Week 7 Flashcards
How doe we measure flow rate?
Flow rate = pressure difference/resistance
What are you assessing for with (PAD) Peripheral Arterial Disorder? List 5
- intermittent claudication
- absent or diminished pulses
- oedema- none or minimal
- skin changes= cold/dry/shiny/thick opaque toe nails
- pallor when elevated
- red when dangling
- ulcers
What are you assessing for with (PVD) Peripheral Venous Disorders? List 3
- pain= aching cramp like that is relieved by activity or elevation
- pulses usually present
- oedema=present/increases by the end of the day
- skin changes
- ulcers
What is intermittent claudication?
pain caused by the inability of the arterial system to provide adequate blood flow to the tissue of face of increased demands for nutrient during exercise.
- muscular cramping (ischaemic) type pain that usually resolves within 10 minutes of rest.
- caused by arterial supply failure.
- lack of blood supply of oxygen/nutrients when increase in demand
Where is the most common site for atherosclerotic obstruction?
Most common place for atherosclerotic obstruction to occur is in the Illiac and common femoral arteries.
List 5 modifiable risk factors for PAD.
- smoking
- diet
- hypertension
- hyperlipidaemia
- diabetes
- obesity
- stress
- sedentary lifestyle
- c-reactive protein (inflammation)
- hyperhomocysteinemia (clotting factor)
List at least 2 non modifiable risk factors for PAD?
- age
- gender
- genetics
List 2 complications that can occur with PAD.
- Atrophy of skin/nerves/muscles
2. Delayed healing/wound necrosis/infection/gangrene
What is an Arterial Aneurysm?
An aneurysm is a localised sac or dilation formed at a weak point in the wall of the aorta.
-it causes a ballooning effect in the blood vessel.
Explain the nursing process of an assessment on a pt with PAD?
-health hx =medications, risk factors
-clinical manifestations of arterial insufficiency =
claudication and rest pain, colour changes, weak and absent pulses, skin changes and skin breakdown
-arterial/venous/lymphatic (medical) diagnosis made
What type of nursing care would we be implementing with a pt who has altered tissue perfusion?
- Exercise and activities:
- walking (stop with pain-gradually increase tolerance)
- graded isometric exercises (promotes circulation and development of collateral circulation)
- specialist advice before commencement (contraindication include leg ulcers/cellulitis/thrombotic occlusions)
- Position strategies
- Temperature
- effects of heat (vasodilation) or cold (avoid)
- Stop smoking
- Stress reduction (counselling)
What would we be trying to plan for with a pt with altered tissue perfusion?
- increase arterial blood supply (dependant on what stage they are at)
- promote vasodilation
- prevent vascular compression
- pain relief management
- attainment or maintenance of tissue integrity
- adherence to self-care programme
Due to poor nutrition and oxygen supply the extremities are susceptible to injury/infection/poor healing in people who suffer from altered peripheral tissue perfusion. What nursing interventions would we try to implement to counteract this?
- protection of extremities and avoidance of trauma
- good hygiene/gentle soap/moisturisers
- regularly inspecting the extremities for infection and inflammation
- podiatric care (footwear and nail care)
- not wearing constricting clothing
- good nutrition (weight reduction if necessary)
- stop smoking
- pt education
what nursing management would we performing on a pt who has undergone peripheral arterial bypass graft?
- vital signs
- neurovascular obs (pulses)
- graft patency obs(doppler)
- ABI (ankle brachial index) performed 8hrly
- IDC (1hrly measures)
- complex invasive line care
- wound care (bleeding/haematoma)
- elevation of extremity/ gently exercise
- graduated compression stockings
- analgesia
- discharge advice/pt education
- care of co-morbidities
what is an arterial aneurysm?
an aneurysm is a localised sac or dilation formed at a weak point in the wall of the aorta.
