PVD: Arterial vs Venous Flashcards
what is intermittent claudication
pain in extremities w/ exercise; relieved by rest
what skin & temp changes happen in peripheral vascular disease
cool & pale
white or blanched appearance when elevated
rubor - reddish discoloration in dependent position
cyanosis
gangrenous changes
what are s/s of peripheral arterial disease
loss of hair
brittle nails
dry, shiny, scaly skin
ulcerations
bruits
what pulse changes happen in peripheral arterial disease
presence or absence
0 to 4+ scale
doppler to detect pulse
what are risk factors for peripheral arterial disease
nicotine use
hyperlipidemia
HTN
diabetes
stress
sedentary lifestyle/obesity
what are nursing interventions for arterial insufficiency
lower extermity to increase perfusion
exercise program
avoid extreme cold
no nicotine
avoid stress
no constrictive clothing
no crossing legs
meds for pain & vasodilation
protective shoes
foot care
meticulous hygiene
proper nutrition
what can we do to manage peripheral vascular disease
exercise program
wt reduction
smoking cessation
what meds can we give for PVD
antiplatelets (clopidogrel & aspirin)
diabetes meds
lipid lowering drugs
what are surgical interventions for PVD
surgical bypass graft:
Aorto-iliac (AIBP)
aorto-femoral (AFBP)
Femoral-popliteal (Fem-pop)
what can cause venous insufficiency
chronic venous status
edema
brownish discoloration
pain
what are the nursing interventions for venous insufficiency
elevating extremities
foot pumping
avoid crossing legs
avoid constrictive clothing
compression stockings
careful assessment
what is virchow’s triad (DVT)
venous stasis
vessel wall injury
altered blood coagulation
we do a thorough ______ extremity assessment for DVT
lower
what do we assess for DVT
limb pain
heaviness
swelling, redness, warmth
tenderness
difference in leg circumference
venous doppler
how can we help prevent DVT
elastic compression stockings (AE hose)
active and passive leg exercises
early ambulation
TCDB
enoxaparin
what is the treatment for DVT
comfort measures
bed rest
elevation
compression stockings
analgesics
anticoagulant thearpy
what are the 3 anticoagulant drugs can we use for DVT treatment
heparin
warfarin
enoxaparin
when we give IV heparin followed by warfarin what lab do we check and how often
anti-xa; every 6 hrs
what other lab will we check when a pt is taking any blood thinner
INR
what labs should we monitor for warfarin
pt/inr
what is the antidote for warfarin
vitamin K or fresh frozen plasma
what is the antidote for heparin
protamine sulfate
what should we manage/watch for when pt is taking anticoagulants
bleeding
thrombocytopenia
drug interactions
what should we educate pts on when they are on warfarin
adhere to PT/INR monitoring
Avoid OTC meds w/out medical advice
Avoid ETOH (alcohol)
Do not stop unless directed
Consider wearing ID band about med
a pt on warfarin should always tell medical that they are _____
taking this med
a pt should report excessive _____ when taking anticouagulants
bleeding
a pt taking anticoagulants should avoid foods high in vitamin ___
K
