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29 Cards in this Set
- Front
- Back
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Give an example of a chronic arterial disease/disorder
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Peripheral Atherosclerosis
The primary sites of involvement are the femoral (groin) and peripheral sites (behind the knee) |
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What is atherosclerosis
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A form of arteriosclerosis
Deposits of fat and fibrin obstruct and harden the arteries-Impairs peripheral blood supply Causes peripheral vascular disease PVD. |
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Names some factors that lead to chronic arterial disease
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Nonmodifiable - heredity, sex/gender, race (African Americans), aging
Modifiable - cigarette smoking, HTN, diabetes Diabetes Cholesterol Obesity Lack of exercise Stress |
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What is intermittent claudication?
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Occurs with chronic arterial dsease
- muscle pain below point of occlusion -caused by tissue hypoxia and lactic acid accumulation -described as gnawing, burning, cramp-like -may be relieved by rest or dependency |
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What will you assess if you suspect chronic arterial diseease
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Weak/absent pulses.
6 Ps Bruit-hum or swish, rubor Thickened, yellowish, discolored nails, Skin - non-healing sores; lack of hair on legs, dry skin. |
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Names some nursing Dxs for chronic arterial disease
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Impaired tissue perfusion
High risk for injury Activity intolerance Knowledge deficit |
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Name some rmodifiable risk factors for chronic arterial disorders
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Exercise and smoking cessation
Exercise until pain then stop and rest until pain stops, then start exercising again |
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When is amputation used for treating chronic arterial disease?
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Amputation -last resort
save as much of limb as possible usually for severe necrosis or infection |
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What is acute arterial occlusion and what is the most common cause?
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Group of diseases that result in occlusion of the branches of aorta and arteries. Atherosclerosis (AS) is the most common cause
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What are the S/S of acute arterial occlusion? Name some nursing Dx for acute arterial occlusion?
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1. Sudden onset of pain coldness, numbness.
2. Muscle weakness 3. Decreased or absent pulses 4. Skin is cool to touch Ndx Impaired tissue perfusion High risk for injury Activity intolerance |
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How is an acute arterial occlusion treated?
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Emergency
Skeletal muscle may survive 6-8 hours TPA therapy (anti clotting: tissue plasminogen activator) Arterial Bypass |
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What meds generally are orderd for acute arterial occlusion?
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Fibrinolytics
-Dissolve clot -IV or arterial -monitor for infiltration and bleeding -followed up with heparin or coumadin |
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What is thrombophlebitis and deep vein thrombosis (DVT)
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Thrombus formation with inflammation of veins.
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Name some risk factors for DVT
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Previous History
Pregnancy Polycythemia (over abundance of RBCs) Obesity Immobility Varicosities |
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What are the S/S of DVT
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Localized, deep, aching, throbbing, pain
vein redd and warm |
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What are some diagnostic tests for DVT?
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Ultrasonography: duplex ultrasound
Ascending contrast venography (Gold standard for diagnosis DVT) |
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How can DVT be prevented?
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Early ambulation and leg exercises
Support hose avoid position that promotes stasis |
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Name some nursing interventions for DVT
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Bedrest (4-10 days)
ROM to unaffected extremity elevate extremity (avoid acute hip flexion) Moist heat anticoagulation meds measure calf Do not rub or massage heparin therapy |
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What is hypertensive crisis? (formerly called Malignant Hypertension)/
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rapid onset
Systolic pressure > 220-240 mm Hg diastolic pressure >120-130 mm Hg |
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What are the S/S of malignant ypertension
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dyspnea, angina, tachycardia, ocular fatigue (eyes tired), occipital headaches, drowsiness
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Which populations are most at risk for malignant hypertension
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Younger people
African Americans Pregnant women Underlying collagen and or renal disease |
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How is malignant hypertension managed
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ICU
IV antihypertensive Danger: intracranial bleeding, MI, CHF |
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What is an aneurysm?
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Acute life-threatening condition
Abnormal localizedvessel dilation caused by a weakness of arterial wall. May allow stasis of blood and thrombus formation Most commonly located in aorta (greatest pressure) |
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What are the S/S of an aneurysm?
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Most are asymptomatic
Vague abd discomfort described as throbbing. Pulsating sensation in abdomen when lying could occur If complaining of sharp, tearing ack pain, suspect rupture |
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What is the most common cause of aneurysms?
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Uncontrolled hypertension most common cause
Involves hemorrhage into vessel wall Acute life-threatening condition |
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What are the S/S of a dissecting aneurysm?
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Location dependent
Excruciating chest//back pain Ripping or tearing Early BP may be increased then drops rapidly may palpate pulsatile mass Auscultate systolic bruit Sx of hemorrhage (tachycardia, pallor, diaphoresis) |
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How are aneurysms treated?
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Control BP
Surgical intervention Elective surgery 5% mortality Ruptured and then OR 50-75% mortality |
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What are the priority nursing interventions when caring for a patient with an aneurysm?
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Monitor for bleeding, infection, arterial occlusion
Assess pedal pulses with VS Antiembolism stockings Extend and dorsiflex feet Monitor cardiac status and urine output |
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Name some nursing diagnoses for an aneurysm
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High risk for injury
Pain Ineffective breathing pattern Bowel elimination |
