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Vascular Disorders
| Question | Answer |
|---|---|
| Term used to describe a variety of conditions, affecting ARTERIES of the neck, abdomen, and extremities - usually involves the progressive narrowing /degeneration of arteries | Peripheral Artery Disease (PAD) |
| most common cause of PAD | atherosclerosis |
| gradual thickening of the intima and media layers of arteries with plaque-like deposition of connective tissue, lipids, smooth muscle cells, machophages, & lymphocytes | atherosclerosis |
| Most significant factors for PAD | Cigarette smoking - hyperlipidemia (LDL's) - hypertension - diabetes |
| outpouchings or dilations of the aortic wall (can also occur with more peripheral arteries) | aortic aneurysms |
| where are most aneurysms found | abdominal aorta |
| what is the most common cause of aneurysms | atherosclerosis |
| two types of aneurysms | fusiform and saccular |
| fusiform aneurysm | uniform in shape |
| saccular aneurysm | sack like outpouching on only ONE SIDE of the artery |
| disruption in all layers of the arterial wall with bleeding contained by surrounding structures (usually more a result of trauma, infection, or bypass surgery) | false aneurysm |
| dysphasia | pressure on the esophagus |
| ecchymosis in the flank area | Grey-Turner's sign |
| if something is "contained" it has been | Tamponated |
| Where would a rupture have to occur where most patients would not survive long enough to get to the hospital, massive hemorrhage occurs, hypovolemic shock, tachycardia, hypotension, pale clammy yadda yadda needs IMMEDIATE SURGICAL REPAIR | anterior abdominal cavity |
| what diagnosic test would show a silhouette and any abnormal widening of thoracic aorta. Calcification of AAA | CXR |
| When would an aneurysm require surgical intervention? | 5.5cm or larger |
| an aneurysm is opened, plaque or thrombus if removed, a synthetic DACRON or polytetrafluoroethylene (PTFE) is sutured to the aorta, the the original repaired aorta is sutured around that to add protection | graft |
| what is a possible complication of clamping the aorta for a period of time during surgical repair | renal failure |
| minimally invasive endoscopic vascular graft | stent |
| complication of stent placement | leaks, dislocation of graft, thrombosis, and/or emboli |
| most common site for aortic dissection | thoracic aorta from a tear in the intimal lining (innermost) arterial wall |
| accumulation of blood within pericardial space with resulting hypotension, narrow pulse pressure. Occlusion of blood supply to vital organs, spinal cord | cardiac tamponade |
| name an IV BETA BLOCKER | BREVIBLOC (esmolol) |
| usually affects aortoiliac, femoral, popliteal, or tibial arteries in any combination. LDL's less than 100 and triglycerides less than 150 | Peripheral arterial disease of the lower extremities (PAD) |
| antiplatelet agent which prevents platelet aggregation are | Plavix |
| drug which increases RBC flexibility and reduces blood viscostiy | Trental (pentoxifyline) |
| Drug that inhibits platelet aggregation as well as increasing vasodilation thus increasing walking distance | Pletal (cilostazol) |
| ischemic limb with advanced PAD is characterized by | pain at rest, arterial leg ulcers, and or gangrene |
| a technique where a catheter with a deflated balloon is inserted into the femoral artery. This opens the artery and stretches the lining | percutaneous transluminal balloon angioplasty |
| complication of PTA (percutaneous transluminal angioplasty) | restenosis (closes up again) |
| Surgery uses a patients own vein or a synthetic graft (Darcon or PTFE) material to bypass or carry blood AROUND the leison. Usually used for long bypasses ie femoral or axillary to popliteal bypass grafts | Peripheral arterial bypass surgery |
| Opening up the artery and surgically removing plaque | endartarectomy |
| opening the artery and removing the plaque then sewing a patch to the opening to widen the lumen | patch graft angioplasty |
| When caring for a surgical patient what must you be concerned with | peripheral pulses - check frequently both affected and nonaffected limbs - CALL MD IF ABSENT |
| peripheral pulses decreased or absent - usually no edema - loss of hair on legs, feet & toes, intermittent claudication or pain at rest, pale elevation pallor, dependent rubor. Lift leg pale & lower it becomes bright red. Muscular atrophy! | arterial insufficiency |
| peripheral pulses present, may be tough to find due to edema (present in the lower leg), hair present (somewhat), pain is dull ache or heaviness, skin bronze-brown | venous insufficiency |
| what are three possible causes of emboli | endocarditis, atrial fibrillation, or heart valves |
| Clinical manifestations of EMBOLI (6 P's) | pain pallor pulselessness parathesias poikilothermia paralysis |
| another name for Thromboangitis Obliterans | Buerger's Disease |
| a segmental, recurrent INFLAMMATORY vaso-occlusive disorder of small and medium sized atreries which damages the arterial wall causing fibrosis and thrombi *strong association with smoking* | Buergers Disease |
| a vasospastic disorder of the cutaneous arteris usually affecting fingers and toes | Raynauds Phenomenon (disease) |
| aka AMERICAN FLAG fingers and toes become whitish, to bluish (cyanosis), then rebound to reddish (rubor) when circulation returns | Raynauds Phenomenon |
| the two disease that decrease cardiac output(thank you Kelly!) | pericardial infusion and pericarditis |
| relax smooth arterial muscle by BLOCKING the influx of calcium into the cells, REDUCING VASOSPASMS | Calcium Channel Blockers |
| the formation of a thrombus (clot) usually in association with inflammation(phlebitis) can occur with peripheral IV therapy | Venous Thrombosis |
| formtion of a thrombosis in a deep vein such as the fremoral vein or the iliac vein. More serious because they can loosen and become a PULMONARY EMBOLI | Deep Vein Thrombosis (DVT) |
| venous stasisdamaged endothelium hypercoaguability of the blood | pathophysiology of thrombosis is established by the presence of *VIRCHOW'S TRIAD* |
| Platelets aggregate, fibrin entraps RBC's, WBC's, and platelets to form a thrombus, if this were to detach and become an emboli if it lodges in the lung it is a....... | pulmonary emboli |
| Palpable firm, cordlike vein with surrounding tenderness, reddness, and warmth with possible low grade fever.....most common cuase is IV therapy | superficial thrombophlebitis |
| extremity pain, edema, warm reddened area at the site, fever, may or may not have all the above symptoms. may or may not have a POSITIVE HOMAN'S SIGN and the most common complication is Pulmonary embolism | Deep Vein thrombosis |
| DRUGS that do NOT dissolve clots, BUT DO prevent the enlargement of an existing clot | Anti-coagulants |
| DRUG is an indirect thrombin inhibitor for DVT's usually on an IV drip. Monitor activated PPT and know the antidote | Heparin - Protamine Sulfate |
| DRUG has the inhibiting activation of vitamin K which is needed for the clotting process. Vitamin K is also the antidote for this drug | Coumadin |
| What would directly dissolve clots | thrombolytics for DVT'S |
| What would filter out a clot in a vein | GREENFIELD FILTER |
| When you have an active DVT you want to do what and monitor what. Keep patient well hydrated to avoid hypercoaguability | prevent embolization, decrease inflammation, and monitor aPTT |
| dilated tortuous subcutaneous veins, most commonly in saphenous vein system, can be small or large and bulging, | Varicose Veins |
| Condition where valves stretch as veins enlarge and become incompetent which allows venous blood to REVERSE | Varicose Veins |
| Condition results from damaged valves with retrograde venous blood flow causeing pooling of blood in the legs and swelling, which can in turn lead to VENOUS STASIS ULCERS | Chronic Venous Insufficiency |
| What causes thick hardened contracted skin with brownish pigment | HEMOSIDERIN |
| What type of dressing would you use for Venous insufficiency | MOIST DRESSINGS |
| What type of dressing would you use for Arterial Insufficiency | DRY DRESSINGS |
Created by:
Beezle
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