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NUR 195 > VD and Problems w/Peripheral Circulation > Flashcards

VD and Problems w/Peripheral Circulation Flashcards

1
Q

Peripheral artery disease is a result of?

A
  • atherosclerotic plaque
  • thromboemboli
  • trauma
  • infections
  • inflammation
  • vasospastic disorders
  • congenital
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2
Q

Peripheral artery disease is a manifestation of?

A

atherosclerosis

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3
Q

What is atherosclerosis?

A

a thickening/hardening of arteries

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4
Q

Atherosclerosis is a slow process that begins?

A

in early adulthood, most people do not know they have it

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5
Q

Assessment considerations for PAD?

A
  • brain
  • heart
  • kidneys
  • mesentery
  • limbs
  • frequently seen in DM and elderly patients
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6
Q

PAD causes:

A
  • partial or totally obstruction
  • lumen narrows
  • infraction
  • accusation of: lipid, calcium deposits, fibrous tissue, stenosis, thrombosis
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7
Q

Who is at risk for PAD?

A
  • tabacco * big factor
  • family
  • age 70
  • obesity
  • HTN
  • HLD
  • DM
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8
Q

PAD asymptomatic/ symptomatic manifestations:

A
  • pain in distal muscle groups: worse when walking
  • ulcers
  • numbness/tingling
  • hairloss
  • pallor
  • cool to touch
  • no pulse
  • paralysis
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9
Q

PAD structural changes:

A
  • hair loss distal to the occlusion
  • thick opaque nails
  • shiny dry skin
  • skeletal muscle atrophy
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10
Q

PAD skin color changes:

A
  • pallor with elevation

- dependent rubor

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11
Q

PAD pulse changes:

A
  • diminished or absent blew area of stenosis/obstruction

- cool extremity distal to occlusion

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12
Q

PAD sensation changes:

A
  • paresthesia: numbness/tingling
  • ulcerations
  • gangrene
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13
Q

With rubor the blood vessel cannot?

A

constrict they stay dilated.

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14
Q

Intermittent claudication is a hallmark symptom for PAD and is?

A

limping pain

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15
Q

What is it when the arterial occlusions develop gradually, and there is less risk of sudden death b/c this ______ ______ may develop.

A

collateral circulation

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16
Q

Over time with collateral circulation continued decreased perfusion results in?

A

ischemia and tissue death

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17
Q

DX of PAD:

A
  • doppler
  • ultrasonography
  • magnetic resonance angiography (MRA)
  • CT
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18
Q

An MRA is able to?

A

isolate blood vessels and vein in 3D

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19
Q

Treatment of PAD:

A
  • thrombolysis
  • percutaneous
  • cilostazeol (aspirin)
  • bypass graft
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20
Q

What is thrombolysis?

A

a thrombolytic agent injected directly into thrombosis to lyse the clot

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21
Q

What is percutaneous?

A
  • angioplasty: balloon expanded stenosis
  • stent placement: assess perfusion/pain
  • bypass graft: rerouting blood flow
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22
Q

Nursing management of PAD:

A
  • pain relief
  • maintain tissue integrity
  • tabacco cessation
  • stress reduction
  • avoid hot temperature
  • avoid constrictive clothing
  • avoid crossing legs
23
Q

Six P’s for acute arterial occlusion:

A
  • pain
  • pallor
  • pulselessness
  • poiikilothermia (cool temp)
  • paresthesia
  • paralysis
24
Q

_______ is vasospasm causing vasoconstriction, and occurs with cold or stress?

A

raynauds syndrome

25
Q

_____ _____ is when blood vessel become inflamed, swell, and become blocked (thrombi).

A

buergers disease

26
Q

Burgers disease puts you at risk for?

A
  • infection

- gangrene

27
Q

Abdominal aortic aneurysm (AAA) is a?

A

localized out pouching sac dilation formed on the arterial wall.

28
Q

AAA is a result of?

A
  • atherosclerotic plaque
  • trauma
  • disease
  • congenital
29
Q

Risk factors for AAA:

A
  • genetic basis

- HTN

30
Q

AAA grows an average of?

A

0.4 cm/year

31
Q

Clinical manifestations of AAA:

A
  • some people may not have any
  • feeling there heart beat in their abdomen when lying down
  • report feeling an abdominal mass or abdominal throbbing
  • mottling of toes
  • IMPENDING RUPTURE: severe pain pain or abdominal pain, persistent of intermittent, often midline
  • Rupturing anerysm: constant, intense back pain, falling BP, decreasing hematocrit
  • MOST IMPORTANT INDICATION: pulsating mass in the abdomen, also systolic bruit may be heard of mass
32
Q

What is the MOST IMPORTANT indication for AAA:

A

pulsating mass in the abdomen.

33
Q

DX of AAA:

A
  • ultrasonography

- CT

34
Q

Treatment of AAA:

A
  • observation
  • monitor BP
  • education
  • anti-hypertensives
  • surgery
35
Q

AAA can be confused with?

A

MI

36
Q

For AAA ultrasound every 6 months and monitor BP is small but if larger than?

A

5.5 cm or significantly enlarging surgical intervention is required.

37
Q

Nursing management for AAA:

A
  • education r/t diet, smoking, meds
38
Q

Postop considerations for AAA:

A

bleeding, circulation, neuro changes, pain management

39
Q

Venous thrombosis is?

A

formation of blood clot in the venous system

40
Q

People at risk for DVT:

A
  • stasis of blood
  • vessel wall injury
  • hormone therapy
  • smoking
  • dehydration
  • varicose veins
41
Q

Manifestations of DVT:

A
  • pain
  • swelling/edema
  • increase in tempature
  • larger leg
  • gray brown skin
42
Q

DX of DVT:

A
  • D dimer
  • ultrasonography
  • MRA
43
Q

a d dimer that is positive:

A

clots when lyse

44
Q

Treatment of DVT:

A
  • heparin
  • warfarin
  • thrombotic therapy
  • surgery
45
Q

Goal for patients with DVT of warfarin:

A
  • INR 2 to 3
  • with heart valve INR 2.5 to 3.5
  • check INR every month
46
Q

heparin does not dissolve a clot that is?

A

already formed.

47
Q

aPTT for heparin:

A

21 - 35 sec

48
Q

Venous Ulceration complication:

A

cellulitis/dermatitis may complicate healing

49
Q

Venus ulcers develop as a result of?

A

increased venous pressure or external trauma

50
Q

Venous ulcerations cause the skin to be?

A

dry, cracked and pruritic

51
Q

Treatment of venous ulceration?

A
  • dressing for debridement
  • hyperbaric oxygenation
  • compression
52
Q

With PAD venous ulceration develops as a result of

A

ischemia and may lead to gangrene

53
Q

Treatment of ulceration

A

keep dry and usually not debriefed until revascularization procedures are performed.

NUR 195 (13 decks)

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