vascular disorders Flashcards
arteries carry _____ blood _____ the heart
oxygenated, away
veins carry _____ blood _____ the heart
deoxygenated, back to
arteries carry blood from the ____ to the ____
aorta to the body
veins return blood via the _______
inferior and superior vena cava
what does the lymphatic system do?
-fluid/waste removal
-absorption of fatty acids
-produce immune cells (lymphocytes, monocytes, plasma)
what is a disorder of natural blood flow?
peripheral vascular disease
what are the 2 types of PVD?
arterial and venous disorders
what are examples of arterial disorders?
reynauds, intermittent claudication
if you have peripheral artery disease, you are also likely to have _____ simultaneously
CAD
what is an example of venous disorders
chronic venous insufficiency
what kind of disorder is where there is not enough blood to the lower extremities (clogged blockages)?
arterial
what kind of disorder is characterized by pressure from blood not returning to the heart?
venous
what is a sign of intermittent claudication
painful ambulation
what is a cause of intermittent claudication?
atherosclerosis
what is the process of intermittent claudication?
-narrowing of arteries in legs
-reduced blood flow
-ischemia / limb necrosis
does pain with intermittent claudication increase or decrease with ambulation?
increase
presentation of client with intermittent claudication?
-leg pain
-erythema legs/feet
-wound (hard to heal)
-cool skin
labs and tests to find intermittent claudication
-CBC BMP D-dimer
-CT/MRI
-vascular ultrasound
-angiography
acute interventions for intermittent claudication
-rest legs (dependent position)
-warm compresses
surgical interventions for intermittent claudication
-angioplasty
-vascular surgery (bypass)
what are complications of intermittent claudication?
-limb ischemia
-pain at rest and walking
-hard to heal ulcers
causes of reynauds?
-cold
-stress
-smoking
-idiopathic
what is happening in reynauds?
-smaller arteries to skin = narrow
-limits blood flow via vasospasm
how will the client presents with reynauds?
-n/t in fingers/toes
-skin pale / blue / reddened
pharmacology for reynauds
-calcium channel blockers
-vasodilators
what calcium channel blockers are used fro reynauds?
-amlodipine
what vasodilator is used for reynauds?
nitro
nursing care for reynauds
-gradual warming
-pain relievers
-avoid cold
-quit smoking
-avoid stress
-wounds
what are venous thromboembolisms and types
moving blood clot, DVT and PE
what do you use for VTE prophylaxis? (DVT/PE)
-heparin SQ (5000 u )
-enoxaparin SQ (weight based)
causes of VTEs?
-virchow’s triad (endothelial damage, venous stasis, altered coag)
-immobility
-surgery/injury
-pregnancy
what makes up virchow’s triad?
-endothelial damage (artery lining)
-venous stasis (not moving)
-altered coagulation (higher risk)
how does a patient with VTE present?
-asymptomatic
-redness to calf
-tender/pain
-edema
what are labs used to find VTE?
-CBC/BMP
-D-Dimer
-venous doppler US
pharmacology for VTE (and examples)
anticoagulants (apixaban and enoxaparin)
acute interventions of VTE
-TPA (altepase)only if PE
-thrombectomy
-vena cava filter
complications of VTE
-pulmonary embolism (PE)
-CVA
-PTS (post thrombotic syndrome)
causes of chronic venous insufficiency?
-vericose veins!!!
-age
-extended sitting/standing
-PTS
-trauma
what happens in chronic venous insufficiency
-venous valves incompetent
-stretch = improper closing of veins
-pooling of blood in veins
-increased pressure = increased stretch
how will clint present with chronic venous insufficiency?
-swelling on lower extremities
-aching / fatigue in legs
-vericose veins
-color change
-flaking/itchy skin
-venous stasis ulcers (wet)
labs to find CVI?
-CBC/BMP
-D-Dimer
diagnostic tests to find CVI
-vascular US
-CT
-XRay
pharmacology used for CVI
-antibiotics (if infection present)
-vena stat
complications of CVI
-cellulitis
-difficult to heal ulcers
nursing care and considerations for CVI
-compression socks
-avoid prolonged sitting/standing
-catch early
-elevate legs
-good hygeine
-quit smoking
causes of lymphedema
removal/damage of lymph node
what is happening in lymphedema
-swelling unilateral or bilateral
-lymph system blocked
-lack of drainage
-tissue swelling / edema
how will a client with lymphedema present?
-swelling in one or both arm/leg
-heavyness/tightness
-dec. ROM
-fibrosis
diagnostics used to diagnose lymphedema?
-CT scan
-dopper US
meds that can help with lymphedema?
antibiotics
treatments for lymphedema?
-compression
-decongestive therapy
-surgery
complications from lymphedema?
cellulitis
considerations for lymphedema?
-compression dressing!!
-elevate
-avoid ice/heat
-good hygeine
avoid tight clothes
causes of cellulitis?
-injury
-skin conditions
-lymphedema
-immunocompromised
-animal bites
what happens with lymphedema?
-infection in tissue
-spreads through blood / lymph
-can be life threatening
how will client present with cellulitis?
-red/swell
-pain/tender
-warmth
-progress to S&S of infection
labs to diagnose cellulitis
-CBC / BMP
-BLOOD CULTURES
-OUTLINE W MARKER
-CT SCAN
meds that can help cellulitis (and examples)
-antibiotics (vanc/penicillin/clindamycin)
what route of meds are chosen for cellulitis?
oral first, if no response IV
complications from cellulitis?
sepsis
lymphedema
necrotizing fasciitis
how can nurses help with cellulitis
-proper wound care
-protect skin
-DM care
-treat infection
-elevate
-cool damp cloth
-analgesics
proper wound care for cellulitis
soap and water
how to protect skin with cellulitis
clean, dry, cover
why do you elevate with cellulitis?
blood back to heart
