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Adult Health Nursing I > Peripheral Vascular Disorders > Flashcards

Peripheral Vascular Disorders Flashcards

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1
Q

Pathophysiology of Disorders of Peripheral Vascular System

A

Related to inefficiency of the heart, blood vessels, incompetent valves, lymphatic obstruction

Normal aging: inner walls of blood vessels become thick and less flexible, which increases vascular resistance

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2
Q

Risk Factors of Disorders of the Peripheral Vascular System

A

Age, gender, heredity, race, diet, exercise, smoking, stress, hyperlipidemia, obesity, diabetes (increased blood glucose)

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3
Q

Arterial Assessment

A

First symptom of decreased arterial circulation is pain

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4
Q

Ischemia

A

Caused by lack of oxygen-rich blood getting to the muscles

Pain frequently in lower extremities, dull ache in calf muscles, occurs even with rest

Accompanied by fatigue and cramping

Precipitated by exercise

Alleviating factor is rest (initially)

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5
Q

Intermittent Claudication

A

Weakness and cramp-like pain in the calves related to poor circulation of the arterial blood

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6
Q

Arterial/Venous Assessment

A 
Pulses
Appearance
Temperature
Capillary refill
Hardness
Edema
Sensation
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7
Q

Venous Assessment

A

First symptom is edema

Dark pigmentation, dryness, and scaling due to chronic venous insufficiency

Chronic edema and stasis leads to stasis ulcerations caused by the pooling of blood

Achy pain and cramps

Alleviated by activity or raising the legs above heart level

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8
Q

Noninvasive Tests of Vascular Insufficiency

A

Treadmill test (taking blood pressures in extremities and monitoring for pain)

Plethysmography (measures changes in volume in different parts of the body)

Doppler ultrasound (continuous recording, color flow, used for looking at claudication and obstruction)

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9
Q

Invasive Tests of Vascular Insufficiency

A

Phebography or venography (injection of dye into an IV)

Angiography (dye in an IV)

Doppler/Duplex Scanning Tests (combines ultrasound and doppler)

D-Dimer (looks for blood clots, thrombus present if test shows > 1591 ng/mL of D-Dimer)

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10
Q

Characteristics of Arterial Insufficiency

A

Pulses decreased or absent

Color is pale, dusky rubor present

Temperature is cool

No edema

Skin is shiny and has absence of hair, ulcers on the toes

Pain aggravated with exercise and relieved with rest

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11
Q

Characteristics of Venous Insufficiency

A

Pulses are present

Color is pink to cyanotic with brown pigmentation at ankles

Temperature is warm

Edema is present

Skin shows ulcers on ankles

Pain is aggravated by long standing or sitting and is alleviated by elevation of legs, lying down, or walking

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12
Q

Pathophysiology of Hypertension

A

Sustained elevated systolic blood pressure greater than 140 mmHg and sustained elevated diastolic blood pressure greater than 90 mmHg

Increases vascular resistance, hastens atherosclerosis and arteriosclerosis, and makes the heart work harder

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13
Q

Essential Hypertension

A

No exact cause, makes up 90-95% of all diagnosed cases

Includes malignant hypertension

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14
Q

Malignant Hypertension

A

Severe, rapidly progressive elevation of blood pressure of over 250/120 mmHg

Medical emergency

Symptoms include headache, visual disturbances, nosebleeds

Can lead to heart attack, stroke, renal failure, or problems with the eyes

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15
Q

Secondary Hypertension

A

Related to something else and can be fixed by fixing the root issue

Examples are hyperthyroidism, fluid overload, kidney problems

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16
Q

Risk Factors for Hypertension

A

Age/Gender (older than 30 increases risk for hypertension; men are more likely to be at risk)

Race/Heredity (higher risk for African Americans)

Smoking/Obesity

High sodium/Elevated cholesterol

Oral contraceptives or estrogen

Alcohol (increases catecholamines that lead to vasoconstriction)

Emotional stress/Sedentary lifestyle

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17
Q

Signs and Symptoms of Hypertension

A

Headache (especially upon awakening)

Blurred vision, spots before eyes

Epistaxis

Complications can occur in the heart, brain, eyes, and kidneys

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18
Q

Pharmacological Management of Hypertension

A

Patients should report signs and symptoms and should not stop taking abruptly

Antihypertensive medications (teach about taking as ordered, teach about side effects such as hypotension, drowsiness, erectile dysfunction)

Diuretics (help to get rid of the extra fluid in the body)

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19
Q

Medical Management of Hypertension

A

Diet (low sodium, reduction of saturated fats, reduce alcohol)

Exercise (30-45 minutes, 3-4 times a week)

No smoking

Relaxation techniques/Stress management

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20
Q

Peripheral Arterial Disease

A

Narrowing or occlusion of the blood vessels

Common sites are iliac, common femoral arteries and superficial femoral arteries

Signs and Symptoms include pain, pulselessness, pallor, paresthesia, paralysis

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21
Q

Diagnosis of Peripheral Artery Disease

A

Ankle Brachial Index (blood pressure taken in both arms and one in the legs; ABI < 0.9 is abnormal)

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22
Q

Treatment of Peripheral Artery Disease

A

Anticoagulants/Fibrinolytics/ACE Inhibitors

Embolectomy, Endarterectomy, Arterial Bypass, Percutaneous Transluminal Angioplasty, Amputation

23
Q

Arterial Embolism Signs and Symptoms

A

Pain

Absent distal pulses

Pale, cool, and numb extremity

Necrosis

24
Q

Management of Arterial Embolism

A

Anticoagulants and fibrinolytics

Endarterectomy

Embolectomy

25
Q

Risk Facters for Arterial Aneurysm

A

Congenital issue, hypertension, arteriosclerosis, atherosclerosis

26
Q

Signs and Symptoms of Arterial Embolism

A

Large pulsating mass inside of the abdomen

Pain

Thoracic Aorta: pain in the neck, shoulders, lower back, abdomen, syncope, dyspnea, increased pulse, color changes, weakness, hoarseness, difficulty swallowing

Abdominal Aorta: bruit, tenderness with deep palpation, lower abdominal and back pain

27
Q

Management of Arterial Aneurysm

A

Goal is to limit the progression and prevent straining of the body

Assess pain, color changes

Pre-Op: teach how to splint, educate on how to get out of bed, give pain medication, check lab work, teach about incentive spirometry, mark the pulses

Post-Op: monitor pulses, vital signs, restrict HOB to less than 45 degrees, watch intake and output, NG tube, manage pain

28
Q

Pathophysiology of Thromboangitis Obliterans (Buerger’s Disease)

A

Occlusive disease of the medium and small arteries and veins that affects the distal portions of the upper and lower limbs

Men between 35-40 years of age who smoke are most affected

29
Q

Signs and Symptoms of Thromboangitis Obliterans

A

Pain, sensitivity to cold

Skin cold and pale

Ulcerations on feet or hands; gangrene

Superficial thrombophlebitis

30
Q

Treatment of Thromboangitis Obliterans

A

Goal is to prevent progression

NO SMOKING

Exercise to develop collateral circulation

Amputation of gangrenous extremities

Sympathectomy: cutting into the SNS by interrupting nerve pathways in order to eliminate pain and vasospasms

Educate, prevent necrosis, hydrate, clean infected areas, encourage well-fitting shoes and socks

31
Q

Pathophysiology of Raynaud’s Disease

A

Intermittent arterial spasms in the lower and upper extremities related to exposure to cold

Mostly affects the ears, toes, fingers, and nose

Women more likely to have this

32
Q

Signs and Symptoms of Raynaud’s Disease

A

Chronically cold hands and feet

Pallor, coldness, numbness, cyanosis, and pain during spasms

Erythema following a spasm

Ulcerations on the fingers and toes

Diaphoresis, numb and prickly sensations

33
Q

Pharmacological Management of Raynaud’s Disease

A

Vasodilators/Calcium antagonists

Sympathectomy

No smoking

Avoid exposure to cold, add warmth

Amputation for gangrene

34
Q

Thrombophlebitis

A

Inflammation of the vein caused by venous stasis, trauma to a blood vessel, immobilization, dehydration, and/or childbirth

35
Q

Phlebothrombosis

A

Clots in the vein

36
Q

Signs and Symptoms of Thrombophlebitis

A

Pain

Edema

Positive Homan’s sign

Erythema, warmth, tenderness along the vein

37
Q

Management of Superficial Thrombophlebitis

A

NSAIDs/Anticoagulants

Bedrest to keep clot where it is

Moist heat

Elevate extremity

Never massage or rub area

38
Q

Management of Deep Thrombophlebitis

A

Anticoagulants/Fibrinolytics

Bed rest, elevate extremity

Anti-embolism stockings

Thrombectomy

Vena cava umbrella (Greenfield filter)

39
Q

Varicose Veins

A

Dilated veins with incompetent valves

Blood collects in the veins and is not returned to the heart in an efficient manner

People with prolonged standing have an increased risk

40
Q

Signs and Symptoms of Varicose Veins

A

Dark, raised, tortuous veins

Fatigue, dull aches

Cramping of the muscles

Heaviness or pressure of extremity, tired legs

Edema, pain, changes in skin color

Slow healing/ulcerations

41
Q

Management of Varicose Veins

A

Elastic stockings

Rest

Elevate legs

Sclerotherapy: injection of a solution in a vein that leads vein to collapse and scar so that the body reroutes the blood deeper into the muscles instead

Vein ligation and stripping

42
Q

Post-Op Care for Ligation and Stripping

A

Monitor for pain, bleeding

Vital signs

Elevate foot of bed

ACE wraps

Early ambulation

Avoid prolonged standing, walk as much as possible, do not strain

43
Q

Venous Stasis Ulcers

A

Caused by varicose veins, burns, trauma, sickle cell anemia, diabetes mellitus, neurogenic disorders, hereditary factors

44
Q

Signs and Symptoms of Venous Stasis Ulcers

A

Pain

Ulceration with dark pigmentation

Edema

45
Q

Management of Venous Stasis Ulcers

A

Increased protein, vitamins A and C, and zinc

Debridement of necrotic tissue

Antibiotics

Unna boot

46
Q

Function of Lymphatic System

A

Maintenance of fluid balance

Production of lymphocytes

Absorption and transportation of lipids from the intestine to the bloodstream

47
Q

Lymph

A

Specialized fluid that is transported through the lymphatic vessels

48
Q

Lymph Nodes

A

Act as a filter, keeping particulate matter such as bacteria from entering the bloodstream

49
Q

Lymphangitis

A

Inflammation of the lymphatic vessels, usually after a staph or strep infection of an extremity

50
Q

Signs and Symptoms of Lymphangitis

A

Local pain

Chills, fever

Red streaks from the affected area

Edema, enlarged lymph nodes

Headache, myalgia

51
Q

Treatment of Lymphangitis

A

Penicillin

Moist heat

Elevate extremity

52
Q

Lymphedema

A

Accumulation of lymph in the soft tissue

Primary: cause unknown, could be malformed lymphatic system

Secondary: usually related to cancer

53
Q

Signs and Symptoms of Lymphedema

A

Massive edema and tightness of affected extremity

Pain

54
Q

Treatment of Lymphedema

A

Antibiotics

Special massage

Compression pump, elastic stocking or sleeve

Restrict sodium, maintain a healthy weight, exercise regularly, avoid constrictive clothing, avoid trauma

Adult Health Nursing I (22 decks)

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