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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
How often should nurse perform vascular checks after fem-pop?
Every 15 minutes for the first hour; | Then, hourly
26
When positioning patient after fem-pop, what position should patient avoid? When should patient begin to ambulate?
Avoid: knee-flexed position Discourage prolonged sitting w/ leg dependency to avoid swelling and clots; Ambulate on post op day 1
27
Nursing Diagnoses for PAD
Ineffective Tissue Perfusion; Risk for Impaired Skin integrity; Acute Pain; Activity intolerance
28
Risk Factors for Abdominal Aortic Aneurysms
Athlerosclerosis; CAD; HTN; Genetics
29
S/S Abdominal Aortic Aneurysm
Often Asymptomatic 1. Pulsating mass in mid/upper abd 2. Bruit over aneurysm 3. Pain (constant or intermittent/mid abd or back)
30
Complications of AAA
Rupture | Embolus
31
Signs of AAA Rupture
Grey Turner Sign - flank ecchymosis
32
Diagnostic Studies for AAA
``` Abd X-Ray Ultrasound CT scan MRI Angiography ```
33
Results when arteries in the lower extremities are occluded. Blood collects and forms clots which shower through the body.
Blue Toe Syndrome
34
Aortic dissection s/s
Chest pain, SOA, high mortality rate, medical emergency
35
Result: hypovolemic shock (increased HR, Decreased BP, pale, clammy, decreased level of consciousness, decreased urine output) Immediate Surgery Required
AAA Rupture in thoracic or abdominal cavity
36
Nursing Care AAA
Gather good History and Physical Bed rest; Calm environment Continuous cardiac monitoring Check UOP hourly; Meds
37
When is surgery normally done for an abdominal aortic aneurysm
Aneurysm is greater than 5 cm or expanding rapidly
38
2 Types of AAA surgery
1. Open AAA Repair | 2. Endovascular Graft procedure
39
Big thing for nurses to watch if procedure requires aorta to be cross clamped?
Watch UOP and peripheral pulses
40
Nursing care after Open AAA Repair
ICU 24-48 hours after; Monitor BP; Check peripheral pulses and UOP hourly; Monitor patient’s LOC
41
Nursing Care for Raynaud’s
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
Clot in superficial vein
Superficial Vein Thrombosis
43
Venous Thromboembolisms
DVTs and Pulmonary embolism
44
Causes of DVT
Venous Stasis; Vessel Wall Injury; Blood hypercoagulability
45
Complication of DVT
Pulmonary Embolism
46
S/S Pulmonary embolism
SOA; Decreased oxygen saturation; chest pain; anxiety; sudden onset
47
Collaborative care for DVT
1. Prevention 2. Treatment for Actual DVT 3. Surgery
48
How to prevent DVT
Change position and ROM exercise q2h; Ambulate 4-6x daily; Ted hose/scds; Pharmacological prophylaxis
49
Two meds given for VTE Prophylaxis
Heparin | Enoxaparin
50
Treatment for actual DVT
Bed rest w/ limb elevation; | Monitor for PE; Anticoagulant therapy
51
Surgical interventions for DVT
Venous thrombectomy; | Inferior Vena Cava Filter (Greenfield Filter)
52
What is a complication of greenfield filter
Patient can develop pneumothorax
53
S/S of Chronic Venous Insufficiency
Leathery appearance; Edema; Stasis Dermatitis; | Venous Ulcers; Pain
54
Collaborative Care for Chronic Venous Insufficiency
1. Compression; 2. Nutrition; 3. Watch for infection 4. 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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