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MedSurge-VASCULAR

MedSurge VASCULAR DISORDERS review

QuestionAnswer
Peripheral arterial disease (PAD) is caused by? atherosclerosis
PAD is related to? cardiovascular disease (eg. coronary / carotid artery disease)
a pouch-like bulge of an artery is what type of aneurysm? saccular aneurysm
A disruption of all layers of an artery with bleeding is what type of aneurysm? pseudoaneurysm
A uniform, circumferential dilation of artery is what type of aneurysm? fusiform aneurysm
An abdominal aortic aneurysm (AAA) may be heard as? bruits in the periumbilical area slightly to the left of the midline
S/S present in rupture of an abdominal aortic aneurysm include? severe back pain with flank ecchymosis
Hoarseness and dysphagia may occur with aneurysms of? the ascending aorta and the aortic arch
S/S present with pressure of a thoracic aneurysm may include? neurologic loss in the lower extremities
Most accurate test to determine size/structure of aneurysm and whether thrombus is present? computed tomography (CT) scan
Good way to prevent expansion of an abdominal aortic aneurysm? control HTN with controlled therapy
Calcium intake (is / is not) related to the calcification of arteries? is not
Periop a pt. with AAA should be monitored for? cardiac, pulmonary, cerebral or lower-vascular problems since AAA is a systemic disease
Postop pt. with AAA BP will be maintained how? BP is balanced: high enough to keep adequate flow through the artery to prevent thrombosis, but low enough to prevent bleeding at surgical site
Which type of aneurysm may be treated by excising only the weakened area and suturing the artery closed? saccular
Postop aneurysm repair, nurse should ensure that? BP and all peripheral pulses are evaluated at least every hour to ensure adequate BP and perfusion of extremities
Postop aneurysm repair, high BP may cause? leaking or rupture at the suture line
Postop aneurysm repair, low BP may cause? thrombosis of the graft
Periop aneurysm repair, (hypothermia / hyperthermia) is induced hypothermia; pt. is rewarmed soon after surgery
Following an ascending aortic aneurysm repair, nurse should immediately report? a change in level of consciousness and ability to speak (pt. may also experience: altered pupil response to light, changes in facial symmetry, movement in upper extremities)
Following an ascending aortic aneurysm repair, lower lend pulses are normally? decreased or absent for a short time after surgery
Presence of a G____ T____ would indicate a complication following aortic aneurysm repair. Graft Thrombosis
Pt. teaching following aortic aneurysm repair should include? avoid heavy lifting, some permanent sexual dysfunction may result, low-fat/cholesterol diet should be maintained
Expected finding in assessment of pt. with distal descending aortic dissection? severe "ripping" back or abdominal pain with decreasing urine output
Aortic dissection of the ascending aorta and aortic arch may affect? the heart and circulation to the head, with development of murmurs, ventricular failure and cerebral ischemia
Initial treatment of pt. with dissection of arch of aorta, experiencing decreased LOC and weak carotid pulses is? immediate surgery to replace the torn area with a graft
Administration of packed RBCs in dissection of arch of aorta, would be indicated if? the dissection ruptures
Relief of pain following a dissection indicates? the dissection has stabilized, and it may be treated with drugs that ↓ BP and myocardial contractility
Paresthesia, is indicative of (arterial / venous) disease? arterial
Heavy ulcer drainage, is indicative of (arterial / venous) disease? venous
Edema around the ankles, is indicative of (arterial / venous) disease? venous
Ulcers over bony prominences of toes and feet, is indicative of (arterial / venous) disease? arterial
Decreased peripheral pulses, is indicative of (arterial / venous) disease? arterial
Brown pigmentation of the legs, is indicative of (arterial / venous) disease? venous
Thickened, brittle nails, is indicative of (arterial / venous) disease? arterial
Ulceration around the medial malleolus, is indicative of (arterial / venous) disease? venous
Pallor on elevation of the legs, is indicative of (arterial / venous) disease? arterial
Dull ache in calf or thigh, is indicative of (arterial / venous) disease? venous
Pruritus, is indicative of (arterial / venous) disease? venous
The classic ischemic pain of PAD is known as? intermittent claudication
Lower limb amputation in PAD is normally due to _____ or _____? non-healing ischemic ulcers; gangrene
Oral anticoagulants (are / are not) recommended for treatment of PAD? are not
Appropriate pt. teaching for PAD pt? keep legs and feet warm / walk min. 30 min/daily, use nicotine to substitute for smoking if unable to stop smoking
Major risk factors for PAD include? HTN, smoking, hyperlipidemia
Postop femoral bypass graft surgery, HCP should be notified if pt. experiences? loss of palpable pulses and numbness and tingling in feet
Expected finding postop femoral bypass graft surgery include? pain, redness, serous drainage at incision site
The SIX P's of acute arterial occlusion are? pain / pallor / pulselessness / paresthesia / paralysis / poikilothermia
Poikilothermia is? the inability to maintain a constant core temperature independent of ambient temperature
Arteriospastic disease is commonly known as Raynaud's syndrome
Raynaud's syndrome involves _____ and is associated with _____? small cutaneous arteries of the fingers and toes; autoimmune disorders
Medication classes used to treat Raynaud's syndrome include? calcium-channel blockers (eg. nifedipine (procardia)
Episodes of white, blue, red color changes in fingertips is indicative of? Raynaud's syndrome
Thromboangitis Obliterans is commonly known as? Buerger's disease
Buerger's disease involves _____ and is associated with _____? inflammation of midsized arteries and veins; smoking
Ulceration and gangrene in Buerger's disease, may result in? amputation of digits, or legs below the knee
Pts. with Buerger's disease, may present with? intermittent claudication of feet, arms and hands
Virchow's Triad describes? describes the three broad categories of factors that are thought to contribute to thrombosis
Virchow's Triad pneumonic SHE --- Stasis (Venous) / Hypercoagulabilty / Endothelial Cell Injury
IV Therapy, Virchow's Triad factor? Endothelial Cell Injury
Prolonged immobilization, Virchow's Triad factor? Stasis (Venous)
Estrogen therapy, Virchow's Triad factor? Hypercoagulabilty
Orthopedic surgery, Virchow's Triad factor? Stasis (Venous)
Smoking, Virchow's Triad factor? Hypercoagulabilty
Pregnancy, Virchow's Triad factor? Stasis (Venous)
Superficial thrombophlebitis is? inflammation of a vein due to a blood clot in a vein located just below the skin's surface
Most common cause of superficial thromboplebitis in the legs is? varicose veins
Characteristics of Superficial thrombophlebitis include? tender, red, inflamed induration along the course of a subQ vein
Venous thromboembolism (VTE) is? a blood clot (thrombus) that forms within a vein
Prevention of emboli formation can be achieved by? bed rest and limiting movement of involved extremity until the clot is stable, inflammation receded and anticoagulation is achieved
Heparin, characteristics? protamine sulfate is antidote, admin IV or SubQ, monitor aPTT
Lovenox, lower molecular weight heparin, characteristics? admin SubQ only, routin coagulation tests usually not required
Hirudin derivatives, characteristics? admin only IV, no antidote available, monitor aPTT
Warfarin (Coumadin), characteristics? vitamin K antidote, admin PO only, monitor INR
Heparin mechanism of action? prevents new clots from forming, does not break apart existing clots
Pt. teaching of VTE patient on Warfarin (Coumadin) should include? exercise programs (swimming), drug will not blacken stools, dark-leafy veges have VitK (don't intake huge amounts), do not massage legs for risk of dislodging clot
Created by: fluency