Vascular Problems Flashcards
Arteriosclerosis
Thickening/hardening of arterial wall that is often associated with aging.
Atherosclerosis
Type of arteriosclerosis that involves formation of plaque within the arterial wall.
*Leading risk factor for cardiovascular disease.
Arterio- Atherosclerosis Risk Factors:
*Older adults
*African American or Hispanic
* Sedentary
* Genetics
*Low HDL
*High LDL
*Increased Triglycerides
*Diabetes
*Obesity
*Smoking
*Stress
Arterio- Atherosclerosis Labs:
- Total Serum Cholesterol (lower better)
*LDL Cholesterol (lower better)
*HDL Cholesterol (higher better)
Arterio- Atherosclerosis Treatment:
Statins: Reduce cholesterol synthesis in liver and increase clearance of LDL from blood.
Peripheral Artery Disease
Chronic condition occurring w/ partial or total arterial occlusion which causes decreased perfusion to lower extremities.
PAD Risk Factors:
*Atherosclerosis: makes it difficult for blood to flow to extremities.
PAD Interventions:
*Exercise
*Positioning
*Promote Vasodilation
*Drug Therapy: Antiplatelets, hematologies agents.
*Blood Pressure Control
*Surgical: Arterial Revascularization.
*Invasive Nonsurgical Procedures: Percutaneous transluminal angioplasty, atherectomy.
PAD Diagnostic:
Magnetic Resonance Angiography: Assesses blood flow in peripheral arteries.
Acute Peripheral Arterial Occlusion:
Occlusions caused by emboli or thrombi and may be sudden and dramatic.
*More common in lower extremities.
Acute Peripheral Arterial Occlusion CM:
*Cold
*Cool
*Pulseless
*Mottled Affect Extremity
*6 P’s: Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia.
Acute Peripheral Arterial Occlusion Treatment:
*Anticoagulant Therapy: Heparin
*Embolectomy or Thrombectomy
Aneurysm:
Permanent localized dilation of an artery which enlarges the artery to at least two times its normal diameter.
Aneurysm Types:
- Abdominal Aortic Aneurysm (AAA)
- Thoracic Aortic Aneurysm (TAA)
AAA CM:
*Abdominal, flank, or back pain
*Prominent pulsation in upper abdomen
AAA Risk Factors:
*Atherosclerosis
*Hypertension
*Hyperlipidemia
*Smoking
Aneurysm Diagnostic:
CT Scan
Aneurysm Interventions:
*Nonsurgical: Monitor and BP at normal level to decrease risk of rupture.
*Surgical: Aneurysmectomy
Venous Thromboembolism:
Comprises deep vein thrombosis (DVT) and pulmonary embolism (PE).
Deep Vein Thrombosis:
Involves a thrombus (blood clot in one location).
Pulmonary Embolism:
Involves an embolus (clot that has moved from one location to another).
VTE Risk Factors:
*Virchow’s Triad: Stasis of blood, vessel wall injury, altered blood coagulation.
VTE Prevention:
*Education
*Leg Exercises
*Early Ambulation
*Hydration
*Compression Stockings
* SCDs
*Avoid oral contraceptives
*Anticoagulant Therapy
DVT CM:
*Tenderness or pain in calf or groin
*Sudden unilateral swelling of one leg
*Induration along blood vessel
*Warmth, edema, redness
*Homan’s Sign: Pain behind knee during dorsiflexion.
DVT Diagnostic:
*Venous Duplex Ultrasound
*Negative D-dimer Test: Can exclude DVT - used for diagnosis when pt has few clinical signs.
DVT Interventions:
*Observe for symptoms of PE: SOB, chest pain, acute confusion.
*Elevate Legs
*Drug Therapy: Anticoagulants (heparin, enoxaparin, warfarin).
DVT Treatment: Warfarin
*Oral
*Monitor: PT, INR, signs of bleeding.
*Antidote: Vitamin K
*Education: Avoid foods high in vitamin K (dark leafy greens).
VTE Treatment: Low Molecular Weight Heparin (LMWH)
*Preferred treatment
*Assess Signs of Bleeding: Hematuria, blood in stool, eccymosis, petechiae, altered LOC, pain.
*Antidote: Protamine Sulfate
*Treating DVT or PE: May overlap w/ enoxaparin and warfarin the client can self-administer at home.
