TOPIC 5 - peripheral vascular diseases

Question 1

disorders of peripheral arterial disease

Answer 1

intermittent claudication
neuropathy
arterial ulcers

Question 2

disorders of peripheral venous disease

Answer 2

venous thromboembolism
venous ulcers

Question 3

medications for PVD

Answer 3

aspirin
clopidogrel
warfarin
heparin
analgesics

Question 4

risk factors for PAD

Answer 4

tobacco, CKD, diabetes, HTN, hypercholesterolemia, african americans, females, elevated C reactive protein, family hx, hypertriglyceridemia, aging

Question 5

manifestations of PAD

Answer 5

intermittent claudication, parasthesia, elevation pallor, dependent rubor, critical limb ischemia

Question 6

6 P’s assessment

Answer 6

paralysis
paresthesia
pallor
pulse
pain
poikilothermic

Question 7

diagnostic testing and labs

Answer 7

ABI
doppler ultrasound
duplex imaging
angiography
magnetic resonance angiography

Question 8

complications of PAD - arterial ulcer

Answer 8

a wound caused by impaired arterial blood flow to the lower leg and foot. impairment in blood flow results in tissue ischemia and necrosis

Question 9

associated skin characteristics of arterial ulcers

Answer 9

cool temp
thin, shiny skin
decreased or absent skin hair
pain
decrease pulse strength

Question 10

nursing diagnosis

Answer 10

ineffective peripheral tissue perfusion
activity intolerance
chronic pain
ineffective health management

Question 11

medications

Answer 11

antiplatelets - ASA, clopidogrel, platelet aggregation inhibitor

phosphodiesterase inhibitors - cilostazol

Question 12

exercise therapy for PVD

Answer 12

exercise 30-45 min a day at least 3 times a week for a minimum of 3 months

Question 13

nutritional therapy

Answer 13

maintain waist circumference less than 40 for men and less than 35 for women

Question 14

interventions

Answer 14

protect limb from injury
decrease ischemic pain
prevent and control infection
improve perfusion
meds : antiplatelets, NSAID, anticoagulants
lifestyle and diet modifications

Question 15

diseases associated with chronic venous diseases

Answer 15

phlebitis
venous thrombosis
superficial vein thrombosis
venous thromboembolism
venous leg ulcers

Question 16

venous thromboembolism can lead to ___

Answer 16

pulmonary embolism (life threatening)

Question 17

risk factors for venous stasis

Answer 17

advanced age, a fib, bed rest, chronic heart failure, fractured leg or hip, long trips without adequate exercise, obesity, orthopedic surgery, pregnancy, stroke, prolonged immobility, spinal cord injury or limb paralysis

Question 18

risk factors for endothelial damage

Answer 18

abdominal and pelvic surgery, caustic or hypertonic IV drugs, fractures of the lower extremities, history of previous venous thromboembolism, indwelling peripherally inserted central vein catheter, IV drug abuse, trauma

Question 19

risk factors for hyper-coagulability of blood

Answer 19

dehydration or malnutrition, erythropoiesis stimulating drugs, high altitudes, hormone therapy, cancer, oral contraceptives, polycythemia vera, pregnancy, sepsis, severe anemias, tobacco use

Question 20

prevention for those with a history of VTE

Answer 20

avoid oral contraceptives
drink fluids
exercise during periods of bed rest

Question 21

prevention for those at risk for VTE

Answer 21

patient education
leg exercises
early ambulation after procedure
compression stockings
anticoagulation therapy
hydration

Question 22

venous ulcer + associated characteristics

Answer 22

a wound caused by a decrease of blood flow return from the lower extremities to the heart

hyperpigmentation, firm skin, dry scaly skin, edema

Question 23

care for venous insufficiency

Answer 23

compression stockings
moist dressings

Question 24

nutrition for venous insufficiency

Answer 24

high protein, vitamin A and C and zinc

Question 25

client teaching for venous insufficiency

Answer 25

control cardiovascular disease
control diabetes
smoking cessation
medication use
exercise tolerance
foot care
daily foot exams
post op care
venous diseases
nutrition