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MedSurg > Vascular Disorders > Flashcards

Vascular Disorders Flashcards

1
Q

Define arteriosclerosis

A

thicken + harden of arterial wall which causes stiffness

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2
Q

Types of arteriosclerosis

A
  • Atherosclerosis
  • Medial calcific sclerosis
  • Arteriolar sclerosis

*Arteriosclerosis does NOT equal atherosclerosis
Atherosclerosis DOES equal arteriosclerosis

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3
Q

Atherosclerosis

A

Plaque buildup in arterial wall d/t LDL

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4
Q

Medial calcific sclerosis

A

Calcium deposition in arterial wall

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5
Q

Arteriolar sclerosis

A

Thickening of tiny arterioles

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6
Q

Distinguish between two types of HTN

A
  • Primary: no exact cause
  • Secondary: high BP d/t other disease (mostly renal dz)
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7
Q

HTN clinical manifestations
(chronically uncontrolled, primary)

A
  • Headache
  • Chest pain
  • Vision changes
  • SOB
  • Renal dysfunction
  • Dizziness
  • Fatigue
  • Nosebleeds
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8
Q

HTN (primary) complications

A
  • Dilated cardiomyopathy
  • Systolic dysfunction
  • Renal failure
  • Stroke
  • Small vessel damage: sexual dysfunction & eyes
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9
Q

Hypertensive crisis

A
  • Hypertensive urgency
  • Hypertensive emergency
  • Target organ damage (heart, brain, kidney, eyes)
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10
Q

Difference between hypertensive urgency & hypertensive emergency

A

Hypertensive urgency:
- DBP > 120mmHG WITHOUT TOD

Hypertensive emergency:
- DBP > 120mmHG WITH TOD (papilledema, aortic dissection, stroke, or HF)

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11
Q

HTN pt teaching

A
  • *Monitor BP at home
  • *Know SS and complications
  • Med adherence
  • Lifestyle change adherence
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12
Q

HTN nursing action

A
  • Meds (diuretics, CCB, BB, ACEi)
  • DASH diet: 1600mg of Na / day
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13
Q

What is Peripheral Artery Disease (PAD)

A
  • Obstruction of blood flow to LEs (occlusion) –> depriving of O2
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14
Q

PAD clinical manifestations

A
  • *Intermittent claudication (pain in calf muscle during exercise, alleviated thru rest)
  • Weak/absent pulses (posterior tibial)
  • Cool or cold d/t not getting arterial blood
  • Prolonged capillary refill
  • Loss of hair on calf, ankle foot
  • *Ulcerations d/t loss of skin turgor
  • *Thickened toenails
  • *Muscle atrophy (super late sign)
  • *Dry, scaly, and pale skin
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15
Q

PAD complications

A
  • Critical limb ischemia
  • Acute limb ischemia
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16
Q

Critical limb ischemia

A

Decreased arterial blood flow –> rest pain, etc., limb loss

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17
Q

Acute limb ischemia

A

Embolus causing complete occlusion

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18
Q

Six Ps of ischemia

A
  • Pain
  • Pallor
  • Pulselessness
  • Paresthesia (tingling)
  • Paralysis (muscle atrophy)
  • Poikilothermia (cold)
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19
Q

PAD nursing action

A
  • Administer meds: antihypertensives, antiplatelets
  • *Proper positioning: pt legs shud be dependent (eg. hang over bed) to facilitate blood flow
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20
Q

PAD pt teaching

A
  • *Positioning
  • *Inspect feet daily
  • *Report chest discomfort
  • LIfestyle change: DASH, no alcohol, no smoking, moderate exercise
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21
Q

Carotid disease

A
  • Vessel wall thicken, plaque form, progressive narrowing
  • Stenosis (narrowing) occur at carotid bifurcation
22
Q

TIA/Stroke clinical manifestations (complication of carotid disease)

A
  • Sudden weakness
  • Dizziness
  • Loss of coordination
  • Difficulty talking
  • Facial droop
  • Sudden vision problems
  • Sudden and severe headache

*BE FAST = balance, eyes, face, arm, speech, time

23
Q

Carotid disease S&S

A

Asymptomatic bc plaque just builds up.
Full plaque obstruction will impact cerebral perfusion and manifest symptoms.

  • Audible bruit d/t turbulent blood flow past obstruction at coronary artery bifurcation (listened by stethoscope)
24
Q

Carotid disease assessment

A
  • Vital signs
  • Carotid bruit
  • Neuro assess
  • Stroke history/signs of stroke
  • Doppler ultrasound: looks at blood flow
25
Q

Carotid disease surgical treatments

A
  • Carotid endarterectomy: take out plaque, patch it back up
  • Carotid artery stenting
26
Q

Post CEA nursing action

A

*Control and assess BP
- Hypotensive: lie flat and anticipate vasoactive drips & fluids
- Hypertensive: maintain head of bed 30 degrees

  • Head in neutral position to alleviate stress on incision and artery
27
Q

Post CAS nursing action

A

*Control and assess BP
- Hypotensive: lie flat and anticipate vasoactive drips & fluids
- Hypertensive: maintain head of bed 30 degrees

  • Encourage fluid intake, maintain IV fluids to aid in flushing IV dye thru kidneys
28
Q

Carotid artery pt teaching

A
  • Clinical manifestations of stroke
  • Lifestyle changes
29
Q

AAA

A
  • Permanent dilation of artery causing bulge
  • Weakened middle layer stretches inner and outer layer
  • Artery widens & arterial wall tension increases
30
Q

AAA complications

A
  • Aortic dissection: tear in inner layer, blood rushes thru tear and splits inner and middle layer
  • Aortic rupture: complete tear thru all layers of aorta
31
Q

AAA S&S

A

Asymptomatic until AAA complication –> usually found when incident happens

32
Q

Aortic dissection/rupture clinical manifestations

A
  • *Chest pain
  • *Back pain
  • *Flank pain
  • Palpable pusatile mass in abdomen
  • Pain occur spontaneously
  • Pain not related to any activity
33
Q

AAA risk population

A

Males

34
Q

Would you palpate pt abdomen w suspected AAA?

A

No

35
Q

AAA risk on pt history

A
  • Smoking
  • HTN
  • High cholesterol
  • CAD
  • Atherosclerosis
36
Q

Signs of possible leaking/bursting AAA:

A
  • Hypotension
  • Decreased O2 sat
  • Severe pain in abd/back
37
Q

Thoracic AAA assess

A
  • Pain
  • Dyspnea/cough
  • Hoarseness & dysphagia
38
Q

Abd AAA assess

A
  • Pain (back and abd)
  • Pulsatile mass near umbilicus
  • Cyanosis, numbness, tingling
39
Q

AAA nursing action

A
  • Administer meds
  • Bowel regimen to reduce strain
  • NO abd palpation
40
Q

AAA pt teaching

A
  • S&S of aneurysm dissection/rupture
  • Medication adherence
  • Screening w congenital problems
  • Smoking cessation
  • Healthy diet
41
Q

Define DVT

A

Blood clot that usually occurs in lower limbs and blocks blood flow

42
Q

Virchow’s triad

A

Factors that contribute to venous thrombosis

  1. Decreased flow rate of blood OR stasis of blood flow
  2. Endothelial injury (damage to BV wall)
  3. Hypercoagulability (increased tendency of blood to clot)
43
Q

DVT clinical manifestations

A

Asymptomatic or symptomatic (depends on clot itself)

  • *Pain
  • Swelling
  • Tenderness
  • Color changes
  • *Redness
  • *Warmth
44
Q

DVT meds

A
  • Heparin
  • Lovenox
  • Eliquis (Apixaban): factor XA inhibitor (oral but irreversible)
  • Warfarin/Coumadin
45
Q

DVT nursing action

A

Prevention:
- Low DVT risk: ambulation
- High DVT risk, low bleed risk: Lovenox or Heparin
- High DVT/bleed risk: compression stockings, SCDs

*Avoid SCD in leg WITH DVT

46
Q

DVT pt teaching

A

Prevention:
- Hydration, early ambulation, leg exercises

Treatment:
- S&S of bleeding
- Lab monitoring compliance
- Safety precautions on anticoags

47
Q

DVT assess

A
  • *Vital signs, oxygen sat
  • *Sign of bleeding: bruising, petechiae
  • Extremity assess: swell, pain, red, warmth
  • Bilateral calf circumference
  • Lab values: d-dimer, pt/ptt/INR
48
Q

DVT complications

A
  • Pulmonary embolism: clot that dislodges to R heart then to lungs and occludes pulmonary artery
  • Post-thrombotic syndrome
49
Q

PE S&S

A
  • SOB
  • Decreased O2 sat
  • Tachycardia
  • Hypotension
  • Sweating d/t activation of SNS
  • Sharp chest pain esp during deep breathing
  • Hemoptysis (bloody sputum)
50
Q

PTS S&S

A
  • Minor leg swell & discomfort
  • Severe leg pain
  • *Leg ulceration
  • *Skin changes

MedSurg (15 decks)

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