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60 Cards in this Set

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  • Back
classic symptom-cranping in the lower extramities
Arterial intermittent claudication
determined by the amount of docimented exercise that the pt can tolerate before pain actually occurs
progression of arterial occlusion
occurrs with exercise, relieved by rest
ischemic pain
persistant in forefoot when at rest..does not go away with rest,,when there is severe occlusion and ish.
rest pain
cool aple extremities, pallor with elevation, rubor with dependant positioning, cyanosis, shiny skin with brittle nails and hair loss
arterial insufficiancy
altered tissue perfusion
risk for inpaired skin integrety pain-due to insufficient o2
Nursing Dx=atrial insuff
aching cramping pain
diminished or absent pulses
pigmentation in gaitor area, skin thickened and tough, may be reddish blue, associated with dermatitis
pulses present, may be diffacult to palpate through edema
granulation tissue--beefy red to yellow in chronic long term ulcer
pale to black and dry gangrene
circular ulcer
deep ulcers, often involving joint space
superficial ulcers
warm enviornment, aviod cold, avoind hot, avoind restrictive clothing, don't cross legs, keep dependent, no smoking
Nursing interventions..promoting tissue perfusion
daily skin assess, gentle cleaning, moisturize, properly fitting shoes, protect feet-no barefoot, lose weaight, proper nutrition
maintaining skin integrety
increacing exercise tolerance-exercise develops collateral circu. slow progressive exercise 30-45 ROM
reducing pain
handheld doppler when pulsus are not palpable,
doppler flow studies
compares systolic BP of arm to BP of ankle, usually ratio of 1:0, if less then arterial insufficiancy is presesnt
ankle-brachial index-ABI
ultrasonic waves produce waveform with peaks and valleys, flattened waveform=obstruction
duplex ultrasound
treadmill 5 min or untill apin is disabling, ankle BP monitores
exercise testing
determine location and extent of disease, assess for contrast media uses contrast--allergies
maintain circulation through repair, VA and pulses frequently, color and temp, I+o, CVP, LOC, fluid imbalances, elevate legs, pressure dressings
Post op care after vascular procedures
smoking, HTN, diabetes, viruses, hyperlipidemia
endothelial injury...causes of artherosclerosis
platelets and monocytes aggragate at site, fatty streaks and fibrous plaques form, rupture causing thrombus
legs most oftern affected, severity depends on extent of obstructive lesions, confined to segments of aorta below renal arteries to popliteal art.
arterial occlusive disease
position below heart, exercise, postural exercise, sit in chair with feet flat on floor
improve arterial circulation
warmth with caution, stop smoking, stress managment, no cross legs, constrictive clothing, vasodialators, adrenergic blockers
promoting vasodialation
med that reduces blood viscosity
ASA, Persantine, Ticlid, Plavix
vasodialators, adenergic blocking agents, CCB, trental, anti-platelet, meds for DM, HTN
Meds for arterial occlusive disease
ADA-low fat, low cholesterol, because of artherosclorosis
diet for AOD
chronic tissue ish, gangrene, necrosis, last resort when med. intervention fails
tissue is dry, cold, and black
dry gangrene
after trauma with infection..very bad odor
moist gangrene
obstructive vascular disorder cause by recurring inflammation in arteries and veins
Buerger's Disease (Thromboangiitis obliterans)
localized, episodic, vasoconstriction of disorder of small arteries in hands and feet that cause temp and color changes
Raynaud's Disease
Thrombosis, embolisim, trauma, occurs suddenly nad w/o warning
Acute arterial Occlusive Disease
autoimmune vasculitis, inflammatory response, white cells infiltrate, fibrosis occurs w/healing causing occlusion
rheumatic heart disease, artificial heart valves, MI, AFib, vascualr surgeryinvasive arterial procedures, trauma or compression of artery
risk factors for acute arterial occlusive disease
necrotic lesions at tips of fingers and toes, see areas that are inflammed then they become necrotic
winter, lupus, RA, trauma or obstruction, cooupational trauma--typistis, pianists, cold, stress, caffine, tobaco
Risk factors--Raynauds
pain, pallor, pulselessness, parasthesia, poikilnthermia, paralysis
6 p's of NV assess. Acute Occ. art. disease
bilateral, instep claudication-main symptom! intense rubor, cyanosis,rest pain, diminished or absent pulses
S/S Buergers
stop smoking, CCB or antiplatelet, sympathectomy to eliminate vasospas. amputation.BKA vs. toe
symmetrical and bilateral, usually tip, not thumb, vasospas. in fingers, pallor early, then reddness as blood returns..very painful
emergency embolectomy, balloon angioplasty, artherectomy stents, bypass
trestment of Acute occlusion
circumferential dialation, relatively uniform in shape
localized outpouching on one side
tear in the intima layer with accumulation b.t the intima and the media layer
elderly, female, immobility, increaced viscosity, intimal damage, oral contraceptives
rick factors for DVT
pain or tenderness, edema, reddness, fever, +Homans
promanant, abmormally dialated veins
pregnancy, obsiety, prolonged standing, chronic diseases
varacose veins..rick fac.
inadequate venous return over a long period of time, chronic pooling of blood leads to hyperpigment and edema over ankles
chronic venous insufficinecy
used for small, localized vari., agent in injected into the vein (NS)
dyspnea, hypotension, tachy card./tacypnea, hypoxemia, hemoptysis, chest pain
S/S pulm embolus
increaced venous tension, and valve imcompatence leads to venous stasis, poor venous return, edema and ulceration
venus ulcer path
irregular margins, copious serous exudate, occurrs over the medial or lateral malleolus(ankle bone)
Venous ulcer