Vascular Problems

Question 1

Arteriosclerosis

Answer 1

Thickening/hardening of arterial wall that is often associated with aging.

Question 2

Atherosclerosis

Answer 2

Type of arteriosclerosis that involves formation of plaque within the arterial wall.

*Leading risk factor for cardiovascular disease.

Question 3

Arterio- Atherosclerosis Risk Factors:

Answer 3

*Older adults
*African American or Hispanic
* Sedentary
* Genetics
*Low HDL
*High LDL
*Increased Triglycerides
*Diabetes
*Obesity
*Smoking
*Stress

Question 4

Arterio- Atherosclerosis Labs:

Answer 4

• Total Serum Cholesterol (lower better)
  *LDL Cholesterol (lower better)
  *HDL Cholesterol (higher better)

Question 5

Arterio- Atherosclerosis Treatment:

Answer 5

Statins: Reduce cholesterol synthesis in liver and increase clearance of LDL from blood.

Question 6

Peripheral Artery Disease

Answer 6

Chronic condition occurring w/ partial or total arterial occlusion which causes decreased perfusion to lower extremities.

Question 7

PAD Risk Factors:

Answer 7

*Atherosclerosis: makes it difficult for blood to flow to extremities.

Question 8

PAD Interventions:

Answer 8

*Exercise
*Positioning
*Promote Vasodilation
*Drug Therapy: Antiplatelets, hematologies agents.
*Blood Pressure Control
*Surgical: Arterial Revascularization.
*Invasive Nonsurgical Procedures: Percutaneous transluminal angioplasty, atherectomy.

Question 9

PAD Diagnostic:

Answer 9

Magnetic Resonance Angiography: Assesses blood flow in peripheral arteries.

Question 10

Acute Peripheral Arterial Occlusion:

Answer 10

Occlusions caused by emboli or thrombi and may be sudden and dramatic.

*More common in lower extremities.

Question 11

Acute Peripheral Arterial Occlusion CM:

Answer 11

*Cold
*Cool
*Pulseless
*Mottled Affect Extremity
*6 P’s: Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia.

Question 12

Acute Peripheral Arterial Occlusion Treatment:

Answer 12

*Anticoagulant Therapy: Heparin
*Embolectomy or Thrombectomy

Question 13

Aneurysm:

Answer 13

Permanent localized dilation of an artery which enlarges the artery to at least two times its normal diameter.

Question 14

Aneurysm Types:

Answer 14

1. Abdominal Aortic Aneurysm (AAA)
2. Thoracic Aortic Aneurysm (TAA)

Question 15

AAA CM:

Answer 15

*Abdominal, flank, or back pain
*Prominent pulsation in upper abdomen

Question 16

AAA Risk Factors:

Answer 16

*Atherosclerosis
*Hypertension
*Hyperlipidemia
*Smoking

Question 17

Aneurysm Diagnostic:

Answer 17

CT Scan

Question 18

Aneurysm Interventions:

Answer 18

*Nonsurgical: Monitor and BP at normal level to decrease risk of rupture.
*Surgical: Aneurysmectomy

Question 19

Venous Thromboembolism:

Answer 19

Comprises deep vein thrombosis (DVT) and pulmonary embolism (PE).

Question 20

Deep Vein Thrombosis:

Answer 20

Involves a thrombus (blood clot in one location).

Question 21

Pulmonary Embolism:

Answer 21

Involves an embolus (clot that has moved from one location to another).

Question 22

VTE Risk Factors:

Answer 22

*Virchow’s Triad: Stasis of blood, vessel wall injury, altered blood coagulation.

Question 23

VTE Prevention:

Answer 23

*Education
*Leg Exercises
*Early Ambulation
*Hydration
*Compression Stockings
* SCDs
*Avoid oral contraceptives
*Anticoagulant Therapy

Question 24

DVT CM:

Answer 24

*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.

Question 25

DVT Diagnostic:

Answer 25

*Venous Duplex Ultrasound
*Negative D-dimer Test: Can exclude DVT - used for diagnosis when pt has few clinical signs.

Question 26

DVT Interventions:

Answer 26

*Observe for symptoms of PE: SOB, chest pain, acute confusion.
*Elevate Legs
*Drug Therapy: Anticoagulants (heparin, enoxaparin, warfarin).

Question 27

DVT Treatment: Warfarin

Answer 27

*Oral
*Monitor: PT, INR, signs of bleeding.
*Antidote: Vitamin K
*Education: Avoid foods high in vitamin K (dark leafy greens).

Question 28

VTE Treatment: Low Molecular Weight Heparin (LMWH)

Answer 28

*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.