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Med Surg 2 > problems with vascular system > Flashcards

problems with vascular system Flashcards

1
Q

vascular system includes

A

arteries
veins
lymphatic vessels

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2
Q

Peripheral Arterial Occlusive Disease

A
  • Involves progressive narrowing and degeneration of arteries of upper and lower extremities.
  • Atherosclerosis is the leading cause in majority of cases.
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3
Q

what is pad caused by

A
  • Atherosclerosis is the gradual thickening of the artery wall.
  • Caused by deposits of cholesterol and lipids within the artery, which leads to narrowing.

Risk factors
- Cigarette smoking: vasoconstritor
- Hyperlipidemia
- Hypertension
- Diabetes mellitus

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4
Q

cad clinical manifestations

A
  • Intermittent claudication: pain/cramping when walking, resolves with rest.
  • Calf muscle atrophy.
  • Skin appears shiny with hair loss and thickened toenails.
  • Poor neurovascular integrity.
    Tingling and numbness of toes
  • Necrotic ulcers.
  • Cool extremities with poor pulses.
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5
Q

clautication

A

walking o2 decreases in legs
- stop walking helps

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6
Q

paresthesia

A
  • Numbness or tingling in the toes or feet
  • Produces loss of pressure and deep pain sensations
  • Injuries often go unnoticed by patient
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7
Q

pain at rest symptoms

A
  • Occurs in the foot or toes
  • Aggravated by limb elevation
  • Occurs from insufficient blood flow
  • Occurs more often at night
  • don’t elevate blood needs to stay
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8
Q

nursing interventions for pad

A
  • Exercise therapy: walk to the point of pain three times a week.
  • Encourage tobacco cessation.
  • Promote weight reduction.
  • Dependent position relieves pain.
  • don’t put stockings or boots on
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9
Q

meds for pad

A
  • pentoxifylline (Trental)
  • cilostazol (Pletal)

Antiplatelet agents
- Aspirin
- Clopidogrel (Plavix)

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10
Q

exercise therapy for pad

A
  • Exercise improves oxygen extraction in the legs and skeletal metabolism
  • Walking is the most effective exercise for individuals with claudication
  • 30 to 60 minutes daily, 3 times/week
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11
Q

pad complications

A
  • Atrophy of the skin and underlying muscles
  • Delayed healing
  • Wound infection
  • Tissue necrosis
  • Arterial ulcers
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12
Q

surgical treatment

A
  • Femoral popliteal bypass surgery
  • Angioplasty
  • Stenting
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13
Q

leg with critical limb ischemia

A
  • Revascularization via bypass surgery
  • Protect from trauma
  • Decrease ischemic pain
  • Prevent/control infection
  • Improve arterial perfusion

Other strategies
- Spinal cord stimulation
- Angiogenesis

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14
Q

most common surgical approach

A
  • A peripheral artery bypass surgery with autogenous vein or synthetic graft to bypass blood around the lesion
  • PTA with stenting may also be used in combination with bypass surgery
  • mark pulses
  • know sensation, temperature
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15
Q

percutaneous transluminal balloon angioplasty (PTA)

A
  • Involves the insertion of a catheter through the femoral artery
  • Catheter contains a cylindrical balloon
  • Balloon is inflated dilating the vessel by compressing atherosclerotic intimal lining
  • Stent is placed
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16
Q

issues with artery stent

A
  • platelets love it
  • monitor for stroke
  • piece break off = stroke
17
Q

A nurse is caring for a client following peripheral bypass graft surgery of the left lower extremity. Which of the following findings pose an immediate concern?
(Select all that apply.)
a. Trace of bloody drainage on dressing
b. Capillary refill of affected limb of 6 seconds
c. Mottled appearance of the limb
d. Throbbing pain of affected limb that is decreased following IV bolus analgesic
e. Pulse of 2+ in the affected limb

A

B, C

18
Q

cryoplasty

A
  • Combines percutaneous transluminal angioplasty and cold therapy
  • Liquid nitrous oxide
  • solution
19
Q

pad complications

A
  • Nonhealing arterial ulcers and gangrene are most serious complications

May result in amputation
- If adequate blood flow is not restored
- If severe infection occurs

20
Q

overall goals for patients with PAD

A
  • Adequate tissue perfusion
  • Relief of pain
  • Increased exercise tolerance
  • Intact, healthy skin on extremities
21
Q

Frequently monitor after surgery:

A
  • Skin color and temperature
  • Capillary refill
  • Presence of peripheral pulses distal to the operative site
  • Sensation and movement of extremity
22
Q

ambulatory and home care

A
  • Management of risk factors
  • Long-term aspirin therapy
  • Importance of gradual physical activity after surgery
  • Importance of meticulous foot care
  • even stent it won’t be same perfusion
  • Daily inspection of the feet
  • Comfortable shoes with rounded toes and soft insoles
  • Shoes lightly laced
23
Q

aorta

A
  • Largest artery in the body.
  • Responsible for supplying oxygenated blood to essentially all vital organs.
24
Q

aortic aneurysm

A
  • Local distention of the aortic artery wall.
  • Usually thoracic or abdominal.
  • Monitored until above 5cm in size.
  • Once above 5cm in size, rate of rupture increases and surgery is usually required.
25
Q

reasons for aortic aneurysm

A
  • infection leaves vessels weak
  • HTN
26
Q

risk factors for aortic aneurysm

A
  • Atherosclerosis: Most common cause
  • Infection
  • Inflammatory disorders
  • Connective tissue disorders
  • morphan syndrome
27
Q

clinical manifestations aortic aneurysm (thoracic)

A
  • Pain
  • Shortness of breath,
  • Hoarseness, cough
  • frequently asymptomatic
  • thrill felt or heard
28
Q

clinical manifestations aortic aneurysm (abdominal)

A
  • Abdominal pain
  • Persistent or intermittent lower back pain (lack of perfusion to kidneys)
  • Pulsating abdominal mass
  • frequently asymptomatic
29
Q

aortic aneurysm diagnostic procedure

A
  • CT scan
  • MRI
  • X-Ray
  • Ultrasound
30
Q

nursing interventions for preop

A
  • Maintain systolic BP 100-120.
  • Give beta blocker/antihypertensives.
    (Hydralazine)
  • Continuous nipride IV infusion may be required.
  • Monitor closely for rupture.
31
Q

rupture of anerusism symtoms

A
  • intense pain
  • decreasing bp
32
Q

post op

A
  • Careful monitoring of peripheral circulation below level of aneurysm.
  • Close BP monitoring.
    +Low BP may indicate hemorrhage
    +High BP may put stress on suture line
  • Postop complications
33
Q

post op complications

A

Arterial occlusion
Hemorrhage
Infection
Renal failure

Med Surg 2 (35 decks)

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