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NSC 386 > Vascular Disorders > Flashcards

Vascular Disorders Flashcards

1
Q

Form of atherosclerosis which decreases the blood flow to peripheral tissues. Occurs more frequently in the arms or legs.

A

Peripheral Arterial disease

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2
Q

What are some of the causes of PAD

A

Tobacco use; hyperlipidemia; HTN; DM; Family History

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3
Q

Signs and symptoms of PAD

A

Pain; Paresthesia; Pallor; Diminished Pulse

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4
Q

Ischemic muscle pain resulting from exercise that resolves within ten minutes of rest.

A

Intermittent Claudication

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5
Q

What is intermittent claudication caused by

A

The release of lactic acid

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6
Q

What are some signs of progressing PAD?

A

Rest pain - burning/aching in toes or forefoot; during sleep

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7
Q

What can make PAD pain better?

A

Dangling legs over the bed

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8
Q

What are some consequences of worsening PAD

A

Ulceration, gangrene, critical limb ischemia, tissue death

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9
Q

6 P’s of Acute Arterial Ischemia

A
  1. Pain. 2. Pallor. 3. Pulselessness. 4. Parasthesia.

5. Poikilothermia. 6. Paralysis

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10
Q

Complications of PAD

A

Wound infections; Tissue Necrosis; Arterial Ulcers; Gangrene

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11
Q

What is the cause of complications of PAD

A

Poor Perfusion

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12
Q

Diagnostic Studies for PAD

A

Doppler Ultrasound; Ankle-Brachial Index (ABI); Angiography; Magnetic Resonance Angiography

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13
Q

Collaborative Care for PAD:

A

Modify risk factors; Proper Exercise; Proper Nutrition; Take Care of Feet; Drug Therapy; Percutaneous Transluminal Balloon Angioplasty; Surgical Therapy

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14
Q

What is important for people with PAD to avoid?

A

Exposure to cold; Constrictive Clothing; Stress; Crossed Legs

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15
Q

When taking segmental blood pressures, what finding is suggestive of PAD?

A

Drop in BP of > 30 mmHg

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16
Q

What are some things to check for if your patient is going to have a magnetic resonance angiography?

A

Check allergies and renal function (dye is hard on kidneys)

Encourage PO fluids to help flush the dye.

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17
Q

How do you measure the ankle-brachial index?

A

Divide ankle SBP by the higher of left v. Right SBP

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18
Q

How should patient take care of their feet?

A

Proper fitting shoes; daily inspection; clean & moisturize feet; proper toenail trimming; keep heels up

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19
Q

What is the nursing interventions for percutaneous transluminal balloon angioplasty?

A

Vascular & Vital signs check every 15 min for first hr;
Watch for bleeding;
Supine 6 hours after; loss of plus in extremity = call MD

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20
Q

What is the most effective exercise for PAD patients?

A

Walking

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21
Q

What kind of diet should someone with PAD go by?

A

Low saturated fat, cholesterol & salt

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22
Q

What are the goals of care for PAD

A

Control disease progression;
Pain Control;
Prevent Complications

23
Q

What is the most common surgical therapy for PAD?

A

Femoral-Popliteal Bypass (Fem-Pop)

24
Q

Top Nursing Interventions for Post Fem-Pop surgery

A

Vascular checks;
Proper positioning;
Monitor for signs of infection;
Notify the doctor if pulse is lost

25
Q

How often should nurse perform vascular checks after fem-pop?

A

Every 15 minutes for the first hour;

Then, hourly

26
Q

When positioning patient after fem-pop, what position should patient avoid? When should patient begin to ambulate?

A

Avoid: knee-flexed position
Discourage prolonged sitting w/ leg dependency to avoid swelling and clots;
Ambulate on post op day 1

27
Q

Nursing Diagnoses for PAD

A

Ineffective Tissue Perfusion;
Risk for Impaired Skin integrity;
Acute Pain;
Activity intolerance

28
Q

Risk Factors for Abdominal Aortic Aneurysms

A

Athlerosclerosis;
CAD;
HTN;
Genetics

29
Q

S/S Abdominal Aortic Aneurysm

A

Often Asymptomatic

  1. Pulsating mass in mid/upper abd
  2. Bruit over aneurysm
  3. Pain (constant or intermittent/mid abd or back)
30
Q

Complications of AAA

A

Rupture

Embolus

31
Q

Signs of AAA Rupture

A

Grey Turner Sign - flank ecchymosis

32
Q

Diagnostic Studies for AAA

A 
Abd X-Ray
Ultrasound
CT scan
MRI
Angiography
33
Q

Results when arteries in the lower extremities are occluded. Blood collects and forms clots which shower through the body.

A

Blue Toe Syndrome

34
Q

Aortic dissection s/s

A

Chest pain, SOA, high mortality rate, medical emergency

35
Q

Result: hypovolemic shock (increased HR, Decreased BP, pale, clammy, decreased level of consciousness, decreased urine output)
Immediate Surgery Required

A

AAA Rupture in thoracic or abdominal cavity

36
Q

Nursing Care AAA

A

Gather good History and Physical
Bed rest; Calm environment
Continuous cardiac monitoring
Check UOP hourly; Meds

37
Q

When is surgery normally done for an abdominal aortic aneurysm

A

Aneurysm is greater than 5 cm or expanding rapidly

38
Q

2 Types of AAA surgery

A
  1. Open AAA Repair

2. Endovascular Graft procedure

39
Q

Big thing for nurses to watch if procedure requires aorta to be cross clamped?

A

Watch UOP and peripheral pulses

40
Q

Nursing care after Open AAA Repair

A

ICU 24-48 hours after;
Monitor BP;
Check peripheral pulses and UOP hourly;
Monitor patient’s LOC

41
Q

Nursing Care for Raynaud’s

A

Provide Education (loose,warm clothing when cold; gloves when handling cold items; avoid temp extremes; smoking cessation; avoid caffeine); Calcium Channel Blockers if severe

42
Q

Clot in superficial vein

A

Superficial Vein Thrombosis

43
Q

Venous Thromboembolisms

A

DVTs and Pulmonary embolism

44
Q

Causes of DVT

A

Venous Stasis; Vessel Wall Injury; Blood hypercoagulability

45
Q

Complication of DVT

A

Pulmonary Embolism

46
Q

S/S Pulmonary embolism

A

SOA; Decreased oxygen saturation; chest pain; anxiety; sudden onset

47
Q

Collaborative care for DVT

A
  1. Prevention
  2. Treatment for Actual DVT
  3. Surgery
48
Q

How to prevent DVT

A

Change position and ROM exercise q2h;
Ambulate 4-6x daily;
Ted hose/scds;
Pharmacological prophylaxis

49
Q

Two meds given for VTE Prophylaxis

A

Heparin

Enoxaparin

50
Q

Treatment for actual DVT

A

Bed rest w/ limb elevation;

Monitor for PE; Anticoagulant therapy

51
Q

Surgical interventions for DVT

A

Venous thrombectomy;

Inferior Vena Cava Filter (Greenfield Filter)

52
Q

What is a complication of greenfield filter

A

Patient can develop pneumothorax

53
Q

S/S of Chronic Venous Insufficiency

A

Leathery appearance; Edema; Stasis Dermatitis;

Venous Ulcers; Pain

54
Q

Collaborative Care for Chronic Venous Insufficiency

A
  1. Compression; 2. Nutrition; 3. Watch for infection
  2. Daily moisturizing; 5. Education: avoid standing/sitting for long periods; elevate legs above heart; avoid crossing legs; start walking

NSC 386 (11 decks)

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