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NURS 310 - Exam 3 > Peripheral Vascular / Peripheral Arterial Disease > Flashcards

Peripheral Vascular / Peripheral Arterial Disease Flashcards

1
Q

______ is a clot consisting of various elements in the blood trapped in a fibrin mesh

A

Venous thrombosis

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2
Q

______ is a loss of proper vein function causing blood to pool in the periphery

A

Venous stasis

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3
Q

Venous stasis causes ______

A

Edema

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4
Q

______ is inflammation of the venous wall

A

Phlebitis

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5
Q

______ is thrombus formation within a vein accompanied by inflammation

A

Thrombophlebitis

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6
Q

Describe the pathophysiology of venous insufficiency (3)

A
  • Venous hypertension occurs in the legs
  • Veins become distended
  • Valves are unable to close causing back flow of blood
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7
Q

What are the risk factors associated with venous insufficiency? (4)

A
  • DVT
  • Aging
  • Immobility
  • Female gender
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8
Q

What are the manifestations of venous insufficiency? (4)

A
  • Edema
  • Stasis ulcers
  • Stasis dermatitis
  • Hemosiderin staining
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9
Q

When are manifestations of venous insufficiency most noticeable?

A

In the evening - result of standing during day

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10
Q

In venous insufficiency, pulses may be difficult to palpate due to ______

A

Edema

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11
Q

What causes stasis ulcers?

A

Rupture of small skin veins

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12
Q

Where are stasis ulcers most likely to occur? (2)

A
  • Lower part of the extremity
  • Medial malleolus
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13
Q

Describe the characteristics of venous stasis ulcers (4)

A
  • Large
  • Superficial
  • Irregular borders
  • Exudative – moist, weepy drainage
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14
Q

Venous stasis ulcers can take ______ to heal

A

6 - 12 months

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15
Q

What type of dressings are used for venous stasis ulcers?

A

Exudative absorbent - keeps the area dry

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16
Q

What are the goals of medical management associated with venous insufficiency? (2)

A
  • Decrease venous stasis
  • Prevent ulcers
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17
Q

Describe the frequency of leg elevation in the treatment of venous insufficiency (3)

A
  • 15 - 20 minutes
  • 4 times / day
  • At night
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18
Q

Describe the education associated with treatment of venous insufficiency (2)

A
  • Avoid prolonged sitting / standing
  • Avoid crossing / dangling legs
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19
Q

What is the purpose of compression stockings in the treatment of venous insufficiency?

A

Increase venous return

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20
Q

Describe the education associated with compression stockings in the treatment of venous insufficiency (2)

A
  • Apply after legs have been elevated
  • Tightest at the ankle - gradually reduce pressure up the leg
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21
Q

What are the risk factors associated with arterial insufficiency? (3)

A
  • Aging
  • Diabetes
  • Male gender
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22
Q

What are the manifestations of arterial insufficiency? (8)

A
  • Diminished / absent pulses
  • Intermittent claudication
  • Pale when elevated
  • Ruddy / cyanotic when dependent
  • Cold skin
  • Shiny skin
  • Lack of hair
  • Thick nails
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23
Q

Describe intermittent claudication (4)

A
  • Aching / cramping pain caused by activity
  • Worse when elevated
  • Improved when dependent
  • Improved with rest
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24
Q

When is ischemic pain from intermittent claudication worst?

A

At night

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25
Q

Where does intermittent claudication occur?

A

Areas distal to stenosis / occlusion

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26
Q

Describe arterial ulcers (4)

A
  • Small
  • Deep
  • Circular
  • Dry
27
Q

Where are arterial ulcers most likely to occur? (3)

A
  • Tips of toes
  • Between toes
  • Heels
28
Q

Describe the treatment of arterial ulcers

A

Debridement of eschar to reveal granulation tissue

29
Q

What type of dressing is used for arterial ulcers?

A

Wet to dry

30
Q

______ must be performed on any extremity that has arterial compromise or is at risk for arterial compromise

A

Neurovascular checks

31
Q

In what situation is an extremity at risk for arterial compromise?

A

After an invasive arterial procedure

32
Q

What are the 6 P’s of neurovascular checks?

A
  • Pain
  • Pallor
  • Pulselessness
  • Paresthesia
  • Paralysis
  • Poikilothermia
33
Q

Assessment of the 6 P’s of neurovascular checks should take place ______ to the damage

A

Distal

34
Q

What is the goal of endovascular therapy in the treatment of arterial insufficiency?

A

Revascularization of an extremity

35
Q

What are the types of endovascular procedures used for arterial insufficiency ? (4)

A
  • Balloon angioplasty
  • Stent
  • Stent graft
  • Atherectomy
36
Q

Describe a balloon angioplasty

A

Catheter inflation of a balloon to open stenosis

37
Q

Describe a stent

A

Tube placement to open stenosis

38
Q

Describe a stent graft

A

Tube shaped like an artery placed over occluded area

39
Q

Describe an atherectomy

A

Removal of plaque from an artery

40
Q

What is the primary benefit of endovascular procedures?

A

Less invasive than surgery

41
Q

Describe post-procedure nursing interventions associated with endovascular procedures (3)

A
  • Avoid ambulation
  • Antiplatelet medications
  • Lay flat for 4 - 6 hours
42
Q

When conducting site checks after endovascular procedures, it is important to assess for ______

A

Hematoma formation

43
Q

Surgical procedures are reserved for what cases? (2)

A
  • Intermittent claudication
  • Amputation
44
Q

Amputation is a ______

A

Last resort

45
Q

The body part amputated is the most ______ as possible while still being able to remove the affected area

A

Distal

46
Q

What are the goals of amputation? (3)

A
  • Relieve symptoms
  • Improve function
  • Improve quality of life
47
Q

Which type of amputation is preferred?

A

Below the knee

48
Q

What complications are associated with amputation? (4)

A
  • Infection
  • Hemorrhage
  • Joint contractures
  • Phantom limb pain
49
Q

Raynaud’s syndrome is more likely in ______

A

Women under age 30

50
Q

What are the manifestations of Raynaud’s syndrome? (3)

A
  • Coldness
  • Numbness
  • Pallor in fingertips / toes
51
Q

Triggers causing ______ should be avoided for patients with Raynaud’s syndrome

A

Vasoconstriction

52
Q

What triggers should be avoided for patients with Raynaud’s syndrome? (3)

A
  • Cold
  • Stress
  • Nicotine
53
Q

What is the primary concern associated with DVT?

A

Pulmonary embolism

54
Q

What are the types of endovascular procedures used for DVT ? (2)

A
  • Thrombectomy
  • Ultrasound-guided thrombolysis
55
Q

A ______ must be in place for ultrasound-guided thrombolysis

A

Vena cava filter - catches dislodged clots

56
Q

Obstruction of blood flow to the lung by an embolus can cause ______

A

Pulmonary infarction

57
Q

Pulmonary infarction leads to …

A

Ischemic necrosis of the lung

58
Q

What are the manifestations of a pulmonary embolism? (3)

A
  • Dyspnea
  • Hemoptysis
  • Pleuritic chest pain
59
Q

Pleuritic chest pain is worse upon ______

A

Inspiration

60
Q

An unstable pulmonary embolism is characterized by ______

A

Refractory hypoxemia

61
Q

What is refractory hypoxemia?

A

Hypoxemia that does not respond to oxygen therapy

62
Q

Describe the pharmacologic treatment for an unstable pulmonary embolism

A

alteplase

63
Q

Describe the pharmacologic treatment for a stable pulmonary embolism (2)

A
  • IV heparin - in hospital
  • LMWH - after discharge
64
Q

During heparin therapy, monitor for manifestations of ______

A

Heparin induced thrombocytopenia (HIT)

NURS 310 - Exam 3 (9 decks)

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