vascular disorders - aorta Flashcards
aorta details
Largest artery in the body
Responsible for supplying oxygenated blood to essentially all viral organs
Branches include right and left common carotid, right and left subclavian, right and left coronary, brachiocephalic, celiac trunk, superior and inferior mesenteric, renal, gonadal, and common iliac
Most common vascular problems of aorta (3 of them)
Aneurysms
Aortoiliac occlusive disease
Aortic dissection
Aneurysms
Localized sac (outpouching) or dilation formed at a weak point in the wall of the artery
Aneurysms classified by (aneuysms shape ppl)
its shape or form
aneurysms increase with
age
AAA - where do they occur? And mostly below what arteries?
¾ occur in abdominal aorta
¼ occur in thoracic aorta
Most occur below renal arteries
The larger the aneurysm, the greater the risk
AAA patho (triple A is dilated)
Dilated aortic wall becomes lined with thrombi that can embolize
Leads to acute ischemic symptoms in distal branches
AAA causes (Triple a degrades from birth due to mechanics, trauma, inflammation or infection
Degenerative
Congenital
Mechanical
Penetrating or blunt trauma
Inflammatory
Infectious
AAA risk factors (triple A is male)
Age
Male gender
HTN
CAD
AAA clinical manifestations (opposite of what you think)
Often asymptomatic
Frequently detected during a routine physical exam or when patient is examined for an unrelated problem (KUB, abdominal CT scan)
AAA complications - rupture into retroperitoneal space
Bleeding may be tamponaded by surrounding structures, thus preventing exsanguination and death.
AAA xrays - chest (Triple A’s x-ray is wide)
Chest –demonstrate mediastinal silhouette and any abnormal widening of thoracic aorta
AAA ECG used to rule out what?
ECG to rule out MI
AAA echocardiography (triple A echoes in the valve)
Assists in diagnosis of aortic valve insufficiency
AAA ultrasonography monitors what? (ultra sound for baby’s size)
Useful in screening
Monitors size
AAA CT scan (Triple A needs a cutie for cross-section)
Most accurate to determine anterior-posterior length and cross-sectional diameter, presence of thrombus, type of surgery
AAA MRI (Mr, I need Triple A to locate the severity of the crash)
diagnose and assess location and severity
AAA angiography (Angie can provide valuable info to triple A)
Can provide accurate information about involvement of intestinal, renal or distal vessels
AAA If ruptured
emergent surgical intervention is required
90% mortality
AAA - pre op
Preop routines; bowel prep, NPO, shower. IV antibiotic (usually keflex) prior to incision
AAA Expectations after surgery - what meds? (Triple A before Beta B)
PACU, tubes, drains, ICU, beta blocker
AAA - Postoperative Nursing - how long in the ICU?
Postoperative Nursing
ICU monitoring 48 hours
AAA - Discharge teaching - what about ambulation?
Increase ambulation
No heavy lifting or staining
Teach about signs and symptoms of complications
Infection
Neurovascular changes
Venous thromboembolism (VTE) - where are they?
Venous thromboembolism (VTE) condition
Blood clots form in the deep veins of the leg,, groin or arm
Leg ulcers
Arterial
Venous
Mixed and other
varicose veins
valves give out, genetics and weight. painful.
venous disorders - Caused by Virchow’s triad (the end of virtue is hyper or stasis)
2/3 must be present
Endothelial injury
Venous Stasis
Hypercoagulability
venous stasis - causes (As you age with afib, HF, and obesity you become stasis)
Advanced age, a fib, chronic HF, obesity
endothelial damage - causes - what types of surgeries? (just stay around the abdomen)
Abdominal/pelvic surgery
hypercoagulability causes - what about thrombin?
Antithrombin II deficiency, smoking
DVT signs and symptoms (PEEW, it’s a DVT)
Erythema, edema, warmth
Pain
DVT complications
PE
Chronic venous insufficiency
Phlegmasia cerulea dolens (rare)
Swollen, blue, painful leg
labs for DVT (don’t forget on a dime)
Coags, platelets, H & H, d-dimer
tests for DVT (DVT tests are ultra Cuties, Mr)
ultrasound, CT Venography, MR Venography
DVT meds - anticoagulants (you know 2, and the 3rd?)
Heparin gtt, enoxaparin (Lovenox), Coumadin