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XIO > vascular disorders - aorta > Flashcards

vascular disorders - aorta Flashcards

1
Q

aorta details

A

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

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2
Q

Most common vascular problems of aorta (3 of them)

A

Aneurysms
Aortoiliac occlusive disease
Aortic dissection

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3
Q

Aneurysms

A

Localized sac (outpouching) or dilation formed at a weak point in the wall of the artery

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4
Q

Aneurysms classified by (aneuysms shape ppl)

A

its shape or form

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5
Q

aneurysms increase with

A

age

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6
Q

AAA - where do they occur? And mostly below what arteries?

A

¾ occur in abdominal aorta
¼ occur in thoracic aorta
Most occur below renal arteries
The larger the aneurysm, the greater the risk

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7
Q

AAA patho (triple A is dilated)

A

Dilated aortic wall becomes lined with thrombi that can embolize
Leads to acute ischemic symptoms in distal branches

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8
Q

AAA causes (Triple a degrades from birth due to mechanics, trauma, inflammation or infection

A

Degenerative
Congenital
Mechanical
Penetrating or blunt trauma
Inflammatory
Infectious

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9
Q

AAA risk factors (triple A is male)

A

Age
Male gender
HTN
CAD

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10
Q

AAA clinical manifestations (opposite of what you think)

A

Often asymptomatic
Frequently detected during a routine physical exam or when patient is examined for an unrelated problem (KUB, abdominal CT scan)

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11
Q

AAA complications - rupture into retroperitoneal space

A

Bleeding may be tamponaded by surrounding structures, thus preventing exsanguination and death.

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12
Q

AAA xrays - chest (Triple A’s x-ray is wide)

A

Chest –demonstrate mediastinal silhouette and any abnormal widening of thoracic aorta

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13
Q

AAA ECG used to rule out what?

A

ECG to rule out MI

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14
Q

AAA echocardiography (triple A echoes in the valve)

A

Assists in diagnosis of aortic valve insufficiency

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15
Q

AAA ultrasonography monitors what? (ultra sound for baby’s size)

A

Useful in screening
Monitors size

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16
Q

AAA CT scan (Triple A needs a cutie for cross-section)

A

Most accurate to determine anterior-posterior length and cross-sectional diameter, presence of thrombus, type of surgery

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17
Q

AAA MRI (Mr, I need Triple A to locate the severity of the crash)

A

diagnose and assess location and severity

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18
Q

AAA angiography (Angie can provide valuable info to triple A)

A

Can provide accurate information about involvement of intestinal, renal or distal vessels

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19
Q

AAA If ruptured

A

emergent surgical intervention is required
90% mortality

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20
Q

AAA - pre op

A

Preop routines; bowel prep, NPO, shower. IV antibiotic (usually keflex) prior to incision

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21
Q

AAA Expectations after surgery - what meds? (Triple A before Beta B)

A

PACU, tubes, drains, ICU, beta blocker

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22
Q

AAA - Postoperative Nursing - how long in the ICU?

A

Postoperative Nursing
ICU monitoring 48 hours

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23
Q

AAA - Discharge teaching - what about ambulation?

A

Increase ambulation
No heavy lifting or staining
Teach about signs and symptoms of complications
Infection
Neurovascular changes

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24
Q

Venous thromboembolism (VTE) - where are they?

A

Venous thromboembolism (VTE) condition
Blood clots form in the deep veins of the leg,, groin or arm

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25
Q

Leg ulcers

A

Arterial
Venous
Mixed and other

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26
Q

varicose veins

A

valves give out, genetics and weight. painful.

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27
Q

venous disorders - Caused by Virchow’s triad (the end of virtue is hyper or stasis)

A

2/3 must be present
Endothelial injury
Venous Stasis
Hypercoagulability

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28
Q

venous stasis - causes (As you age with afib, HF, and obesity you become stasis)

A

Advanced age, a fib, chronic HF, obesity

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29
Q

endothelial damage - causes - what types of surgeries? (just stay around the abdomen)

A

Abdominal/pelvic surgery

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30
Q

hypercoagulability causes - what about thrombin?

A

Antithrombin II deficiency, smoking

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31
Q

DVT signs and symptoms (PEEW, it’s a DVT)

A

Erythema, edema, warmth
Pain

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32
Q

DVT complications

A

PE
Chronic venous insufficiency
Phlegmasia cerulea dolens (rare)
Swollen, blue, painful leg

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33
Q

labs for DVT (don’t forget on a dime)

A

Coags, platelets, H & H, d-dimer

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34
Q

tests for DVT (DVT tests are ultra Cuties, Mr)

A

ultrasound, CT Venography, MR Venography

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35
Q

DVT meds - anticoagulants (you know 2, and the 3rd?)

A

Heparin gtt, enoxaparin (Lovenox), Coumadin

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36
Q

DVT surgical treatment (DVTs can be removed or filtered)

A

Venous thrombectomy
Inferior vena cava (VC) filter
Filters clots

37
Q

how to prevent DVT

A

early ambulation, leg exercises, graduated compression stockings, intermittent pneumatic compression devices, Subcutaneous heparin (unfractionated) LMWH
Fondaparinux, Lifestyle changes
Weight loss
Smoking cessation
Regular exercise

38
Q

DVT nursing management

A

Pregnancy
Obesity
Central lines , PICC, PIV

39
Q

highest risk for DVT

A

A 25-year-old patient with a central venous catheter in place to treat septicemia - it’s the sepsis

40
Q

chronic veinous insufficiency - causes (chronic bad veins are from Valves, veins, birth or fists)

A

Damaged valves
Deep vein obstruction
Congenital venous malformation
AV fistula

41
Q

chronic veinous insufficiency complications - just one, you know it.

A

ulcers

42
Q

chronic veinous insufficiency - appearance (veins are itchy leather) Think of the patient

A

Brownish, leathery, itchy skin

43
Q

chronic veinous insufficiency prevention (same as the others)

A

Avoid standing for prolonged periods
Use of compression stocking or TED hose
Ambulation/Exercise
Good skin care –inspection and moisturizer
Avoid trauma

44
Q

chronic veinous insufficiency diet - think infection

A

Diet
Increase protein intake (if medically safe)
Vitamin A & C
Zinc
albumin is ok

45
Q

chronic veinous insufficiency education - and what about extremities?

A

keep skin hydrated, don’t bump into anything, avoid standing for long periods, elevate the extremity, use compression if possible,

46
Q

assessment of pt with leg ulcers

A

History of the condition
Assess pain, peripheral pulses, edema
Treatment depends on the type of ulcer
Assess for presence of infection
Assess nutrition

47
Q

neurovascular assessment - 5 Ps

A

pain, pulse, pallor, paresthesia, paralysis

48
Q

leg ulcer medical management - compression?

A

Anti-infective therapy depends on the infecting agent
Oral antibiotics are usually prescribed
Compression therapy
Debridement of wound
Dressings
Other

49
Q

leg ulcer nursing interventions - avoid what?

A

Restoring skin integrity
Cleansing wound; positioning; avoiding trauma; avoid heat sources

50
Q

leg ulcer nursing interventions - Improving physical mobility - can you walk?

A

Improving physical mobility
Physical activity initially restricted to promote healing; gradual progression of activity
Activity to promote blood flow; encourage patient to move about in bed and exercise upper extremities
Diversional activities
Analgesic agents before scheduled activities

51
Q

leg ulcer nursing intervetions diet

A

Promoting adequate nutrition
Protein; Vitamins C and A; Iron; Zinc

52
Q

buerger’s disease (burger smokes)

A

rare, progressive, inflammation and thrombus, almost only young men who smoke, toes and fingers turn blue symptoms include claudication, Raynaud’s , pain (often mistaken for joint/muscle pain

53
Q

varicose vein prevention - how often to walk and elevate leg and compression stockings?

A

Avoid activities that cause venous stasis (wearing socks that are too tight at the top or that leave marks on the skin, crossing the legs at the thighs, and sitting or standing for long periods)
Elevate the legs 3 to 6 inches higher than heart level
Encourage to walk 30 minutes each day if there are no contraindications
Wear graduated compression stockings
Overweight patients should be encouraged to begin weight reduction plans

54
Q

Lymphangitis - what causes it? (my gitis is obese)

A

inflammation or infection of the lymphatic channels - from surgery or obstruction, obese. painful. lymph fluid itself can get infected.

55
Q

Lymphadenitis (the dentist inflames me)

A

inflammation or infection of the lymph nodes

56
Q

Lymphedema - primary and secondary

A

tissue swelling related to obstruction of lymphatic flow
Primary: congenital
Secondary: acquired obstruction

57
Q

promote lymphatic drainage by (nymphs fly high)

A

Constant elevation of the affected extremity

58
Q

cellulitis

A

S&S: localized swelling or redness, fever, chills, sweating, pain
Treat with oral or IV antibiotics based on severity

59
Q

cellulitis nursing management - leg position and warm packs? (cellulitis elevated me)

A

Mark the cellulitis with a skin pen and date and time, then take a photo as per your agency’s policy
Elevate affected area 3 to 6 inches above heart level
Warm, moist packs to site every 2 to 4 hours
Educate regarding prevention of recurrence
Reinforce education about skin and foot care

60
Q

raynaud’s phenonmenon

A

Intermittent arterial vasoocclusion, usually of the fingertips or toes

61
Q

AAA risk factors (Grandma, butter and pads are risky)

A

Family history
High cholesterol
Lower extremity PAD

62
Q

AAA risk factors (Triple A in my carotid stroking me out)

A

Carotid artery disease
Previous stroke
Tobacco use
Being overweight or obese

63
Q

AAA - May mimic pain associated with…

A

abdominal or back disorders

64
Q

AAA - symptoms (Claud works for Triple A)

A

May cause back pain, epigastric discomfort, altered bowel elimination, intermittent claudication

65
Q

AAA - blue toe syndrome (Triple A makes me blue, spontaeously blue)

A

May spontaneously embolize plaque causing “blue toe syndrome”

66
Q

AAA rupture - symptoms

A

Severe back pain
May/may not have back/flank ecchymosis (Grey Turner’s sign)

67
Q

AAA Rupture into thoracic or abdominal cavity

A

Massive hemorrhage
Most do not survive long enough to get to the hospital

68
Q

AAA xrays - abdomen (Triple A has calcium on the xray)

A

Abdomen (KUB) =may show calcification within wall of AAA

69
Q

AAA post op - what to monitor? (the usual)

A

Neuro, cardia, resp function, Renal GI
FEN (fluid electrolytes nutrition)

70
Q

AAA post op - monitor graft for…

A

Pain control
Monitor graft patency
Infection
check LOC

71
Q

types of venousthromboembolisms (the veins in my embolus are DVT, SVT, and PE)

A

DVT and PE
SVT (superficial vein)

72
Q

causes of venousthromboembolisms (think venous, smoking and what else) cancers?

A

smoking, cancer, birth control, cancer in abdomen, ascities, liver disease

73
Q

endothelial damage - IVs?

A

caustic IV meds

74
Q

endothelial damage - fractures? (endothelial is down low)

A

pelvic, hip leg fractures

75
Q

endothelial damage - history of…(the end of you)

A

history of previous VTE, PICC or central line, IVDU, trauma

76
Q

hypercoaguability - (think thick blood)

A

dehydration, malnutrition, increased factor VIII or lipoprotein

77
Q

hypercoagulability - HMOSS is hyper (Moss on a mountain)

A

high altitude, malignancies, oral contraceptives, sepsis, severe anemia

78
Q

complications of DVT surgery (Davit has air when he migrates)

A

Air embolism, improper placement, filter migration , perforation of vena cava

79
Q

DVT nursing management - No mechanical prophylaxis for…

A

those with skin breakdown or limb ischemia due to PVD

80
Q

Contraindications for pharmacological DVT prophylaxis (think bleeding, that’s it)

A

Active or recent bleeding
Coagulopathy (INR > 1.5
Planned surgical procedure in next 6-12 hours
Thrombocytopenia (<50,000, sometimes < 100,000)
Bleeding disorders

81
Q

varicose veins - use stockings?

A

yes

82
Q

raynaud’s disease vs. raynaud’s syndrome (the disease is idiopathic)

A

Raynaud’s disease: primary or idiopathic
Raynaud’s syndrome: associated with other underlying disease such as scleroderma

83
Q

raynaud’s symptoms - don’t forget tingling

A

Manifestations: sudden vasoconstriction results in color changes, numbness, tingling, and burning pain

84
Q

raynaud’s brought on by what?

A

Episodes brought on by a trigger such as cold or stress
Occurs most frequently in young women
Protect from cold and other triggers. Avoid injury to hands and fingers

85
Q

AAA - ambulate or not after surgery?

A

Increase ambulation, don’t strain or lift

86
Q

venous stasis causes (this pregnancy and surgery are giving me static)

A

ortho surgery, pregnancy/postpartum, prolong immobility

87
Q

venous stasis causes (Static when I stroke my hair with varicose veins)

A

stroke, varicose veins

88
Q

chronic veinous insufficiency - where are ulcers located? Are they painful?

A

Ulcers usually above ankle
Ulcers are painful when swollen or infected

XIO (393 decks)

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