pvd ppt 14

Question 1

right side of heart

Answer 1

pumps blood through lungs to pulmonary circulation

Question 2

left side of heart

Answer 2

pumps blood to all other body tissues through the systemic circulation

Question 3

poor circulation: gerontologic considerations

Answer 3

changes in vessels
increased peripheral resistance
impaired blood flow
increased left ventricular workload

Question 4

physical assessment

Answer 4

skin: cool, pale, loss of hair, brittle nails, dry/scaly skin, atrophy, ulcerations, rubor
pulses: absent or weak in extremities

Question 5

doppler US

Answer 5

handheld US device to detect blood flow in vessels

ankle brachial index (ABI)

Question 6

exercise testing

Answer 6

determines how long pt can walk

measures ankle systolic BP in response to walking

Question 7

duplex US

Answer 7

determines level of venous disease
evaluates flow of distal vessels
significance of plaque causing stenosis

Question 8

angiography/MRA

Answer 8

confirms dx of occulsive arterial disease

Question 9

contrast phlebotomy (venography)

Answer 9

contrast dye injected to reveal an unfilled segment of vein if thrombus is present

standard to dx lower extremity thrombosis

Question 10

peripheral arterial occlusive disease

Answer 10

ischemia in distal extremity causes intermittent claudication (aching, cramping pain that occurs with activity or at rest)

Question 11

PAD assessment

Answer 11

sensation of cold/numb extremities
extremity elevated: cool/pale
extremity in dependent position: ruddy, cyanotic
skin/nail changes
ulcerations/gangrene

Question 12

to improve circulation

Answer 12

walking
isometric exercise
positioning strategies
smoking cessation
stress reduction

Question 13

PE/DVT

Answer 13

caused by endothelial damage, venous stasis, altered coagulation
can occur after period of immobility
clinically silent; often undiagnosed

Question 14

risk factors for endothelial damage

Answer 14

trauma
surgery
dialysis access catheter
chemical irritation from IV solution

Question 15

risk factors for venous stasis

Answer 15

bedrest
obesity
spinal cord injury
>65 y/o

Question 16

risk factors for altered coagulation

Answer 16

cancer
pregnancy
factor V Leiden defect
septicemia
protein C and S deficiencies

Question 17

DVT prevention

Answer 17

compression stockings
pneumatic compression devices
early ambulation
subq heparin
lifestyle changes

Question 18

enoxaparin (lovenox)

Answer 18

low molecular weight heparin

treatment for DVT and prophylaxis if at risk

Question 19

wafarin (coumadin)

Answer 19

used to treat current DVT

Question 20

rivaroxaban (xarelto)

Answer 20

oral factor Xa inhibitor

fixed dose regimen for acute DVT

Question 21

dabigatran (pradaxa)

Answer 21

oral direct thrombin inhibitor

first-dose regimen for DVT

Question 22

alteplase (activase, t-PA)

Answer 22

thrombolytic

dissolves existing clot

Question 23

arterial ulcer

Answer 23

small, deep ulcerations on tips of toes or between toes
intermittent claudication not relieved by rest
pain not relieved by opioids

Question 24

venous ulcers

Answer 24

medial/lateral malleolus
large, superficial, highly exudative
achy/heavy pain
6-12 months to heal
recurrence rate is near 100% without compression therapy

Question 25

medical mgmt of ulcers

Answer 25

abx
compression
debridement
negative pressure wound therapy