PVD Flashcards
1
Q
Three layers in blood vessels:
A
Tunica intima
Tunica media
Tunica externa
2
Q
- forms a friction-reducing lining
- Endothelium
A
Tunica intima
3
Q
- Smooth muscle and elastic tissue
- Controlled by sympathetic nervous system
A
Tunica media
4
Q
- forms protective outermost covering
- Mostly fibrous connective tissue
- Supports and protects the vessel
A
Tunica externa
5
Q
have a heavier, stronger, stretchier tunica media than to withstand changes in pressure
A
Arteries
6
Q
- have a thinner tunica media and operate under low pressure
- also have valves to prevent backflow of blood
- Lumen is larger
- Skeletal muscle “milks” blood here toward the heart
A
Veins
7
Q
- Only one cell layer thick
- Allow for exchanges between blood and tissue
A
Capillaries
8
Q
Form networks that consist of:
- A vascular shunt
- True capillaries
A
capillary beds
9
Q
Blood flow through a capillary bed is known as
A
microcirculation
10
Q
A permanent localized
dilation of an artery,
which enlarges the artery
to at least 2 times its
normal diameter
A
ANEURYSM
11
Q
diffuse dilation affecting the entire circumference of the artery
A
Fusiform
12
Q
an outpouching affecting
only a distinct portion of the artery
A
Saccular
13
Q
what specific anatomic sites
is aneurysm most common?
A
abdominal aorta.
14
Q
Aneurysm forms when
the ____ of the artery is
weakened, producing a
stretching effect in the
inner layer (T. intima) and
outer layers (T. adventitia)
of the artery
A
middle layer (T.
media)
15
Q
most common cause of all
aneurysm with hypertension & cigarette smoking
being contributing factors
A
Atherosclerosis
16
Q
signs of rupturing AAA
A
- hypotension
- diaphoresis
- mental obtundation,
- oliguria
- dysrhythmias
- S/S of hypovolemic shock
DIAGNOSTI
17
Q
reveals “eggshell” appearance in cases of AAA
A
X-ray
18
Q
Standard tool that determines the size and location or aneurysm
A
CT scan
19
Q
Nonsurgical management of aneurysm:
A
- frequent CT scanning
- maintenance of BP
- treated with
anti-hypertensive agent
20
Q
surgical management of aneurysm:
A
Abdominal Aortic Aneurysm
Resection
Goal: to secure a
stable aortic integrity & tissue
perfusion throughout the
body
21
Q
excision of aneurysm from the abdominal aorta to prevent or repair the rupture
A
Abdominal Aortic Aneurysm
Resection
22
Q
Disorders that alter the natural flow of blood
through the arteries & veins of the peripheral
circulation
A
PERIPHERAL VASCULAR DISEASE
23
Q
most frequently affected are the lower
extremities
A
PERIPHERAL VASCULAR DISEASE
24
Q
AORTIC BRANCHES:
A
- Ascending Aorta
- Aortic Arch
- Thoracic Arch
- Abdominal Aorta
25
noninvasive technique that provides accurate diagnosis, as well as information about the size & location of AAA
Ultrasonography
26
Pain: Intermittent claudication
Arterial insufficiency
27
Pain: aching, cramping
Venous insufficiency
28
Pulse: diminished or absent
Arterial insufficiency
29
Pulse: present, assessment may be difficult due to edema
Venous insufficiency
30
Skin: dependent rubor
Arterial insufficiency
31
Skin: increased pigmentation in the gaiter area
Venous insufficiency
32
Location: tip of toes, heels (pressure areas)
Arterial insufficiency
33
Location: medial malleolus, lateral malleolus, anterior tibial areas
Venous insufficiency
34
Depth: deep, may affect the joint
Arterial insufficiency
35
depth: superficial
Venous insufficiency
36
Shape: circular
Arterial insufficiency
37
Shape irregular
Venous insufficiency
38
Ulcer base: pale to black, dry gangrene
Arterial insufficiency
39
Ulcer base: granulation tissue
Venous insufficiency
40
Leg edema: minimal
Arterial insufficiency
41
Leg edema: moderate to severe
Venous insufficiency
42
Thickening or hardening of
the arterial wall
Arteriosclerosis
43
A type of arteriosclerosis that involves
the formation of plaque within the arterial wall
Atherosclerosis
44
involves the distal end of the aorta & the common, internal, external iliac arteries (located above the inguinal ligament)
INFLOW OBSTRUCTION
45
involves femoral, popliteal & tibial arteries (below the superficial femoral artery)
OUTFLOW OBSTRUCTION
46
- Most common cause
- Risk factor includes hypertension, hyperlipedimia, DM, CIGARETTE SMOKING, obesity & familial predisposition
ATHEROSCLEROSIS
47
discomfort in the lower back, buttocks or thighs
Inflow disease
48
burning or cramping in the calves, ankles, feet & toes
Outflow disease
49
- Intermittent claudication
- Rest Pain
- Loss of hair on the lower calf, ankle & foot;
- dry, scaly, dusky, pale or mottled skin
- thickened toenails
- Cold extremity & cyanotic
- pallor occurs when
the extremity is elevated
- Diminished or absent distant peripheral pulses
PERIPHERAL ARTERIAL DISEASE
50
PERIPHERAL ARTERIAL DISEASE DIAGNOSTIC ASSESSMENT:
* Arteriography
* Segmental Systolic BP measurements
* Ankle-Brachial Index (<0.9)
* Exercise Tolerance Testing
51
medications to PERIPHERAL ARTERIAL DISEASE:
Pentoxifylline (Trental)
Aspirin
52
PERIPHERAL ARTERIAL DISEASE SURGICAL INTERVENTIONS:
- Percutaneous Transluminal Angioplasty (PTA)
- Laser-Assisted Angioplasty
- Bypass procedures
53
- Reserved for clients with smaller occlusions in the distal superficial femoral, proximal popliteal & common iliac arteries
- Heat from the laser vaporizes the arteriosclerotic plaque to open the occluded or stenosed artery
Laser-Assisted Angioplasty
54
- grafts preferred are saphenous vein, cephalic or basilic arm veins, synthetic materials such as polytetrafluoroethylene, GoreTex & Dacron
Bypass procedures;
55
recurring inflammation of the intermediate and small arteries and veins of the lower and upper extremities
BUERGER’S DISEASE
(THROMBOANGIITIS
OBLITERANS)
56
- Pain
- Instep claudication
- Aggravated by emotional
disturbances, nicotine or chilling
- Sensitivity to cold
- Dependent rubor
- Absent or diminished radial or ulnar pulses
- Digital ulceration and gangrene
BUERGER’S DISEASE
57
NURSING INTERVENTIONS IN BUERGER’S DISEASE:
- Complete abstinence from tobacco
- Avoid to extreme cold
58
Caused by vasospasm of the arterioles and arteries of the upper & lower extremities
RAYNAUD’S DISEASE
59
- blanching of the extremities occurs followed by cyanosis
- Numbness, coldness, pain. swelling
- ulcers may also be present
RAYNAUD’S PHENOMENON
60
management in raynauld's disease:
● Calcium Channel Blockers – potent vasodilator
● Nifedipine – first choice
● Sympathectomy
61
first choice medication for raynaulds disease
Nifedipine
62
- Calf or groin
tenderness & pain
- unilateral swelling
of the leg
- Localized edema in
one extremity may
suggest
thrombophlebitis
DEEP VEIN THROMBOSIS
63
DO NOT MASSAGE THE AFFECTED
EXTREMITY!!!
DEEP VEIN THROMBOSIS
64
management for DEEP VEIN THROMBOSIS:
Rest – supportive therapy; bed rest & elevation of
the extremity
65
Drug therapy for deep vein thrombosis:
anticoagulant
66
- prevent formation of other clots & prevent enlargement of the existing clot.
- discontinued if there is severe
- heparin-induced thrombocytopenia & thrombosis (due to platelet aggregation)
- SE: Bleeding
UNFRACTIONATED HEPARIN Therapy
67
- Works in the liver to inhibit synthesis of the four vitamin K-dependent clotting factors
- Takes 3-4 days before it can exert therapeutic anticoagulation
WARFARIN Therapy
68
- recombinant tissue plasminogen activator, Alteplase, Reteplase
- effective in dissolving clots or preventing new clots
- serious complication: intracerebral bleeding
THROMBOLYTIC Therapy
69
Antidote for heparin
Protamine sulfate
70
Dilated tortuous veins
VARICOSE VEINS
71
COMMON AFFECTED SITES in varicose veins:
saphenous leg veins (lack support from
surrounding muscles)
● also occurs in
- Rectum : Hemorrhoids
- Esophagus : Esophageal varices
72
ASSESSMENT OF VARICOSE VEINS:
- Legs feel heavy & tired
- Leg veins look distended & tortuous seen under the skin as dark blue or purple,
snakelike elevations
- Feet, ankles, legs may appear swollen
73
VARICOSE VEINS STAGES:
1. Reticular or spider veins
2. Varicose veins or venous nodes
3. Edema of the lower legs
4. Varicose eczema or trophic ulcer
74
MILD VARICOSE VEINS
MANAGEMENT:
* exercise (walking, swimming)
* losing weight
* wearing elastic support stockings
* avoidance of prolonged sitting & standing
75
SEVERE VARICOSE VEINS
MANAGEMENT:
* Vein ligation
* Vein stripping
* Sclerotherapy
76
veins are tied off above & below the area of incompetent valves,
but the dysfunctional vein remains
Vein ligation
77
ligated veins are severed & removed
Vein stripping
78
Injection of chemical in the varicose veins to scar and close it
Sclerotherapy
