PVD Flashcards

1
Q

PVD

A

inadequate blood flow from extremities to heart d/t problem in vein

superficial and deep veins in lower extremities have valves to prevent backflow of blood as it returns to heart. PVD = disfunction of valves, not closing properly to prevent back flow leading to pooling of blood and dilation of veins

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2
Q

PVD: Risk Factors

A
  • prolonged sitting or standing
  • obesity
  • pregnancy
  • thrombophlebitis
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3
Q

PVD: Sx

A
  • fullness/heaviness in legs
  • stasis dermatitis extending up to calf
  • edema
  • wet stasis ulcer around ankles
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4
Q

PVD: Interventions (Pre-Surgery)

A
  • elevate legs during day and night (6 inches)
  • no crossing legs or constrictive stocking
  • apply compression stocking when legs not swollen
  • antibiotics for skin infection (cellulitis)

*compression stocking are not constrictive clothing b/c they apply even pressure throughout the entire extremity and encourage blood flow back to heart

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5
Q

DVT vs VTE

A

DVT: local coagulation (clot formed locally in one vein)
VTE: clot formed but has moved to different site

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6
Q

DVT/VTE: Cause

A
  • venous stasis
  • injury
  • thrombus formation
  • hypercoagability state
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7
Q

DVT/VTE: Risk Factors

A
  • surgeries
  • heart failure
  • immobility
  • pregnancy
  • OCP (oral contraceptives)
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8
Q

DVT/VTE: Sx

A
  • sudden onset of pain
  • erythema
  • swelling
  • firmness
  • compare circumference to other extremity
  • assess for sx of PE (complication)
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9
Q

DVT/VTE: Interventions (Pre-Surgery)

A

-bed rest
-elevate extremity
-no massage
-medication to prevent further clots from forming, stop clots from getting bigger, try to clear existing clot:
Heparin IV: monitor aPTT and platelets (SE = bleeding, antidote = protamine sulfate)
Lovenox subQ bid: (SE = bleeding, antidote = protamine sulfate)
Coumadin (warfarin): monitor PT/INR (2-3 is therapeutic range) (antidote = vitamin K)
TPA: tissue plasminogen activator - thrombolytic & platelet inhibitor administered directly to the clot.

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10
Q

DVT/VTE: Interventions (Surgery)

A

Revascularization: bypass graft that reroutes circulation around occlusion

Graft is autologous (from another part of the body) or synthetic

Only done one limb at a time, never both

circulation returning after surgery can be very painful (may see warmth, redness, edema as it returns)

Nursing: assess 5 P’s and compare to other extremity

  • Pain (severe and localized)
  • Pallor (pale limb)
  • Paresthesia (numbness)
  • Pulselessness (mark distal pulse sites with pen so it’s easier to find again with doppler)
  • Paralysis (can’t move toes or feet)

monitor CR and CMS
prevent hypotension: causes clot or graft collapse
prevent hypertension: causes bleeding at the site
educate on no crossing leg or above heart, wear loose clothing, no smoking or cold exposure

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11
Q

DVT/VTE Revascularization Surgery Complications

A

Graft occlusion
graft collapse
compartment syndrome

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