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vascular disorders Flashcards

1
Q

describe arteries

A
  • carry oxygenated blood away from the heart
  • aorta to body
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2
Q

describe veins

A
  • carry deoxygenated blood back to the heart
  • returns via the inferior and superior vena cava
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3
Q

describe the lymphatic system

A
  • fluid/waste removal
  • absorption of fatty acids and fats to circulatory system
  • produce immune cells (lymphocytes, monocytes, plasma cells)
  • makes antibodies
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4
Q

what is peripheral vascular disease

A

disorder of natural flow of blood

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5
Q

name a couple and describe arterial disorders

A

raynauds and intermittent claudication

  • if you have peripheral arterial disease most likely to concurrently have CAD
  • same disease process: atherosclerosis
  • same risk factors: smoking, DM, stress, HTN, hyperlipidemia
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6
Q

describe venous disorders

A

chronic venous insufficiency

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7
Q

whats a cause of intermittent claudication

A

atherosclerosis

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8
Q

what is happening with intermittent claudication

A
  • narrowing of arteries feeding leg
  • reduce blood flow to leg
  • ischemia -> limb necrosis
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9
Q

how will a patient with intermittent claudication present?

A
  • intermittent leg pain (increased with exercise or walking)
  • erythema to legs/feet
  • wounds are difficult to heal
  • progressing to pain at rest
  • cool skin
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10
Q

what labs are used for intermittent claudication

A
  • CBC, BMP, D-dimer
  • CT/MRI
  • vascular ultrasound
  • angiography (will show where decreased blood flow is)
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11
Q

what are some acute interventions for intermittent claudication

A
  • rest legs (dependent position)
  • warm compressions (vasodilate)
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12
Q

what are some surgical interventions for intermittent claudication

A
  • angioplasty
  • vascular surgery (bypass)
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13
Q

what are some complications of intermittent claudication

A
  • limb ischemia
  • pain at rest and walking
  • hard to heal ulcers (DRY)
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14
Q

what are some nursing considerations for intermittent claudication

A
  • frequent breaks
  • dependent position
  • warm compress
  • inspect and protect legs/feet
  • medication compliance
  • control DM
  • if in bed = sit upright and dangle
  • same prevention as CAD
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15
Q

what are some causes of raynaud’s

A
  • cold
  • stress
  • smoking
  • idiopathetic
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16
Q

whats happening with raynaud’s

A
  • smaller arteries to the skin (narrow)
  • limits blood flow via vasospasm
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17
Q

how will a client with raynaud’s present?

A
  • numbness and tingling in fingers/toes
  • skin pale/blue/reddend
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18
Q

what meds may be used for raynaud’s

A
  • calcium channel blockers (amlodipine)
  • vasodilators (nitro)
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19
Q

what are some nursing considerations for raynaud’s

A
  • gradual warming
  • pain relievers/CCBs
  • avoid cold temps
  • quit smoking
  • avoid emotional stress
  • wounds are harder to heal
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20
Q

whats used for venous thromboembolism prophylaxis

A
  • heparin SQ (5000units)
  • enoxaprin SQ (weight based)
21
Q

what are some causes of venous thromboembolism

A
  • vichows triad: endothelial damage, venous stasis, altered coagulation
  • immobility
  • major surgery/injury
  • pregnancy
22
Q

whats happening with venous thromboembolism

A
  • asymptomatic
  • redness possible to calf
  • tenderness/pain
  • edema
23
Q

what are some diagnostic tests for venous thromboembolism

A
  • CBC, BMP
  • D-dimer (increased indicates liklihood of clots)
  • venous doppler ultrasound
24
Q

what meds may be used for venous thromboembolism

A

anticoagulants (apaxiban, enoxaparin)

25
Q

what are some acute interventions for venous thromboembolism

A
  • TPA only if PE (life threatening)
  • thrombectomy (vena cava filter)
26
Q

what are some complications of venous thromboembolism

A
  • pulmonary embolism (PE)
  • CVA
  • post thrombotic syndrome (PTS)
27
Q

what are some nursing considerations for venous thromboembolism

A
  • watchful waiting
  • anticoagulants
  • early ambulation
  • SCD’s/ted/enoxaparin/heparin (VTE prophylaxis)
  • stay active (lifestyle changes)
  • discuss risks of birth control
  • discuss HTN meds and treatment
  • discuss symptoms of PE
  • post thrombotic syndrome (PTS)
  • follow up for ultrasound to monitor
28
Q

what are some causes of chronic venous insufficiency

A
  • varicose veins
  • age
  • extended sitting or standing
  • reduced mobility
  • PTS
  • smoking
  • trauma to leg
29
Q

whats happening with chronic venous insufficiency

A
  • venous valves incompetant
  • stretching = improper closing of valves
  • pooling of blood in veins
  • increased pressure = increased stretch
  • capillaries rupture (red/brown/purple skin)
  • tissue swelling/inflammation
30
Q

how will a client with CVI present?

A
  • swelling to lower extremities
  • aching/fatigue in legs
  • varicose veins
  • change in color of legs
  • flaking/itchy skin
  • venous stasis ulcers (WET)
31
Q

what are some labs/diagnostics for CVI

A
  • CBC, BMP
  • D-dimer
  • vascular US
  • CT
  • xray
32
Q

what drugs may be used for CVI

A

antibiotics if theres an infection from ulcers

33
Q

what are some complications of CVI

A
  • cellulitis
  • difficult to heal ulcers
34
Q

describe nrusing care and considerations for CVI

A
  • support hose; sit breaks
  • avoid prolonged sitting/standing
  • catch early
  • surgical options
  • elevate legs when sitting
  • exercise
  • good hygiene - take care of legs
  • wound care
  • quit smoking
  • hyperbaric therapy (creates angiogenesis)
35
Q

what are some causes of lymphedema

A

removal/damage of lymph node (typically occurs with cancer)

36
Q

what is happening with lymphedema

A
  • swelling (usually unilateral)
  • lymph system blocked
  • lack of drainage
  • tissue swelling/edema
37
Q

how will a client present with lymphedema

A
  • mild - moderate - severe
  • swelling in one or both arm/leg
  • heaviness/tightness in affected limb
  • decreased ROM
  • aching
  • infections
  • fibrosis (late finding)
38
Q

what labs/diagnostics are used for lymphedema

A
  • CT scan
  • doppler US
39
Q

what meds mayy help for lymphedema

A

antibiotics (for infection)

40
Q

what are some treatments of lymphedema

A
  • compression
  • decongestive therapy (push it to where it can drain, used in first two stages)
  • surgery (as stages progress, not done a lot)
41
Q

what are some complications of lymphedema

A

cellulitis

42
Q

describe some nursing considerations for lymphedema

A
  • protect from injury
  • after CA treatment care
  • avoid ice/heat
  • elevate
  • avoid tight fitting clothes
  • good hygiene
  • exercise
  • compression dressing
  • massage
  • wound care dressing
43
Q

what are some causes of cellulitis

A
  • injury
  • skin conditions
  • lymphedema
  • animal bites
  • immunocompromised
44
Q

whats happening with cellulitis

A
  • infection in tissue
  • spreading through blood/lymph
  • can be life-threatening: sepsis
45
Q

how will the client with cellulitis present

A
  • continuous redness and swelling
  • pain and tenderness
  • warmth
  • progress to S&S of infection
46
Q

what labs/diagnostics for cellulitis

A
  • CBC, BMP
  • blood cultures
  • outline with marker
  • CT (to see depth)
47
Q

what meds can help with cellulitis

A

antibiotics (vanc, penicillin, clindamycin)
clindamycin is primary for outpatient
try oral first, no response? go to IV

meds are dependent on severity

48
Q

what are some complications of cellulitis

A
  • sepsis
  • lymphedema
  • necrotizing fasciitis
49
Q

what are some nursing considerations for cellulitis

A
  • education!
  • proper wound care
  • protect skin
  • DM special care
  • treat skin infections
  • if redness exceeds line -> ED
  • elevate
  • cool damp cloth
  • take entire course of antibiotics
  • analgesics
  • protect area

adults (51 decks)

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