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195 Cards in this Set
- Front
- Back
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This disease involves progressive narrowing and degeneration of the arteries in the neck, abdomen and extremities.
a. PAD b. CAD c. intermittent claudicatino d. Venous thrombosis |
PAD
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Occlusive disease, aneurysmal disease and vasospatic phenomenon are sub categories of what?
a. PAD b. CAD c. intermittent claudicatino d. Venous thrombosis |
PAD
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Venous diseases primarily affect what part of the body, and is categorized as venous thrombosis and chronic venous insufficiency
a. upper extermities b. Head c. lower extremities d. midline |
lower extremeties
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What disease is responsible for the majority of cases in PAD
a. Diabetes b. atherosclerosis c. hypertension d. MI |
b Athersclerosis
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People with PAD have 4to 5 times the risk of dying from a cardiovasculat event
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true
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The pathologic changes that occur withh atherosclerosis consist of migration and repilcation of:
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smooth muscle cells, depostion of connective tissue, lymphocyte and macrophage infiltration and accumulation of lipids
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What is the 4 most common risk factors of PAD?
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Smoking, hyperlipidemia, hypertension and DM. The most important being smoking
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PAD of the lower extremities may affect the aortoiliac, _____, popliteal, _____, or peroneal arteies
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femoral, tibial
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In PAD the femoral-popliteal area is the site most commonly affected in which patients?
a. diabetic b. non diabetic |
b. Non-diabetic
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This patient tends to develop PAD in arteries below the knee, tibial, peroneal
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diabetic patient
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The classic symptom of PAD of the lower extremities is called?
a. intermittent claudication b. ischemia c. paresthesia d. neuropathy |
a,\. intermittent claudication
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This is ischemic muscle ache or pain that is precipitated by a consisten t level of exercise, resolves within 10 ninutes or lesw ith rest and is repoducible
a. intermittent claudication b. ischemia c. paresthesia d. neuropathy |
a .Intermittent claudication
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How do you get ischemic pain? And how does the pain stop?
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due to the end products of anaerobic cellular metabolism like lactic acid. When you stop exercsising the metabolites clear and pain subsides
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Match the palceswhere pain is caused by claudication:
1. Calf 2. Buttocks and thighs 3. erectile dysfunction a. aortoiliac arteries b. internal iliac c. femoral or popliteal |
1. c
2. a 3. b |
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This is another manifestation of the PAD in the lower extremities. It is manifested by numbness or tingling in the toes or feet, may result from nerve tissue ischemia
a. intermittent claudication b. ischemia c. paresthesia d. neuropathy |
c paresthesia
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In reregards to PAD, true peripheral neuropathy occurs more commonly in patients with DM.
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info
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PAD can produce excruciating shooting or burning pain in the extremity,The gradual diminished perfusion of blood to the neurons produces loss of both pressure and deep pain sensations, and injuries and pain often go unoticed by the patient.
a. intermittent claudication b. ischemia c. paresthesia d. neuropathy |
d. Neuropathy
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In PAD.. the physical appearance provides impt information about the adequacy of blood flow. what happens to the skin with people that have PAD. Skin becomes
a. thin, shiny, taut, hairless legs, absent pulses b. dullt, loose, hairy legs, bounding pulses |
a. Skin becomes thin, shiny, and taut, hairless legs, absent pulses.
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With severe PAD what happens when you raise the foot.
a. reactive hyperemia b. pallor |
Pallor or blanching
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With severe PAD what happens when you hang the foot off the side of the bed.
a. reactive hyperemia b. pallor |
a Reactive hyperemia.. redness of the foot
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A clincal manifestation of PAD, as the diease progress advances and involves multiple arterial segements, continuous pain develops at ____
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rest
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In people with PAD,rest pain most often occurs in the ___ or toes and is aggravated by limb ____
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forefoot, elevation
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This type of pain occurs when there is insufficient blood flow to maintain basic metabolic requirements of the tissue and nerves of the distal extremity.
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rest pain
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Rest pain Often happens at night because the cardiac output tends to drop during sleep. True of false
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true
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What happens to the skin and underylying muscles of people with prolonged ischemia?
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Atrophy
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Complications of PAD. because of decreased arterial blood flow to the lower extremities it may result in delayed ____, wound ____, tissue _____,
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healing, infection, necrosis
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What is the most serious complications of end stage PAD, and what willhappen if blood flow is not restored?
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non-healing arterial ulcers and gangrene, amuptation
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Partial pain control with people with pad is if you dangle your foot off the side of bed.
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True
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Where to arterial uclers usually occur in the PAD
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Over the bony prominences
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Diagnositic studies of people with PAD, this is a probe transducer contains a crystal that directs high frequency soundwaves toward the artery or vein being examined.
a. doppler ultrasound b. duplex imaging c. angiography |
Doppler ultrasound
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This is a useful in determing the presence of blood flow by sound waves in PAD
a. doppler ultrasound b. duplex imaging c. angiography |
a
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A palpable pulse and a doppler pulse are equivalent, and these terms should be used interchangeably. True or false
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False
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These types of blood pressures are obtained a the thigh below the knee, and at the ankle level while the patient the is supine.
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segmental blood pressure
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This is a diagnostic study of PAD done by dividing the ankle systolic BP by the brachial SBP
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ankle-brachial index
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This PAD diagnositc study that uses a bidirectional doppler system to systematically map blood flow throughout the enytire region of an artery. It provides anatomical and physiological information about the blood vessels
a. doppler ultrasound b. duplex imaging c. angiography |
b. Duplex imaging
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This diagnositc study is used to further delinieate the location and extent of the disease process, providing information on inflow and outflow vessels to plan for surgery
a. doppler ultrasound b. duplex imaging c. angiography |
c angiography
MRA |
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What is the first treatment goal of people with PAD
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modiby cardiovascular risk factors:
Smoking Decrease hyperlipidemia controlled hypertension and DM |
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Treatment of hyperlipidemia includes this lipid lowerin agent such as statin. It lowers cholesterol levels and reduces cardiovaascular morbiddity and mortality. It also improves walking distance and speed in pts with PAD, regardless of cholesterol
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Zocor
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in controlling cardiovascular events with PAD what level should the BP and A1c be.
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<130/80 and 7.0%
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In drug therapy for PAD, these agents such aspirin, ticlid, and plavix are considered critically imporrnat for reducing the risks of cardiovascular death in pts with PAD. These are what?
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antiplatelets
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What is the first line oral antiplatelet therapy for patients with PAD?
a. aspirin b. ticlid c. plavix |
a. or C.
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Which antiplatelt is less prescribed because of the serious side effects of thrombocytompenia, neutropenia or thrombotic thrombocytopenic purpura.
a. aspirin b. ticlid c. plavix |
b.
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Drug therapy and treatment like ramipril helps hypertension LV. dysfunctions and PAD
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ace inhibitors
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Ace inhibitors (↑↓) cardiovascular morbidity, (↑↓) mortality, (↑↓) peripheral blood flow, (↑↓) abi, and (↑↓) walking distance
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decrease, decrease, increase, increase, increase
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what are the two drugs that are prescribed for treatment of intermittent claudication?
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Trental and pletal
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This intermittent claudication drug increases erythrocyte flexibility and reduces blood viscosity.
a. trental b. pletal |
Trental
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This intermittenty claudication drug inhibits platelet aggregation and increases vasodilation. It also increases walking distance Howeverit does not reduce cardiovascular morbidity andmortality and is contraindicated for patietns with chornic heart failure
a. trental b. pletal |
b. pletal
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in people with PAD The primary nonpharmacologic treatment for claudication is?
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exercise training program
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what is the most effective exercise for individuals with claudication?
how many minutes a day |
walking
30-60 |
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nurtional therapy in patients with PAD should be taught to evaluate their dietary intake. Diet cholesterol should be < ____mg/day, a decreased ___ intake and animal protein replaced with ___ protien products
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200, fat, soy
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This alternative therapy in intermittent claudication is effective increasing walking distance for patients. However side effects indclude h/a, nausea, gastrick symptoms, diarrhea, and allergic skin reactions.
a. aspring b. bilberry c. goldenseal d. ginkgo biloba |
d. Ginkgo biloba
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If you are on antiplatelets we should consult with a helath care provider before taking ginkgo because of what?
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increased bleeding risks
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Taking folate, b6 and b12 helps lower homocysteine levels which is an amino acid that increaes CVD
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info
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This is a chronic condition characterized by ischemic rest pain, arterial leg ulcers, and or gangrene of the leg due to advanced PAD
a. chronic venous insufficency b. aortic disection c. DVT d. critical limb ischemia |
d. critical limb ischemia
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Conservative managment goals for critical limb ischemia is ____ extermity from trauma, ____vasospasm, _____ infection, and _____arterial pefusion.
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protect, decrease, prevent, maximize
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soaking of the affected foot should be avoided in critical limb ischemia to prevent skin masceration.
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true
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other cares with Critical lim ischemia is immune modulation therapy to reduce the ____ response present in PAD and angiogenic gene terhapy to ehance the development of _______ circulation
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inflammatory. collateral
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interventional radiologic procedures are indicated for critical limb ischemia when?
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intermittent claudication become incapacitating, Rest pain, sever ulceration or limb threatening gangrene
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this is a inteventional radiologic procedure tha a catheter is inserted through the femoral artery, which contains a special baloon. the end of the catheter is advanced to the narrowed area of the artery, the balloon is inflated and the cracks the confinine atherosclerotic intimal shell while strching the underlying media. allowing blood fflow
a. endovascular graft b. percutaneously transluminal balloon angioplasty c. endarectomy d. patch graft angioplasty |
percutaneously transluminal balloon angioplasty
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Balloon angioplasties are more effectieve in the (illiac-femoral, femoral politeal)
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illiac femoral.
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True or false. Percutaneously transluminal ballong angioplastys are effective on arteries with long segment lesions
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false
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These are expendable metallic devices that are positioned within th artery immediately after angioplasty, it assits in manintaining vessel patency after the procedure.
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stents
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The most common surgery for people with PAD that have long occluded arteries are?
a. endovascular graft b. percutaneously transluminal balloon angioplasty c. endarectomy d. peripheral arterial bypass operation |
d peripheral arterial bypass operation with autogenous vein or synthetic material
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These grafts are used for long bypasses.
a. synthetic b. autogenous vein |
synthetic
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when an autogenous vein is not availabel for a bypass for PAD, human umbilical, cyropreserved vein, or composite sequential bypass graft is available
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info
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This surgical option for PAD is used to open the arter by removing the obstructing plaque
a. endovascular graft b. percutaneously transluminal balloon angioplasty c. endarectomy d. peripheral arterial bypass operation |
endarterectomy
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this surgical option for PAD is opening the artery removing the plaque and sewing a patch to the opening to widen the lumen.
a. endovascular graft b. percutaneously transluminal balloon angioplasty c. endarectomy d. patch graft angioplasty |
patch graft angioplasty
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Health history of PAD:
DM, smoking, hypertension, hyperlipidemia, obesity and asessements of PAD, exercise intolerance, loss of hiar, decreased or absent peripheral pulses |
info
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Goals for pt with PAD
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adequate tissue perfusion, relief of pain, ↑ exercise tollerance, intact healthy skinand extremities
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The nurse should look at serum lipid pannels, hypertension, obesity and diabetes. edcuate hazards of tobacco and laziness, reduce intake of cholesterol, saturated fats proper care of feet .
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info
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Acute intervention after surgical or radiologic intevention shuolld be what?
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checked every 15mintues initially than hourly for skin color, termperature, cap refill, presence of peripheral pulses, sensation and movement of the extremity
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After the PAD pt leaves the recovery area. nursing care should focus on continued _____ assessment and monitoring for potential problems like bleeding, hematoma, thrombosis, emoblization
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circulation
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Knee flexed positions should be avoided except for exercise with people after bypass graft surgery?
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true
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amubulatory and home care with PAD and after surgery
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be aware of risk factors, like smoking and cholestero levels. Patients should be taught about foot care an skin inspections. Patients should be taught to gradaully build up to physical activity, comfortable shoes and shoes lightly laced
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Evaluation of people after surgeries with PAD
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Identify activites that promote circulation
maintain adequate peripheral perfusion intact skin, free of infection, plans for walking program increased activity tolerance |
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Outpouchings or dilations of the arterial wall and are common problems involving the aorta.
a. CAD b. PAD c. Aneurysms d. atherosclerosis |
aneurysms
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Aneurysms invlve the aortic ____, _____ aorta, or ____ aorta
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arch, thoracic, abdominal
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Most aneurysms are found in the _____ aorta. below the level of hte renal arteries
a. arch b. thoracic, c. abdominal |
c. abdominal
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the most common etiology of aneurysms of the descending and abdominal aorta is? This causes teh deposits beneath the intima, and causes chagnes to the media where it loses elasticity, weakening and then it causes it to outpouch
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athersclerosis
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a congenital abnormality that develops aneurysms is related to specific defects in collagen.
a. ehlers-danlos syndrome b. marfans syndrome |
a.
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a congenital abnormality that develops aneurysms is related to the premature degneration of vascular elastic tissue
a. ehlers danlos syndrome b. marfans syndrome |
b.
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aortic aneurysms can be causes by infections aortitis like syphilis, salomenlla
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info
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this aneurysm is one in which the wall of the artery forms the aneurysm, with at least one vessel latyer still intact. It is deivided into two forms fusiform and saccular
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true aneurysm
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two types of aneurysms can be further subdivided into fusiform and saccular
This aneurysm is cricumferenctiona dn relatively uniform in shape a. fusiform b. saccular |
a.
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two types of aneurysms can be further subdivided into fusiform and saccular
This is a pouch like with a narrow neck connecting the bulge to one side of the arterial wall. a. fusiform b. saccular |
b.
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This type of aneurysm is not an aneurysm but the intima of the artery is torn and blood outpoutches a little bit, but is contained somehow
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pesudoaneurysm
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The most common manifestation of thoracic aorta aneurysms are often asymptomatic but the most common manifestation is?
a. hoarsness b. laryngeal nerve pressure c. deep diffuse chest pain |
c deep diffuse chest pain.
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aneurysms in teh aortic arche area produces angina, hoarsness because of pressure on the laryngeal nerve and pressure on the esophagus can cause dysphagia
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info
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AAA are often asymptomatic and frequently detected on routine phsycial examination. A pulsatile mass in the periumbical area slightly to the left of the midline may be detected by bruits.
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info
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The mos serious complication related to an untreated aneurysm is a ______.
a. chest pain b. diaphoresis c. rupture |
c. rupture
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If a patients AAA ruptures you may have severe back pain and stomach pain.. may or may not have back or flank ecchymosis called. What is this ecchymosis called.
a. blue toe syndrome b. grey turners sign. |
grey turners sign
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If ruptures occurs anteriorly in a AAA most pts do not survive long enough to get to the hospital.
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True
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Preoperative for a person with an aneurysm as nurses we need to hydrate the patient, check electrolytes and coagulation, and hematocrit abnormalities are corrected
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info
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How do you repair a aneurysm
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incise the diseased segment of the aorta, remove the thrombus or plaque, insert a synthetic graft and suture to the aorta, and then sture the native aorta wall around the graft for protective covering. All AAA resections require cross-clamping.
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This aneurysm surgical procedure is a minimally invasive procedure that involves the placement of a suturless aortic graft into the abdominal aorda inside the aneurysm via a femoral arter cutdown. The graft is constrcuted from a dacron sylinder when the balloon is inflated there are a series of hooks that is anchored to the vessel.
a. edarectomy b. endovascular graft procedure c. patch graft angioplasty |
b. endovascular graft procedure.
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The most common complication of an endovascular graft this is the seeping of blood from the new endograft back into the old aneurysm site.
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perigraft leak
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Signs of an aneurysm rupture is: diaphoresis, paleness, wekaness, tachycardia, hyptension, abdominal, back, groin or periumbilical pain, LOC, pulsating abdininal mass
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Signs of a rupture
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Nursing managment for surgery of a aneurysm. baseline data: peripheral pulses, neurological status, skin lesions
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Info
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Patient goals undergoing an aortic surgery:
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normal tissue perfusion, intact motor and sensory function, no complication r/t surgical repair, Thrombis/infection
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Health promtion for nurses during Aortic aneurysms
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encourage to reduce CVD, BP control, smoking cessation, increase physical activity, maintian normal body weight
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Post op for aortic surgery?
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monitor for graft patency
Cardiovascular status- continuous monitorying, frequent electrolyte anr ABG, o2 administration, infection- watch WBC count GI status neurological status peripheral perfusion status renal perfusion status |
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aortic diessection is not a aneurysm.
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true
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This is a the result of a tear in the intimal lining of the arterial wall. It affects men more often than women and occurs most frequently b/t the 4th and 7th decareds of life
a. aortivc dissection b. PAD c. Aneurysms d. atherosclerosis |
a. aortic dissection
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In an aortic dissection blood flows inbetween the ___- and ____ creating an false lumen. As heart contracts the pressure ____ and the tear gets bigger, and this can start to occlude other vessels
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intima and media, increases
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Person predispose to Chornic hypertension, marfan syndrom, pregnancy, blunt trauma are prone to aortic dissection
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true
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Persons with this syndrome, a premature degeneration of vascular elastic tissue have a higher incidence of aortic dissection
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marfan syndrome
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The manifestations of this is tearing and ripping, a severe pain that mimics that of an MI
a. aortic disection b. aortic rupture c. Aneurysms d. atherosclerosis |
a. aortic disection
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Clinical manifestations of a aortic dissection depends on the location of the intimal tear
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ture
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A severe lifethreatining complication of aortic dissection of the ascending aortic arch is this, which ocurs when blood escapes formthe dissection ito the pericardial sac
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cardiac tamponade
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Another complication of a aortic dissection is this, which results in exanguination and death.
a. aortic disection b. aortic rupture c. Aneurysms d. atherosclerosis |
b. aortic rupture
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another complication of aortic dissection is when the dissection grows and _____ the arterial suuply to vital organs.
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occludes
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This is the blockage in the lymphatic system swelling in one arm or leg, primarily causes are inherited conditions, secondary causes are conditions that damage lymph nodes or lymph vessels. Treatment focuses on reducing swelling and controlling pain
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lymphedema
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This is the sudden interruption in the arterial blood suplly to tissue, an organ or an extremity, if left untreated can result in tissue death.
a. chronic venous insufficency b. aortic disection c. acute areterial ischenmia d. critical limb ischemia |
c. acute areterial ischenmia
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What are the most frequent cause of acute arterial occulsion
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embolism, thrombus, and aneurysm
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The clinical manifestation of ACute aterial ishcemic disorders is abruptly onset. and includes the 6ps. what are then
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pain, pallor, pulselessness, paresthesia, paralysis and poiklothermia
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This is the adaptation of an ischenmic limb to its environmental temperature, most often cool
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poiklothermia
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True or false: in cregards to acute arterial ischemia, without intervention, ischemia may prgress quickly to tissue necrosis and gangrene within a few hours
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true
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This is the most traditional anticoagulant for arterial ischemia.
a. warfarin b. heparin c. lovanox |
b unfraactionated heparin
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Collaberative care for arterial ischemic disorders is: anticoagulation, thrombolysis, embolectomy, surgical revascularization, amputation
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info
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This is a rare, nonatherosclerotic, segmental, recurrent inflammatory, vasocclusive disorder of the small and medium sized arteries, veins and nerves of upper and lower extemities
a. buregers disease b. raynauds phenomenon |
a. buregers disease
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Buergeer disease affect women or men more?
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women
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This disease is a type of arteritis in which the inflammatory process damates teh arterial wall, lympohcites and giatn cells infiltrate the vessel wall accompaonied by fibroblast proilferation.
a. buregers disease b. raynauds phenomenon |
buergers disease
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This disease is often confused with PAD, there are no diagnostic tests for it and treatment is complete cessation of tobacco including second hand smoke
a. buregers disease b. raynauds phenomenon |
buergers disease
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This is an episodic vasospastic disorder of small cutaneous arteries, most frequently involving the fingers and toes.
a. buregers disease b. raynauds phenomenon |
Raynauds phenomenon
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Raynauds phenomenon affect mainly women between 15 and 40 yoa
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info
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Raynauds phenomenon secondary are related to RA, lupus scherloderma
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info
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This characterized by vasospams induced color changes of the figners, toes ears and nose. nown at red white and blue
a. buregers disease b. raynauds phenomenon |
raynauds phenomenon
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In raynauds phenomenon, decreased tissue perfusion results in ______ (white), the digits become ___ (blue), and followed by tre restoration of tissue _____ (red)
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palor, cyanotic, perufsion
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What would you teach patients with raynaudes phenomenon. Temperature extremes shoud be avoided, avoid caffien, immers hands in warm water often decreases vasospsm
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info
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Nifedipine is the most commonly used (type of drug) for raynauds phenomenon
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calcium channel blocker
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The most common disorder of the veins is the formation of a thrombus in associating with inflammation of the vein.
a. venous thrombosis b. superficial thrombophlebitis c. venous stasis d. DVT |
venous thrombosis
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This is the inflammation of hte suverificial vein.
a. venous thrombosis b. superficial thrombophlebitis c. venous stasis d. DVT |
superficial thrombophlebitis
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this is a disorder involving a deep vein, most commonly the iliac and femoral vein
a. venous thrombosis b. superficial thrombophlebitis c. venous stasis d. DVT |
DVT
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The 3 factors of venous throumbosis is called the virchows triad this includes?
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venous stasis, endothelieum damage, hypercoagulability of hte blood
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THis factor of thrombosis occurs when the valves are dysfunctional or the muscles of the extremities are inactive. And the blood does not move very fast
a. venous thrombosis b. superficial thrombophlebitis c. venous stasis d. DVT |
Venous stasis
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The pathophysiology of venous thrombosis is when platelts and fibrin entrap RBC, WBC and more platelts to form a thrombus, this cauess venous stasis, as the throubms enlarges it can occulde the vein and then if the thrombus gets knocked loose youhave a pulmonary embolism
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info
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The turbulence of __- __ is a major fctor contributing to detachment of the thrombus fro the venous wall
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blood flow
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The clinical manifestions of this venous problem is pt. may have a plapable firm subcutaeous ordlike vein, with tenderness redeness and warmth, slight temperature elevation caused by leukocytosis
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superficial thrombophlebitis
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The most common cause of superficial thrombophlebitis in the upper extremities is caused by?
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IV therapy
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The most commony cause of superficial thrombophlebitis in the lower extremeties is related to ____, more common in older pts.
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trauma
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The treatment for superficial thrombophlebitis is, ____ the affected exermity to promote venous return and decrease edema, and the application of ____, moist heat
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elevate, warm
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If you suspect thrombophlebitis shouldyou remove the cathter
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yest
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What is usually given as a mild analgesic for superficial thrombophlebitis?
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aspirin and NSAIDS
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Clinical manifestations of DVT are unilateral leg edema, extermity pain, warm, skin, erythemia, and a systemic temperature greater than 100.4 degrees
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info
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The most common complication of DVT is pulmonary embolism, chornic venous insufficency and plegmasia cerulea dolens
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info
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This complication of DVT results from valvular destruction, allowing retrograde flow of venous blood
a. CVI b. Plegmasia cerulea dolens |
A Chonic venous insufficency
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This complication of DVT is the swollen, blue and painful leg , a very rare complication that may develop in a patietn in the advanced stages of cancer
a. CVI b. Plegmasia cerulea dolens |
b.
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DVT diangosis:
blood tests suct as ptt, platelet count, D-dimer testing venous doppler evaluation duplex scanning venogram |
info
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prevntion and prophylaxis DVT.
Early mobilization is the easiest and most cost effective method to decrease the risk of DVT Change positions often TED hose Intermittent compression devices preventative anticoagulation |
info
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Nonpharmacoligc treatment ofr DVT
bed rest elevation of exgtermity anticoagulation therapy warm compresses Jobst stockings |
info
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The goal for anticoagulationo eherpay for DVT prohylaxis is ot prevent dvt formation. WHere as the goals in the treatment of the DVT is to prevent propagation of hte clot, development of any new thrombi and emobilization
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info
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Four major classes of the Drug therapy for DVT
vitamin K anticoagulants, indirect thrombin inhibitors, direct thrombin inhibitors and factor Xa inhibitors |
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This is drug therapy for DVT are the comarins and indandiones. Warferin (coumadin)
a. vitamin K antagonists b. indirect thrombin inhibitors c. direct thrombin inhbitors d. factor Xa inhibitors |
a.
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UH (heparin) and LMWHs (lovenox)affects both intrinsic and common pathways of blood coagulation by way of the plasma cofactor antithrombin
a. vitamin K antagonists b. indirect thrombin inhibitors c. direct thrombin inhbitors d. factor Xa inhibitors |
b.
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These can be classified as hirudin derivatives or synthetic thrombin inhibitors.
a. vitamin K antagonists b. indirect thrombin inhibitors c. direct thrombin inhbitors d. factor Xa inhibitors |
c.
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Tis inhibits Xa disriectly or indirectily.. fondaperinux
a. vitamin K antagonists b. indirect thrombin inhibitors c. direct thrombin inhbitors d. factor Xa inhibitors |
d.
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for prophylaxis of DVT this is the chose to prevent DVT for most surgical patients. It lasts the duration of the hospitalization, orthopedic surgery may be prescribed prohylaxis for up to 1 month post discharge
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LMWH (heparin)
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The primary indication for suregery of DVT is to prevent recurrent PE
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true
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This surgical therapy of a dvt involves the removal of a DVGT through an incision in the vein.
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venous throbectomy
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These devices for DVT arefilters that are placed inthe jugular or the venoua cava to prevent emboli from going pulmonary.
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venea cava interruption devices greenfield filter, etc.
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Goals for patients with DVT
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relief of pain, decreased edema, no skin ulceration, no compliations from anticoagulant theapy n oevidence of pulmonary emboli
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These are dilated, tortuous subcutaneous veins most frequently found in the saphenous system. May be small and innocousous or large and bulgin
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vericose veins
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This type of vericose vein is idiopathic, which are more common in women and pts with a strong family history and probably caused by congenital wekaness of the veins
a. primary b. secondary c. reticular d. telangiectasias |
a.
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This type of varicose veint typically results from a previos DVT or another identifiable obstruction.
a. primary b. secondary c. reticular d. telangiectasias |
b.
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this varicose vein are smaller varicose veins that apperar flat, less tortuous, and blue green in color
a. primary b. secondary c. reticular d. telangiectasias |
c
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these varicoase veins are often refered to as spider veins are very small visible vessels.
a. primary b. secondary c. reticular d. telangiectasias |
d.
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Etiology of varicose veins are unknown.
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true
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Riskt factors for varicose veins :
congenital weakness female gnder use of oral contraceptives increasing age obesity pregnancy occupations requring prolonged standing |
true
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What is the most common symptom of varicose vein is?
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ache or pain after prolgoned standing which is rlieved by wlakig or elevating hte limb
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Common manifestations of varicose viens
swelling, discomfort, noturnal leg cramps |
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supervicial varicose viens can be diangosed by ______, if they are deep varicose veins.. _____ imaging detects the obstruction.
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appearance, duplex
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Treatment for vericose veins is usually a Cosmetic problem
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info
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This therapy for cosmetic varicose veins ivolves the injection of a substance that obliterates, spider, reticular, and superficial varicose veins
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sclerotherapy
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Nurse should instruct pt to avoid sitting, or standing for longperiods of time, maintain ideal body weight, avoid wearing constrictive clothing and participate in a daily walking program
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prevention
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this is a common problem in the elderly, in which the vlaves in the veins are damaged, which results in retrograde venous blood flow, pooling of blood in the legs and swelling
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CVI
chronic venous insufficiency |
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The basic dysfunciton of this medical problem is incompentent valves aof the deep veins
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CVI
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this is a clinical manifestation of what? the skin of hte lower leg is leathery, witha characterisitc brownish or brrawny appearance from the hemosiderin deposition
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CVI
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In people with CVI, venous ulcer healing, and prevention of ulcer recurrence this is important in managment
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comp
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Moist environmental dressing are the mainstay of wound care for venous ulcers.
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info
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adequate protein calories and micronutrients are essential for healing of venous uclers
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long-term managment includes education about self care:
avoid trama to limbs proper skin care compression stockings activity and positioning |
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A pt diagnosed with peripheral arterial disease is most likely to also have
a. CAD b. degnerative joint disease c. a history of atrial fibrillation d. a history of renal inssuficiency |
a.
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a 62 year-old woman weighs 92 kg and has a history of daily alcohol intake, smoking, high BP, high sodium intake, and sedentary lifestyle. The nurse identifies the risk factors most highl related to peripheral arterial diseas in this patent as
a. gender and age b. weightt and ETOH intake c. cigs and hypertension d. sedentary lifestyle and high sodium intake |
c.
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a pt is scheduled for an abdominal aoritc aneurysm repair. the nurse suspects rupture of the aneurysm
a. the pt becomes dizzy and SOB b. the pt. complains of sudden, severe back pain c. a bruit and thrill are present at the site of the aneurysmm d. the pt. develops blue, patch mottling of the feet and toes. |
b
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imporant nursing measures after an abdominal aortic aneurysm repair are to:
a. elevate the legs and apply ted hose b. assess cranial nerves and mental status c. administer IV heparin and monitor aPTT d. monitor urine output, BUN and creatinine |
d.
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Specific symptoms of aortic dissection vary depending on
a. the medications that are administered b. how elevated the BP becomes c. the aortic branches affected in the descent of the dissection d. the respiratory status of the pt. before dissection occurs |
c.
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rest pain is a manifestaion of peripheral arterial diseas tha occurs as a result of
a. the beginning of a venous leg ulcer b. inadequate blood flow to the nerves of hte feet c. inadequate blood flow to the muscles during exercise d. inadequate blood flow to the skin after application of the heat |
b
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a pt. with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. the nurses intial action should be to
a. notify the physician b. elevate the leg to prmote venous return c. wrap the leg in a blanket to provide warmth d. perform passive range of motion to stimulate circulation to the leg. |
a.
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the usual medical treatment of raynauds phenomenon involves
a. transluminal balloon angioplasty b. amputation of affected digits c. peripheral arterial bypass surgery d. administration of calcium channel blocers |
d
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the pt. who is most liketly to have th highest risk for DVT
a. 25 year old obese woman who is 3 days postpartum b. 25 year old woma who smokes and uses oral contraceptives c. 62 yoa man who had a strke with left sided hemiparesis d. 72 yoa man who had a suprapubic prostatectomy for cancer of the prostate |
d.
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the nurse suspects the presence of a DVT b ased on the findins of
a. paresthesia and coolness of the leg b. pain in the calf that occurs with exercise c. generalized edema of the inovled extremity d. pallor and cyanosis of the inolved extermiety |
c.
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a priority nursing intevention in the plan of care for the pt. with acute lower extemity deep vein thrombis would include
a. applying elastic compression stockings b. administering anticoagulants as ordered c. positioning the leg dependently to promote arterial circulation d. encouraging wlaking and leg exercises to promte venous return |
b.
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the nurse instructs the pt discharged on anticoagulant therapy
a. limit intake of vitaminsC b. report symptoms of nausea to the physician c. have blood drawn routinely to check electrolytes d. be aware of and report s/s of bleeding |
d.
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in planning care and patient teaching for the patient with venous leg ulcers, the nurse recognizes that the most important intervention in healing and control of this conditions is
a. application of antibiotic cream to the ulcers b. debridemeent of the uclers with skin grafting c. elevation of hte extremities to increase venous return d. performance of leg exercised to increase collateral circulation |
c.
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