Vascular Disorders Flashcards
Older adult considerations
-aging affects transport of oxygen and nutrients
-vessels stiffen: increased peripheral resistance, impaired blood flow, increased left ventricular workload
Improving peripheral arterial circulation
-positioning: body below heart (pAd)
-exercise (to the point of pain then stop and rest and start again)
-temperature
-discourage nicotine
-stress reduction
risk factors for atherosclerosis and PAD
-nicotine
-DM
-hypertension
-hyperlipidemia
-age
-familial predisposition
-genetics
Complications of PAD
-atrophy
-decreased arterial blood flow
-infections
-necrosis
-ulcers
-gangrene
-amputation
Upper extremity arterial disease
-less frequent (better collateral circulation, decrease workload)
-claudication pain to the forearm
-
Aortoiliac disease
-stenosis or occlusion
-asymptomatic
-butt or lower back discomfort with walking
-intermittent claudication
Aneurysm
-localized sac or dilation weak point
-most common are saccular and fusiform
-saccular only one side
-fusiform is entire
Raynaud’s phenomenon
-trigger: cold or stress
-color changes, numb, ting, burn
-protect from triggers and avoid injury
Buerger’s disease
-men, age 25-35, smoking
-younger than 50
-no risk factors for atherosclerosis
Buerger’s disease assessment
-painful, blue discoloration
-amputation
-gangrene
-pain worse at night
Buerger’s disease treatment
Stop smoking
Arterial embolism/embolus
-MEDICAL EMERGENCY
-pain (early)
-pallor (late)
-pulselessness (late)
-paresthesia (late)
-poikilothermia (cool)
-paralysis (late)
Venous thromboembolism
-virchow’s triad (endothelial dmg, venous stasis, alt coag)
-deep veins (red, swollen, warm, tender)
-superficial veins (swell, edema, prominent, thrombophlebitis, goes away on its own)
Preventative measures for venous thromboembolism
-early ambulation
-compression stockings
-intermittent pneumatic compression devices
-heparin or LMWH
-weight loss, smoking cessation , regular exercise
Phlegmasia cerulea Dolans
-swollen, blue, painful leg
-sudden, massive swelling, deep pain, intense cyanosis
-untreated leads to occlusion, gangrene, amputation
Pulmonary embolism
-dyspnea, tachypnea, chest pain, anxiety, fever, tachycardia, apprehension, cough, diaphoresis , hemoptysis, syncope
-RESPIRATORY STATUS, CXR, ECG, D-DIMER, ABG, CT scan
-thrombolytic treatment, surgical embolectomy
Chronic venous insufficiency treatment
-avoid causes
-elevate legs
-compression stocking
-protect from injury
-avoid crossing legs and ankles
-avoid constriction garments
-weight loss
Manifestation of arterial ulcers
-small
-circular
-deep
-tips of toes or web spaces
-little drainage
-punched out appearance
-necrotic/black
Manifestations of venous leg ulcers
-large
-superficial/shallow
-highly exudative
-medial or lateral malleolus
-irregular edges
-deep pink/red
Interventions for leg ulcers
-clean wound, position, avoid trauma, avoid heat
-restrict physical activity then gradual progression, analgesic before
-protein, vitamins C and A, iron, zinc
Cellulitis
-local swelling or redness, fever, chills, sweating
-tx with oral or if antibiotics
-elevate area; warm, moist packs; edu prevention; reinforce skin and foot care
