Legs During Exercise (KNOWN AS INTERMITTENT CLAUDICATION)
Numbness or Burning Pain When Elevated

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10
Q

How is pain relieved in patients with PAD?

A

Legs should be placed in a dependent position

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11
Q

What are some normal objective findings in patients with PAD?

A
  1. Bruit over femoral & aortic arteries
  2. Capillary refill >3 seconds
  3. Decreased or Nonpalpable Pulses
  4. Hairless, dry, scaly, shiny skin.
  5. Elevated Pallor or Dependent Rubor (RED)
  6. Muscle Atrophy
  7. Ulcers & gangrene toes
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12
Q

What are some diagnostic tests that can be performed for pt. with PAD?

A

Arteriography - Injection of Contrast X-ray

Stress Test - Used to Evaluate Intermittent Claudication

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13
Q

What are some nursing actions r/t Arteriography?

A

Monitor for bleeding & hemorrhage
Take vital signs
Palpate pedal pulses to ID possible occlusions

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14
Q

What are some Nursing Interventions to help a pt. with PAD?

A
  1. Encourage pt. to exercise - supports collateral circulation.Exercise gradually & slowly. Walk until claudication, stop & rest, then walk more.
  2. Positioning - Avoid crossing legs, No belts, Elevate Legs But Not Above Heart.
  3. Promote Vasodilation - Warm environment, socks, avoid cold.
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15
Q

What kind of medications should be administered to a pt. with PAD?

A
  1. Antiplatelets - ASA, Plavix:
    Reduces blood viscosity, Increases blood flow
    Monitor for bleeding - Abd pain, coffee ground emesis, black stools.
  2. Statins - Simvastatin & Atorvastatin:
    Relieves S/S of PAD claudication
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16
Q

What is Percutaneous Transluminal Angioplasty?

A

Using a Balloon & Stent to open & maintain patency of the vessel.

17
Q

What are some nursing actions to care for a pt. that underwent PTA?

A
  1. Monitor for bleed
  2. Monitor vital signs, Peripheral pulses & Capillary refill
  3. Anticoagulant therapy
18
Q

What is Arterial Revascularization Surgery?

A

Surgery reserved for severe PAD when pain happens during rest.
It’s a bypass graft that retoutes the circulation around the occlusion

19
Q

What are some nursing actions r/t Arterial Revascularization bypass graft surgery?

A
  1. Maintain adequate circulation
  2. Pedal or dorsal pulse should be marked & strength compared with other leg with
  3. Assess for warmth, redness, edema of affected limb as a result of increased blood flow.
  4. Monitor the client for pain. May be severe bc of reestablishment of blood flow.
  5. Monitor BP. Hypotension may result & increase risk for clotting & HTN increases risk for bleeding.
20
Q

What should I teach my pt. about bypass graft surgery?

A
  1. Do not cross legs
  2. Do not raise legs above heart level
  3. Instruct on wound care
  4. Discourage smoking & cold temperatures
  5. Foot care
    Keep dry, wear good fitting shoes, no bare foot, cut toenails across
21
Q

What is graft occlusion & what is the nurses priority?

A

Complication of arterial revascularization occurring within the 1st 24 hrs.

  1. Promptly notify physician of manifestations:
    a. Decreased Pedal Pulses
    b. Increased Pain
    c. Change In Extremity Color
    d. Temperature Change
22
Q

What is compartment Syndrome?

A

Considered a medical emergency
Tissue pressure within a confined body space can restrict blood flow which results in ischemia that leads to irreversible tissue damage.

23
Q

Clinical Manifestations of Compartmental Syndrome

& Nursing Interventions

A 
Tingling
Numbness
Worsening Pain
Edema
Unequal Pulses
IMMEDIATELY REPORT TO PHYSICIAN
Loosen dressing

N3 Cardiac (12 decks)

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