Week 7 - Vascular disorders and problems of circulation Flashcards
What is the function of the vascular system?
To meet the circulatory needs of the tissues.
How does it work?
Blood flows from high pressure areas to low pressure.
From arterial to venous.
Peripheral flow rate is affected by:
- Haemodynamic resistance: blood viscosity, vessel diameter
- Regulation of peripheral vascular resistance: e.g. vasoconstriction
- Movement of fluid across the capillary wall: hydrostatic & osmotic force, metabolic needs.
Peripheral Arterial Disorders (PAD), clinical manifestations:
- Intermittent claudication
- Pulses diminished or absent
- Oedema - none/minimal
- Skin changes
Peripheral Venous Disorders (PVD), clinical manifestations:
- Pain: aching to cramp like relieved by activity/elevation
- Pulses usually present
- Oedema - present/
- Skin changes
Intermittent Claudication - Signs & symptoms
• Muscular/cramping (ischaemic) type pain
- precipitated by exercise, resolves within 10 mins of rest.
- Must be reproducible.
Intermittent Claudication - Causes
- Lack of blood supply of O2/nutrients when increased demand
* Caused by arterial supply failure
Peripheral Arterial Disease (PAD) - Causes
- Atherosclerosis (accumulation of plaque)
* Arteriosclerosis (hardening of arteries)
Peripheral Arterial Disease - nursing diagnoses
- Altered peripheral tissue perfusion
- Chronic pain
- Risk for impaired skin integrity
- Knowledge deficient
Nursing interventions for Altered Peripheral Tissue Perfusion
- Protection of extremities and avoidance of trauma
- Good hygiene - moisturisers
- Reg. inspection of extremities
- Podiatric care
- Good nutrition
- Weight reduction
What is an aneurysm?
An aneurysm is a localised sac or dilation formed at a weak point in the wall of the aorta (or any artery really).
Risk factors for Venous thromboembolism - DVT
- Venous stasis (HF, paralysis). 2. Venous endothelial damage (trauma).
- Hypercoagulability of the blood (smoking/the Pill). 4. Age. 5. Pregnancy.
DVT pathophysiology
RBCs/WBCs/platelets/fibrin clump together to form a thrombus.
Drug therapy for DVT
• Unfractionated heparin (sodium heparin) IV infusion
• LMW heparin (enoxaparin).
Minimise venipuncture (pressure 10 mins+ after injection)
Anticoagulant Drugs
- heparin • dalteparin & enoxaparin (LMWHs)
* warfarin