T1 Blueprint - Vascular Disease (Josh) Flashcards
What is the definition of HTN?
140/90 or greater in people without DM
For HTN, what cholesterol levels should we keep in our diet?
less than 200 mg/dL
With PAD, where would pain be for INFLOW DISEASE?
lower back, buttocks, and thighs
With PAD, where would pain be for OUTFLOW DISEASE?
burning or cramping in calves, ankles, feet, and toes
What are the 6 P’s of PAD?
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Pokilothermia (coolness)
PAD:
How is the pain alleviated?
when the lower extremity is placed in dependent postion
PAD:
When does pallor occur?
when the extremity is raised above heart level
What are the Stages of Chronic PAD?
Stage I: no claudication, bruit may be present
Stage II: claudication with exercise
Stage III: pain while at rest, frequently at night
Stage IV: ulcers or blackened tissue present
What is postop nursing responsibility for Bypass for PAD?
Deep breathing q 1-2 hr
Monitor for graft occlusion (emergency)
Monitor for compartment syndrome
Assess for infection
PAD Postop:
What is the most common type of graft occlusion?
embolis
***Most common in lower extremities
What is Buerger’s Disease?
occlusive disease of arteries and veins in distal portion of upper and lower extremities
**eventually become gangrenous
What is associated with Buerger’s Disease?
tobacco smoking
What are S/S of Buerger’s Disease?
Claudication
Aching pain
Sensitivity to cold
Diminished pulse
Cool, red, or cyanotic extremities
How do you manage Buerger’s Disease?
Avoid all forms of tobacco
Avoid exposure to cold
Vasodilators
Where would pain from an Abdominal Aortic Aneurysm be located?
abdomen
flank
back
S/S of Thoracic Aneurysm?
Coughing / Wheezing
Horner’s Syndrome
Hoarse Voice
Difficulty swallowing
Back pain
Mass visible above suprasternal notch
What is Horner’s Syndrome?
drooping eyelid, constricted pupil and dry skin on one side of face associated with TAA
Post-op care for Aneurysm resection?
NGT and Strict NPO
Control pain (epidural catheter)
Arterial Line (manage HTN and hypotension)
Neuro Assessment
Renal Function (UOP hourly)
HOB less than 45 degrees
Drug therapy for Raynaud’s?
Nifedipine
Cyclandelate
Phenoxybenzamine
Target Cholesterol level?
less than 200 mg/dL
Target HDL level?
Men: 35-65 mg/dL
Women: 35-80 mg/dL
Target LDL level?
less than 130 mg/dL
***even less if they have high risk of CAD
Target VLDL level?
7-32 mg/dL
Target HDL:LDL ratio?
3:1
Target Triglycerides level?
Men: 40-160 mg/dL
Women: 35-135 mg/dL
Which vessel is mostly affected by an Anterior MI?
Left Anterior Descending (LAD) Artery
Which leads will show the Anterior MI?
V3-V4
Which vessel is mostly affected by an Inferior MI?
Right Coronary Artery (RCA)
Which leads will show an Inferior MI?
II, III, aVf
Normal Troponin T levels?
less than 0.02 mg/L
When do Troponin T levels return to normal?
14-21 days
***T = Two - Three wks
— is an oxygen carrying protein found in cardiac and skeletal muscle.
Myoglobin
**normal is less than 90 mcg/L
**return to normal in 24 hrs
Anticoagulation:
— decreases platelet aggregation.
— prevents re-occlusion.
ASA
Heparin
Immediate Treatment for MI:
M
O
N
A
Morphine (2-10 mg q 5-15 mins)
Oxygen
Nitroglycerine
ASA (or Plavix)
Which meds can prevent Ventricular Remodeling?
ACE Inhibitors (-pril)
ARBs (-sartan)
What are S/S of Cardiogenic Shock?
SBP less than 90
Weak, thready pulse
HR greater than 100
S3 and S4
Tachypnea
UOP less than 30 mL/hr
Decreased CO and CI
Increased CVP and PAWP
JVD
Increased SVR (compensatory)
What is the DOC to increase contractility of vessles during Cardiogenic Shock?
DA
