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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
Q

why do we make where the pulses are

A

to save us time and the other nurses time
sometimes we have to check pulses every 15 mins so this will save us time

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26
Q

arterial sensations

A

decrease sensation feeling

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27
Q

since arterial disorders have decrease sensation feeling

A

need meticulous foot care

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28
Q

since CT scan and angiography both use contrast what are we going to do

A

allergies
kidney (BUN/CR)
increase fluids

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29
Q

if the patients are allergic to contrast what do we do

A

premeditate with mucomist

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30
Q

why do we increase fluids after contrast

A

flush out contrast

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31
Q

MRI what do we assess for

A

implanted devices
the type of metal depends
if unsure ask

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32
Q

modifiable risk factors

A

nicotine
hypertension
diabetes (1 and 2)
obesity
stress
sedentary lifestyle
c reactive protein
diet

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33
Q

nonmodifiable risk factors

A

age
female gender
genetics

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34
Q

nicotine

A

modifiable

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35
Q

hypetension

A

modifiable

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36
Q

diabetes

A

modifiable

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37
Q

obesity

A

modifiable

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38
Q

stress

A

modifiable

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39
Q

sedentary lifestyle

A

modifiable

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40
Q

c reactive protein

A

modifiable

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41
Q

diet

A

modifiable

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42
Q

age

A

nonmodifiable

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43
Q

female gender

A

nonmodifiable

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44
Q

genetics

A

nonmodifiable

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45
Q

segmental systolic blood pressure measurement

A

blood pressure of whole leg
normal is no change

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46
Q

arterial peripheral vascular disorder
cap refill

A

delayed

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47
Q

primary goals

A

relief of pain
maintence of tissue integrity

48
Q

APVD
- exercise

A

promote collateral circulation
*consult primary health care provider before prescribing an exercise routine

49
Q

APVD
- positioning

A

neutral
dependent

50
Q

APVD
- temp

A

cool temp

51
Q

APVD
- use of cold and hot therapy

A

avoid
- cannot tell if it is too hot or cold

52
Q

APVD
- why not use cold

A

causes vascoconstriction which will worsen

53
Q

APVD
- where do we apply heating pad

A

abdomen

54
Q

APVD
- smoking

A

STOP

55
Q

APVD
- medications

A

lipid lowering
BP
pain

56
Q

APVD
- protection of extremities and avoidance of trauma

A

shoes

57
Q

APVD
- nutrition

A

low fat

58
Q

APVD
- gangrene type

A

dry

59
Q

APVD
- gangrene who is at highest risk

A

elderly
*symptoms more pronounced

60
Q

APVD
- why is gangrene left undisturbed

A

wound would not heal after amputation

61
Q

APVD
- hallmark sign and symptom

A

intermittent claudication

62
Q

APVD
- sensation

A

cold or numbness

63
Q

APVD
- color

A

pale when elevated
lobster when dependent

64
Q

APVD
- pulses

A

diminished

65
Q

APVD
- position

A

neutral or dependent

66
Q

APVD
- PTA

A

similar to cath lab for the arteries

67
Q

APVD post op bypass
- monitoring

A

pulses
- doppler
color
temp
cap refill
sensory
motor
* 15 min

68
Q

APVD post op bypass
- incision

A

infection

69
Q

ansyrusm

A

weak area and bigger

70
Q

aneurysm management

A

lower BP

71
Q

are all aneurysms the same

A

no they depend on the location and vary

72
Q

do all aneurysm patients have symptoms

A

no some can be asymptomatic

73
Q

what is the most prominent symptom in aneurysm

A

pain

74
Q

aneurysm
thoracic aortic
- symptoms

A

dyspnea
cough
hoarsness
strdor

75
Q

aneurysm
aortic
- symptoms

A

many are asymptomatic
pulsing in abdomen
low back pain

76
Q

signs and symptoms of impending abdominal rupture

A

severe back/abdominal pain
decreasing BP
decreasing HGB
hematoma in flank
feeling of impending doom

77
Q

after aneurysm repair
- HOB and position

A

supine 6 hours
HOB 45 degrees 2 hours

78
Q

after aneurysm repair
- monitoring

A

VS
Doppler
peripheral pulses

bleeding
pulsation
swelling
pain
hematoma (flank)

79
Q

after aneurysm repair
why monitor temp

A

body rejecting the graft

80
Q

after aneurysm repair
why monitor urine output

A

may be a period of time where the kidneys were not perfused
need to know if the kidneys are damaged

81
Q

signs of bleeding

A

hemoglobin
pulse
respirations
urine output
mental status

82
Q

DVT risk factors

A

vessel trauma
venous statsis
hypercoagulopathy

83
Q

DVT prevention

A

SCD
heparin (short term)
warfarin (long term)
mobility
movement
positioning elevation

84
Q

DVT signs and symptoms

A

calf or groin tenderness
unilateral leg swelling
redness
localized edema
s/s of PE might be first symptom

85
Q

if someone has a DVT do we use SubQ or IV heparin

A

IV

86
Q

why do we have an overlap of heparin and warfarin

A

warfarin takes a long time to start working so we start them at the same time since heparin starts working fast

87
Q

do we use unfractionated heparin or LMWH

A

unfractioned

88
Q

what precautions are someone on heparin should be on

A

bleeding and falls

89
Q

heparin dosage is monitored on

A

aPTT
INR (iv only)
platelet counts

90
Q

why do we monitor platelet for heparin

A

heparin induced thrombocytopenia

91
Q

heparin reversal

A

protamine sulfate

92
Q

warfarin reversal

A

vit K

93
Q

warfarin monitoring

A

INR

94
Q

INR therapeutic for warfarin

A

2-2.5

95
Q

thrombolytic therapy is a high risk for

A

bleeding

96
Q

why would we monitor hemoglobin on patients on anticoagulants

A

bleeding

97
Q

IV heparin is always administered via a

A

infusion pump

98
Q

normal aPTT

A

25-31 seconds

99
Q

what is theraputic for aPTT

A

1.5x control

100
Q

new generation med reversal

A

platelet
FFP
vitamin K

101
Q

what clothing do we want for surgery for these patients

A

normal

102
Q

VPVD
- stasis dermatitis

A

brown sock

103
Q

VPVD
- ulcer

A

moist
infection

104
Q

VPVD
- varicose veins cause

A

prolonged standing

105
Q

lymphedema

A

lymph node removal

106
Q

cellulitis apperence

A

scaly
red
warmth
swelling
trauma for bacteria to be introduced

107
Q

complications of VPVD

A

infection
venous ulceration

108
Q

if suspected infection what should we get

A

culture

109
Q

venous ulcer pharm treatment

A

antiseptic agents
antibiotics

110
Q

venous ulcers another form of treatment

A

hyperbaric treatment

111
Q

cellulitis

A

infection and swelling of skin tissues

112
Q

cellulitis is a common infectious cause of

A

limb swelling

113
Q

cellulitis can occur

A

as a single isolated event or series of recurrent events

114
Q

cellulitis entry point

A

through normal skin

115
Q

cellulitis
s/s

A

pain
swelling
localized redness and pain
fever
chills
sweating

116
Q

what pharm treatment is required for cellulitis

A

antibiotics and if severe IV

117
Q
A

Med Surg 1 (47 decks)

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