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Med Surg 1 > Vascular and Peripheral Circulation Disorders > Flashcards

Vascular and Peripheral Circulation Disorders Flashcards

1
Q

peripheral vascular disease

A

disorders that alter the natural flow of blood through the arteries and veins of the peripheral circulation

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2
Q

arteries and arterioles

A

thick wall
away from heart
big to small
muscle around the vessel causes it to dilate and constrict

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3
Q

veins and venules

A

no muscle so it cannot dilate or constrict
has valves

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4
Q

function of the vascular system

A

provide oxygen and nutrients to the tissues

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5
Q

what is a supply and demand issue

A

demand is how much oxygen is needed by the tissues

supply is how much oxygen/blood is reaching the tissues

these need to be equal to avoid harm

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6
Q

supply does not equal demand causes what

A

ischemia
injury
infarct

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7
Q

what causes an increase in demand

A

exercise
fever
infection
illness

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8
Q

exercise (or other situations causing increase in demand) causes

A

increase HR RR
vasodilation

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9
Q

if the heart rate cannot increase or if the vessels are unable to deliver blood in times of higher demand what will happen

A

ischemia
injury
infarct

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10
Q

what occurs in the body during rest

A

vasoconstriction
decrease HR RR

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11
Q

why do the vessels constrict during rest

A

tissues do not demand much oxygen

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12
Q

why do the vessels dilate during exercise

A

tissues demanding more oxygen

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13
Q

what should we assess when assessing pain

A

PQRST

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14
Q

what are two pain types people might have

A

intermittent claudication
rest pain

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15
Q

intermittent claudication

A
  • pain with exercise due to lack of blood flow and ultimately lack of oxygen
  • pain is relieved with rest
  • arterial disorder
  • decrease supply increase demand
  • rest causes decrease in demand so pain subsides
  • supply is adequate with rest
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16
Q

rest pain

A
  • pain at rest
  • lack of blood flow majority of the time
  • supply issue most of the time
  • supply is greatly decrease to not meet any demands
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17
Q

what should we assess during the skin

A

color
temp
apperence

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18
Q

skin color
arterial

A

bright red when dependent
pale when elevated

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19
Q

skin color
vein

A

brown sock apperence

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20
Q

skin temp
arterial

A

cold

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21
Q

skin temp
vein

A

warm

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22
Q

skin apperence
arterial

A

shiny
hair loss (due to no nutrients)
dry

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23
Q

pulses
arterial

A

diminished/absent

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24
Q

what do we do if we cannot feel arterial pulses

A

varifiy with doppler and mark where pulses are

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25
why do we make where the pulses are
to save us time and the other nurses time sometimes we have to check pulses every 15 mins so this will save us time
26
arterial sensations
decrease sensation feeling
27
since arterial disorders have decrease sensation feeling
need meticulous foot care
28
since CT scan and angiography both use contrast what are we going to do
allergies kidney (BUN/CR) increase fluids
29
if the patients are allergic to contrast what do we do
premeditate with mucomist
30
why do we increase fluids after contrast
flush out contrast
31
MRI what do we assess for
implanted devices the type of metal depends if unsure ask
32
modifiable risk factors
nicotine hypertension diabetes (1 and 2) obesity stress sedentary lifestyle c reactive protein diet
33
nonmodifiable risk factors
age female gender genetics
34
nicotine
modifiable
35
hypetension
modifiable
36
diabetes
modifiable
37
obesity
modifiable
38
stress
modifiable
39
sedentary lifestyle
modifiable
40
c reactive protein
modifiable
41
diet
modifiable
42
age
nonmodifiable
43
female gender
nonmodifiable
44
genetics
nonmodifiable
45
segmental systolic blood pressure measurement
blood pressure of whole leg normal is no change
46
arterial peripheral vascular disorder cap refill
delayed
47
primary goals
relief of pain maintence of tissue integrity
48
APVD - exercise
promote collateral circulation *consult primary health care provider before prescribing an exercise routine
49
APVD - positioning
neutral dependent
50
APVD - temp
cool temp
51
APVD - use of cold and hot therapy
avoid - cannot tell if it is too hot or cold
52
APVD - why not use cold
causes vascoconstriction which will worsen
53
APVD - where do we apply heating pad
abdomen
54
APVD - smoking
STOP
55
APVD - medications
lipid lowering BP pain
56
APVD - protection of extremities and avoidance of trauma
shoes
57
APVD - nutrition
low fat
58
APVD - gangrene type
dry
59
APVD - gangrene who is at highest risk
elderly *symptoms more pronounced
60
APVD - why is gangrene left undisturbed
wound would not heal after amputation
61
APVD - hallmark sign and symptom
intermittent claudication
62
APVD - sensation
cold or numbness
63
APVD - color
pale when elevated lobster when dependent
64
APVD - pulses
diminished
65
APVD - position
neutral or dependent
66
APVD - PTA
similar to cath lab for the arteries
67
APVD post op bypass - monitoring
pulses - doppler color temp cap refill sensory motor * 15 min
68
APVD post op bypass - incision
infection
69
ansyrusm
weak area and bigger
70
aneurysm management
lower BP
71
are all aneurysms the same
no they depend on the location and vary
72
do all aneurysm patients have symptoms
no some can be asymptomatic
73
what is the most prominent symptom in aneurysm
pain
74
aneurysm thoracic aortic - symptoms
dyspnea cough hoarsness strdor
75
aneurysm aortic - symptoms
many are asymptomatic pulsing in abdomen low back pain
76
signs and symptoms of impending abdominal rupture
severe back/abdominal pain decreasing BP decreasing HGB hematoma in flank feeling of impending doom
77
after aneurysm repair - HOB and position
supine 6 hours HOB 45 degrees 2 hours
78
after aneurysm repair - monitoring
VS Doppler peripheral pulses bleeding pulsation swelling pain hematoma (flank)
79
after aneurysm repair why monitor temp
body rejecting the graft
80
after aneurysm repair why monitor urine output
may be a period of time where the kidneys were not perfused need to know if the kidneys are damaged
81
signs of bleeding
hemoglobin pulse respirations urine output mental status
82
DVT risk factors
vessel trauma venous statsis hypercoagulopathy
83
DVT prevention
SCD heparin (short term) warfarin (long term) mobility movement positioning elevation
84
DVT signs and symptoms
calf or groin tenderness unilateral leg swelling redness localized edema s/s of PE might be first symptom
85
if someone has a DVT do we use SubQ or IV heparin
IV
86
why do we have an overlap of heparin and warfarin
warfarin takes a long time to start working so we start them at the same time since heparin starts working fast
87
do we use unfractionated heparin or LMWH
unfractioned
88
what precautions are someone on heparin should be on
bleeding and falls
89
heparin dosage is monitored on
aPTT INR (iv only) platelet counts
90
why do we monitor platelet for heparin
heparin induced thrombocytopenia
91
heparin reversal
protamine sulfate
92
warfarin reversal
vit K
93
warfarin monitoring
INR
94
INR therapeutic for warfarin
2-2.5
95
thrombolytic therapy is a high risk for
bleeding
96
why would we monitor hemoglobin on patients on anticoagulants
bleeding
97
IV heparin is always administered via a
infusion pump
98
normal aPTT
25-31 seconds
99
what is theraputic for aPTT
1.5x control
100
new generation med reversal
platelet FFP vitamin K
101
what clothing do we want for surgery for these patients
normal
102
VPVD - stasis dermatitis
brown sock
103
VPVD - ulcer
moist infection
104
VPVD - varicose veins cause
prolonged standing
105
lymphedema
lymph node removal
106
cellulitis apperence
scaly red warmth swelling trauma for bacteria to be introduced
107
complications of VPVD
infection venous ulceration
108
if suspected infection what should we get
culture
109
venous ulcer pharm treatment
antiseptic agents antibiotics
110
venous ulcers another form of treatment
hyperbaric treatment
111
cellulitis
infection and swelling of skin tissues
112
cellulitis is a common infectious cause of
limb swelling
113
cellulitis can occur
as a single isolated event or series of recurrent events
114
cellulitis entry point
through normal skin
115
cellulitis s/s
pain swelling localized redness and pain fever chills sweating
116
what pharm treatment is required for cellulitis
antibiotics and if severe IV
117

Med Surg 1 (47 decks)

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