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Cardio 4
OLOL N130 Cardio 4
| Question | Answer |
|---|---|
| Thick walled structures that carry blood from the heart to the tissues? | Arteries |
| What are the three layers of walls of the arteries and arteriloles? | Intima, Media, and Adventitia |
| What is the inner endothelial cell layer of the walls of the arteries called? | Intima |
| What is the middle layer of smooth elastic tissue in the walls of the arteries called? | Media |
| What is the outer layer of connective tissue in the walls of the arteries called? | Adventitia |
| If an artery is punctured for and ABG, how long should the nurse hold pressure? | 5-10 minutes |
| What is the most important factor in regulating the caliber of blood ? | Sympathetic ( adrenergic) nervous activity, stimulation causes vasoconstriction |
| What are potent vasodialators? | histamine, bradykinin, prostaglandin, and certain muscle metabolites |
| What is Arteriosclerosis? | Hardening as we age, lose elastic, Hardening of arteries, most common disease of the arteries |
| What is the most common disease of the arteries? | Arteriosclerosis |
| What is Atherosclerosis? | Frequently at bifurcation or branch areas, fibrous plaque( fatty plaque) build up in abdominal aorta, coronary, popliteal, and internal carotid arteries |
| What are the nonmodifiable risk factors for Peripheral arterial disease/ | Age, gender, familial predisposition |
| What are the Modifiable risk factors for Peripheral Arterrial disease? | Nicotine, diet-high fat, hypertension, diabetes, stress, sedentary lifestyle, obesity |
| Where will you usually see Peripheral Arterial Occlusive disease? | In the feet |
| What is Peripheral Arterial Occlusive disease? | Arterial insufficency, build up of plaque over time, mainly lower extremities, but can be upper |
| What is predominately from aorta below the renal arteries to the popliteal artery | Peripheral arterial occlusive disease |
| Where is distal occlusive disease frequently seen?> | In pts that have diabetes and the elderly |
| What is intermittent claudification? | aching cramping fatigue or weakness, blockage in the legs, pain usually in the muscle group one joint below level of the occlusion |
| What are clinical manisfestations of Peripheral arterial disease? | Intermittent Claudication, coldness or numbness int he extremity, Pallor, diminished or absent pulses, dry shiny skin, loss of hair over toes, nails thick and ridgid |
| What are more serious clinical manisfestations of peripheral arterial disease? | ulcerations, gangrene, muscle atrophy |
| What are characteristics of Ulcers? | Tips of toes, toe webs, hell or other pressure areas if confined to bed, very painful, deep, often involving joint space, circular shape, ulcer base is pale to black and dry gangrene, minimal edema, unless kept in dependent position for a prolonged time |
| Why is a treadmill test done to test for Claudication? | To test for pain |
| What is an arteriography? | A radiographic procedure for obtaining an arteriogram. SEE: angiography 2. Description of arteries. |
| What exercise is recommended for pt's with Peripheral Arterial occlusive disease? | Walking because it increases distance pt can walk without pain- colateral circulation |
| How is Peripheral arterial occlusive diseases medically managed? | Exercise, weight reduction, stop smoking, antiplatelet meds, surgical management |
| Decreased UOP equals | decreased cardiac output |
| How often after surgery for Peripheral artierial occlusive disease would you check pulse, color, temp, cap refill, sensory and motor function? | q hour for eight hours, then q 2 hours for 24 hours |
| What should the pt avoid after a peripheral arterial occlusive disease surgery? | avoid crossing legs, and prolonged extremity dependency |
| What should the nurse interventions be after peripheral arterial occlusive disease surgery? ( vascular grafting, bypass grafts, endarterectomy, embolectomy, amputation) | avoid leg crossing, elevate the extremity and encourage leg exercises, possible elastic compression stockings, |
| What is compartment syndrome in Peripheral arterial occlusive disease surgery? | severe edema, pain, decreased sensation of toes and fingers |
| What is autoimmune vasculitis of the intermediat and small arteries, aka inflammation, body attacks it's own arteris. What is this disease called? | Buerger's Disease |
| What people are at high risk for Buerger's disease? | men between 20 and 35, all races, smokers |
| What are the clinical manisfestations of buergers disease? | Pain, foot cramps ( esp. in the arch) after exercise Pain is relieved by rest, intense rubor of the foot, absence of pedal pulse, as disease progresses, defined redness or cyanosis of the part in dependant position, bilateral and uilateral, ulcers, gangr |
| In buergers disease, what is buring pain aggravated by> | emotional disturbances, nicotine, or chilling |
| Symptoms of Buergers disease are usually relieved by stopping what? | Smoking |
| What is not given in Buergers disease and why? | Vasodialators because it diverts blood from occluded vessels |
| In Buergers disease, what is done for gangrene? | amputation |
| After a pt. has an amputation, what are the nursing care guidelines? | elevate the stump for 24 hrs to promote venous return and decrease edema, monitor for hemotoma, asses fit of elastic bandage(two fingers fit btwn layers of wrap), encourage feelings after loss ( phantom pain limb sensations) |
| What is episodic spasms of the small peripheral arteries and arterioles precipitated by exposure to cold or stress? | Raynauds disease |
| Raynauds disease is most common in women age | 16 to 40 years |
| How do you medically manage Raynauds disease>? | calcium channel blockers procardia, aldalat helps cut down on spasms, relaxes arteries |
| What is sypathectomy and what is it used for? | interrupting the sympathetic nerves, Raynauds disease |
| What should a pt with Raunauds disease avoid? | cold, tobacco dress warm in winter, take sweater in air condition room, careful with sharp objects, careful with postural hypotention from calcium channel blockers |
| Thoracic aortic aneurysm are most common site for | dissecting aneurysm |
| Thoracic aortic anerurysms are common in men age | between 40 nd 70 years old |
| What are the s&s of and abdominal aortic aneurysm? | pulsatile mass in middle and upper abomen, systolic bruit (swishing) heard, 80% can be palpated |
| What would you use to diagnos an abdominal aortic aneurysm? | Ultrasounds, CT |
| If an abdominal aortic aneurysm is found and it's small what is done? | follow up q 6 months til reach a size to repair ( may be stable over years) |
| Rupture is likely when and aneurysms is wider than | 6cms |
| When is surgery for aneurysms done? | When the aneurysm is wider than 5cm (2 inches) |
| What would the nurse assess for before an aneurysm surgery? | assess for impending rupture ( severe back pain, or ab pain, lower ab to left midline, low back pressure on lumbar nerves, falling bp and hematocrit, retroperitoneal rupture ( bruising in scrotum perimeum, flank or penis) |
| What is retroperitoneal rupture? | Hematomas (brusing) in the scrotom, perineum, flank or penis |
| What should the nurse montitor for in a pt after an aortic aneurysm surgery? | Intense monitoring of pulmonary, cardiovascular, renal, and neurologic status, possible complications with arterial occlusion, hermorrhage, infection, ischemic bowel , renal failure and impotence |
| What is a dissecting aorta and what happens? | rupture in the intaimal layer .. as separation progresses, the arteries branching from the involved area of the aorta shear and occlude. |
| Where is a dissecting aorta most common? | In the aortic arch |
| What are the s & s of a dissecting aorta ? | usually sudden, severe, persistant pain, (described as tearing or ripping) pain in area of anterior chest or back and extends to shoulders, epigastric areas or ab. pallor sweating, tachy, possible BP difference in arms |
| What might s&s of dissecting aorta be mistaken for? | an Myocardial Infarction |
| What test are done to diagnos a dissecting aorta | CT ultrasound, MRI , arteriogram |
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