week 4 module 13 peripheral vasculature Flashcards
vascular disease HPI
pain or cramps swollen extremities extremity fatigue, restless non-healing wounds erectile dysfunction travel or immobilization high altitude hypercoagulable state recent injury or surgery
PMH vascular disease
meds - CCB - oral contraceptive cardiac or peripheral disease vasculitis or vasospastic chronic illnesses - clotting disease - heart disease - dyslipidemia - aortic aneurysm
FH vascular disease
peripheral vascular disease
abdominal aortic aneurysm
leg pain/cramps HPI
onset and duration: with activity or rest?
cont. burning in toes, pain in thighs/butt
skin changes: cold, pallor, darkened, redness/warmth
swelling
limping
vascular disease infants and children
hemophilia sickle cell renal disease coarctation of the aorta leg cramps during exercise
vascular disease and preg
Blood pressure
- preeclampsia
– HA, vision changes, N/V, epigastric pain, RUQ pain
– oliguria, rapid onset edema, hyperreflexia, proteinuria,
Legs
- edema, varicosities, pain or discomfort
risk factors for preeclampsia
older than 40 first preg preexisting HTN renal disease DM multifetal gestation FH of preeclampsia previous preeclampsia obesity
vascular disease and older adults
leg edema: pattern, freq. time of day interference with ADL ability of pt and family to cope claudication: area involved, uni/bilateral, distance one can walk before onset, sensation, length of time required for relief medications
vascular disease and personal/social hx
employment tabacco use wt exercise age standing/sitting for long periods
inspection of extremities
pallor, cyanosis, or erythema
collapsed or engorgement of superficial veins
atrophied skin/nails and loss of hair
palpate arterial pulses
amplitude
- 4: bounding
- 3: full, increased
- 2: expected
- 1: diminished, barely palpable
- 0: absent, not palpable
PAD
dull ache with muscle fatigue/cramps with sustained exercise.
- walking/stairs
- a few minutes of rest relieves it
occulsion 3 P’s
pain
pallor
pulselessness
types of PAD
stenosis or atherosclerosis aneurysm vasculitis vasospastic raynauds
claudication
pain that results from muscle ischemia
arterial disease and location of pain calf
superficial femoral artery
arterial disease and location of pain thigh
C femoral, external iliac
arterial disease and location of pain buttock
C iliac or distal aortic
Arterial disease S/S
pain diminished pulses ulcers skin color/temp: cool and pale dec. cap refill time
3 type of veins
superficial
deep
penetrating: connects superficial and deep
venous inspection of sufficiency
color temperature: warmth skin texture nail changes presence of hair muscular atrophy edema or swelling: pitting varicose veins venous ulcers
venous obstruction Homans sign
cal pain with dorsiflexion of the foot
older adults
arteries calcify
arterial walls lose elasticity and tone
superficial vessels become more prominent
inc. peripheral vascular resistance -> inc. BP
dec. perfusion
infants bounding pulse
associated with a large left to right shunt
- PDA
coarctation of aorta vasculature findings
difference noted in pulse amplitude between the upper extremities or between the femoral and radial pulses
or femoral pulses absent
infant weak pulse
cardiac output may be diminished or peripheral vasoconstriction may be present
