Vasculular disorder 2 Flashcards

1
Q

A dilated segment of an artery caused by weakness and stretching of the arterial wall; can be congenital or acquired

A

Aneurysms

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2
Q

s/s Aneurysms

A

Thoracic aneurysms usually have no symptoms, though some report deep, diffuse chest pain
If aneurysm puts pressure on the recurrent laryngeal nerve, patient may complain of hoarseness
Pressure on the esophagus may cause dysphagia
If superior vena cava compressed, edema of the head and arms
Signs of airway obstruction may be present if the aneurysm presses against pulmonary structures
Abdominal aneurysms may be palpated as a pulsating mass in the area slightly left of the umbilicus

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3
Q

complications

A

Rupture, thrombus formation that obstructs blood flow, emboli, pressure on surrounding structures

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4
Q

Medical and surgical treatment

A

Repair of aneurysms done by replacing the dilated segment of the artery with synthetic graft or, in some cases, by suturing or patching the defective area

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5
Q

Preoperative nursing care

A

It is important to document chronic conditions, such as emphysema or heart disease, that increase the risk of postoperative complications

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6
Q

Postoperative Nursing Care

Assessment

A

Monitor vital signs, hemodynamic status, renal function, and fluid balance. Inspect and palpate the extremities for color, warmth, and peripheral pulses

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7
Q

Acute, life threatening hemorrhage into vessel wall
A small tear in the intima permits blood to escape into the space between the intima and the media
Blood accumulates between the layers, causing the media to split lengthwise
The split may extend up and down the aorta, where it can occlude major arteries

A

Aortic Dissection

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8
Q

Thoracic Ascending: most common, most fatal Aortic Dissection
s/s

A

Signs & Symptoms: pain, unequal intensities of Rt carotid and Lt radial pulses, bradycardia, pericardial friction rub

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9
Q

Descending Thoracic:

s/s

A

Signs & Symptoms: pain (sharp, tearing b/w shoulder blades)

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10
Q

Transverse:Aortic Dissection

s/s

A

Signs & Symptoms: pain (sharp, radiating to shoulders), dyspnea, dry
cough, dysphagia, hoarseness

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11
Q

Pain described as

Aortic Dissection

A

“tearing” or “ripping” pain and will have

syncope spells

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12
Q

Generally Medical treatment

Aortic Dissection

A

immediate surgery

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13
Q

If no complications, patient managed with

Aortic Dissection

A

antihypertensives
and drugs to decrease the strength of cardiac contraction
Otherwise, affected area is replaced with a synthetic graft

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14
Q

A key aspect of postoperative care

Aortic Dissection

A

: keep blood pressure at lowest

possible level

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15
Q

Varicosities are dilated, tortuous, superficial veins, often the saphenous veins in the lower extremities
Dilation of the vessels results from incompetent valves in the veins
Classified as primary (only superficial veins affected) and secondary (characterized by deep vein obstruction

A

Varicose Vein Disease

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16
Q

Signs and symptoms Varicose Vein Disease

A

Oversized, discolored (purplish), and tortuous veins
Dull aching sensations when standing or walking; a feeling of heaviness in the affected legs; muscle cramps, especially at night; increased muscular fatigue in the affected area; and ankle edema

17
Q

Medical diagnosis

Varicose Vein Disease

A

Based on their appearance and duplex ultrasonography

18
Q

Medical and surgical treatment

Varicose Vein Disease

A
Avoid restrictive garments, prolonged standing or sitting, crossing the legs or knees, and injury to compromised areas 
Weight reduction
Support stockings
Sclerotherapy or laser therapy
Ligation and stripping
19
Q

Assessment

Varicose Vein Disease

A

Health history determines pain, edema, cramps, and muscle fatigue
Note family history of varicose veins
Patient’s occupation and usual activities
Physical examination: inspect the legs for color, edema, turgor, and capillary refill
Palpate the legs for tenderness

20
Q

Inflammation of the vein wall

A

Phlebitis

21
Q

Clot has formed at the site of inflammation within a vein

A

Thrombophlebitis:

22
Q

Presence of a thrombus in a vein as a result of stasis, deviation of the intima, or hypercoagulability

A

Phlebothrombosis

23
Q

Clot in a deep vein rather than in superficial

A

Deep vein thrombosis

24
Q

Risk factors

A

Prescribed bed rest
Surgery for people older than 40 years of age
Leg trauma resulting in immobilization from casts or traction
Previous venous insufficiency
Obesity
Use of oral contraceptives
Virchow’s Triad: 3 factors that contributes to venous thrombus formation 1.) stasis if of the blood; 2.) Damage to the vessel walls, and
3.) hypercoagulability… 2 of 3 must be present for thrombus formation

25
Q

Deep vein

Signs and symptoms

A

Edema, warmth, and tenderness at the area of compromise; positive Homans’ sign

26
Q

Superficial vessels

Signs and symptoms

A

Pain, redness, warmth, or tenderness in the affected area

27
Q

Medical and surgical treatment

Venous Thrombosis

A

Anticoagulant or thrombolytic therapy, or both
Patient teaching about the disease; ongoing assessment for pulmonary emboli; bed rest; elevation of the extremity; warm, moist soaks to the affected area; and antiembolism hose
Surgery considered when patient cannot receive anticoagulants or thrombolytic therapy or when high possibility of pulmonary emboli

28
Q

Culmination of long-standing pressure that stretches the

veins and damages the valves

A

Chronic Venous Insufficiency

29
Q

s/s Chronic Venous Insufficiency

A

Edema around the lower legs, pain, brownish skin discoloration (stasis dermatitis), and stasis ulcerations
Heaviness or dull ache in the calf or thigh
Skin temperature is cool, and nails are normal
Feet and ankles often cyanotic when in a dependent position

30
Q

Medical and surgical treatment

Chronic Venous Insufficiency

A

Compression
Elastic or compression stockings and pneumatic compression device
If patient has an ulcer, special dressings, systemic antibiotics, topical débriding agents such as Elase, and Unna boots
Hyperbaric oxygen therapy

31
Q

Assessment

Chronic Venous Insufficiency

A
Inspect the lower extremities for rubor and stasis dermatitis, palpate skin temperature, and determine the presence of pain in the affected extremityInterventions
Ineffective Tissue Perfusion 
Disturbed Body Image 
Risk for Infection 
Impaired Skin Integrity
32
Q

Acute inflammation of the lymphatic channels
The inflammation is the result of an infectious
process, usually caused by streptococcus

A

Lymphangitis

33
Q

s/s

Lymphangitis

A

Enlargement of the lymph nodes along the lymphatic channel
Tenderness as these nodes are assessed
Red streak from the infected wound extends up the extremity along the path of the lymphatics
Elevated temperature and chills

34
Q

Medical and surgical treatment

Lymphangitis

A

Antimicrobials
Abscess is incised to drain the suppurative material
Rest and elevation of the limb; warm, wet dressings; and elastic support hose

35
Q

Assessment

Lymphangitis

A

Inspect skin for open wounds, inflammation, and red streaks along the paths of lymphatic channels
Palpate lymph nodes in groin and underarm areas for enlargement

36
Q

Interventions

Lymphangitis

A

Analgesics, antimicrobials, and elevation of the extremity to reduce lymphedema
Application of warm, moist soaks to the infected areas
Elastic support hose