Peripheral Vascular Disorders Flashcards
What gender is more at risk for vascular disorders?
Men
Define peripheral arterial disorder (PAD)
- reduced arterial blood flow to the extremities, thickening/narrowing of artery walls
- marker of advanced systemic atherosclerosis
5 Symptoms of PAD
- Intermittent Claudication
- Paresthesia
- Dependent rubor (erythematous discoloration of limbs)
- Skin change (cool to touch, pallor, increased cap refill, loss of hair, taut and thin skin)
- Decreased circulation
3 Indicators of intermittent claudication
- Response to exercise (increased O2 demand)
- Resolves with rest (within 10 mins)
- Repeatable
3 complications of PAD
- Continuous pain at rest
- Gangrene (death of body tissue due to a lack of BF)
- Limb threatening disease
3 Diagnostic Tests for PAD
- Ankle Brachial Pressure Index (Ankle SBP/Brachial SBP ratio, NORMAL IS 1-1.4)
- Doppler ultrasound (shows vessels and BF)
- Magnetic resonance angiography
5 Interventions for PAD
- Surgery
- Drug Therapy
- Nutritional Therapy
- Exercise Therapy
- Risk factor modification
Risk Factors of PAD
HTN, overweight, smoking, diabetes
Define Acute Arterial Ischemic Disorder
- occurs suddenly when there is significant blockage and no BF to limb
- caused by embolism, thrombus, or trauma
- early Tx essential to keeping limb
Clinical Manifestations of Acute Arterial Ischemic Disorder
6Ps
- Pain
- Pallor
- Pulselessness
- Paresthesia
- Paralysis
- Perishingly cold
5 Nursing Diagnosis for PAD
- Ineffective Tissue perfusion
- Impaired skin integrity
- Acute pain
- Activity intolerance
- Ineffective therapeutic regimen management
How are blood clots formed in venous thrombuses?
Virchow’s triad (edit: read more in textbook)
1. Stasis (immobility)
2. Hypercoagulability (polycythemia - too many RBC)
3. Endothelial damage (vessel wall injury causing clots to form)
Define Superficial Vein Thrombosis
- in upper or lower extremities (in SQ smaller veins)
- palpable
- tender
- red
- warm
- could be caused by a bad IV
- often not hospitalized
- interventions: compression stocking and elevation
6 Clinical Manifestations of DVT
- May have no symptoms
- Unilateral leg edema
- Extremity pain
- Heaviness in thigh or calf
- Skin changes: warm, erythema, cyanosis
- Temp > 38C
4 Complications of DVT
- PE
- Chronic venous insufficiency (Hemosiderin released causing RBCs leaking to tissues)
- Phlegmasia cerulea dolens (purple skin requiring immediate surgery or amputation)
- Venous leg ulcer
4 Diagnostic tests for DVT
- Tests for how long blood clots form -> PTT (partial thromboplastin time), INR (international normalized ratio), platelet count
- D-dimer (protein made when a clot is dissolved)
- Venous compression ultrasound
- Magnetic resonance venography
5 Nursing Diagnoses for DVT
- Acute pain
- Ineffective health maintenance
- Risk for impaired skin integrity
- Risk for bleeding
- Risk for PE
4 Nursing Interventions for DVT
- Early and aggressive mobilization (4-6x/day)
- Bedrest patients (rotate ankles Q2-4H)
- Compression stockings
- Sequential compression devices
Define Aortic Aneurysm
- outpouching or dilation of the aortic vessel wall
- Risk factors: smoking, older male, HTN
- classified in TRUE or FALSE
- clinical manifestations depend on location (ascending/descending thoracic aortic aneurysms, and abdominal which perfuses into peritoneal cavity and causes sharp back pain)
Define Aortic Dissection
- NOT an aneurysm
- tearing/dissection of the intimal layers and puts blood in between vessel walls
- can be acute/subacute/chronic
- risk factors: HTN, atherosclerosis, aortic valve disease, aortic aneurysm, trauma
- clinical manifestations are severe chest or back pain and are more abruptly onset than MI pain