Vascular disorders Flashcards
Involves thickening of the artery walls and progressive narrowing of arteries of upper and lower extremities
Peripheral Artery Disease (PAD)
PAD is leading cause of
Atherosclerosis
PAD risk factors
Low HDL-C High LDL-C Increased triglycerides Genetic predisposition Diabetes Obesity Sedentary lifestyle Smoking Stress African Americans older adults
PAD of Lower Extremities
a. PAD may affect
b. Iliac artery
c. Femoral artery
d. Popliteal artery
e. Tibial artery
f. Peroneal artery
Clinical manifestations of PAD
Intermittent claudication Ischemic muscle p! Paresthesia Reduced BF p! @ rest Reactive hyperemia of foot
Most serious complication of PAD
delayed healing; tissue necrosis
Non-healing arterial ulcers & gangrene
Diagnostic studies of PAD
Dopper ultrasound
Angiography
ABI
Nursing care of PAD
Walking is most effective exercise
Walk to point of p!; then stop
Uses contrast medium to identify coronary blockages
Coronary angiography
Removal of obstructing plaque
Atherectomy
Arterial Revascularization Post operative
Deep breathing
maintain circulation–pedal pulses
Monitor for graft occlusion
Acute care of arterial revascularization
circulatory assessment
Avoid knee-flexed positions & crossed legs
turn frequently
Abdominal aortic aneurysms clinical manifestations
Detected on routine physical exam
May mimic p! with abdominal or back disorders
Abdominal aortic aneurysm may cause
back pain
epigastric discomfort
altered bowel elimination
intermittent claudication
Most common manifestation of thoracic aorta aneurysm (TAA)
Deep diffuse chest pain, Pain may extend to interscapular area
Ascending aorta/aortic arch aneurysm manifestations
Angina; transient ischemic attacks
Coughing
SOB
Hoarseness
Dysphagia
Risk factors for aortic aneurysm
a. Age
b. Male gender, Family History
c. HTN
d. Coronary artery disease
e. Family history
f. Tobacco use
g. High cholesterol
h. Lower extremity PAD
i. Carotid artery disease
j. Previous stroke
k. Excess weight or obesity
Serious complication of Aortic aneurysm
Rupture
bleeding; severe back p!; back/flank ecchymosis (Grey Turners)
Rupture into thoracic or abdominal cavity
Massive hemorrhage causes hypovolemic shock
Diagnostic Studies of Aneurysms
Xrays
ECG–rule out MI
Signs of aneurysm rupture:
i. Diaphoresis
ii. Pallor
iii. Weakness
iv. Tachycardia
v. Hypotension
vi. Abdominal, back, groin or periumbilical pain
vii. Changes in LOC
viii. Pulsating abdominal mass
Pt care: aneurysm
VS
Monitor ABG; oxygen; electrolytes; CBC
Urine output
Never palpate/massage abdomen
Abdominal aortic aneurysm resection Report:
any changes in sensation; temperature; cyanotic; do not elevate the bed, check BP (must be kept at a very therapeutic range), cardiac rehab
