Vascular Disorders

Question 1

Older adult considerations

Answer 1

-aging affects transport of oxygen and nutrients
-vessels stiffen: increased peripheral resistance, impaired blood flow, increased left ventricular workload

Question 2

Improving peripheral arterial circulation

Answer 2

-positioning: body below heart (pAd)
-exercise (to the point of pain then stop and rest and start again)
-temperature
-discourage nicotine
-stress reduction

Question 3

risk factors for atherosclerosis and PAD

Answer 3

-nicotine
-DM
-hypertension
-hyperlipidemia
-age
-familial predisposition
-genetics

Question 4

Complications of PAD

Answer 4

-atrophy
-decreased arterial blood flow
-infections
-necrosis
-ulcers
-gangrene
-amputation

Question 5

Upper extremity arterial disease

Answer 5

-less frequent (better collateral circulation, decrease workload)
-claudication pain to the forearm
-

Question 6

Aortoiliac disease

Answer 6

-stenosis or occlusion
-asymptomatic
-butt or lower back discomfort with walking
-intermittent claudication

Question 7

Aneurysm

Answer 7

-localized sac or dilation weak point
-most common are saccular and fusiform
-saccular only one side
-fusiform is entire

Question 8

Raynaud’s phenomenon

Answer 8

-trigger: cold or stress
-color changes, numb, ting, burn
-protect from triggers and avoid injury

Question 9

Buerger’s disease

Answer 9

-men, age 25-35, smoking
-younger than 50
-no risk factors for atherosclerosis

Question 10

Buerger’s disease assessment

Answer 10

-painful, blue discoloration
-amputation
-gangrene
-pain worse at night

Question 11

Buerger’s disease treatment

Answer 11

Stop smoking

Question 12

Arterial embolism/embolus

Answer 12

-MEDICAL EMERGENCY
-pain (early)
-pallor (late)
-pulselessness (late)
-paresthesia (late)
-poikilothermia (cool)
-paralysis (late)

Question 13

Venous thromboembolism

Answer 13

-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)

Question 14

Preventative measures for venous thromboembolism

Answer 14

-early ambulation
-compression stockings
-intermittent pneumatic compression devices
-heparin or LMWH
-weight loss, smoking cessation , regular exercise

Question 15

Phlegmasia cerulea Dolans

Answer 15

-swollen, blue, painful leg
-sudden, massive swelling, deep pain, intense cyanosis
-untreated leads to occlusion, gangrene, amputation

Question 16

Pulmonary embolism

Answer 16

-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

Question 17

Chronic venous insufficiency treatment

Answer 17

-avoid causes
-elevate legs
-compression stocking
-protect from injury
-avoid crossing legs and ankles
-avoid constriction garments
-weight loss

Question 18

Manifestation of arterial ulcers

Answer 18

-small
-circular
-deep
-tips of toes or web spaces
-little drainage
-punched out appearance
-necrotic/black

Question 19

Manifestations of venous leg ulcers

Answer 19

-large
-superficial/shallow
-highly exudative
-medial or lateral malleolus
-irregular edges
-deep pink/red

Question 20

Interventions for leg ulcers

Answer 20

-clean wound, position, avoid trauma, avoid heat

-restrict physical activity then gradual progression, analgesic before

-protein, vitamins C and A, iron, zinc

Question 21

Cellulitis

Answer 21

-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