PAD 2
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Created by:
rachelcathey22 on March 19, 2011
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32 terms
Terms | Definitions |
|---|---|
 Carotid artery disease | Atherosclerotic process where plaque clogs carotid arteries Plaque blocks blood supply to brain and increases risk of stroke Develops slowly and initially goes unnoticed First symptom stroke - cerebral vascular attack (CVA) OR transient ischemic attack (TIA) |
| Carotid artery disease treatment | *Lifestyle changes- risk factor modifications as CAD & PVD Medications - as PVD Carotid Endarterectomy or Carotid Artery Stenting |
| Endarectomy | Treatment of carotid artery disease Make opening and pull out blockage. Usually do one site, wait and then do other side. Before heart surgery they make sure they have good circulation to brain before putting them under, due to risk of strokes post-op (safer) Put patients on meds (like Plavix) to prevent platelets from sticking. |
| Aortic aneurism patho | Localized area of aorta weakened by loss of elasticity in blood vessel that leads to dilation. Pressure is high from left ventricle and area can get stretched out. Most often found below kidneys (Abdominal Aortic Aneurysm (AAA)) Growing aneurysm increases the risk of rupture Higher chance of survival the lower it goes |
| Aortic aneurysms predisposing factors | Strong genetic link - congenital weakness Marfan's syndrome (tall and it's stretched out) |
| Aortic aneurysm assessment findings | Secondary to location & size -Thoracic - varies from asymptomatic to deep diffuse chest and/or back pain -Ascending & aortic arch - anginal pain, hoarse voice -AAA - often asymptomatic; hear bruit on auscultation with physical exam |
| Aortic aneurysm diastostics | CXR, MRI, CT, Abdominal ultrasound (Helps determine size and type) BP gradient between arms (higher in right, lower in left -- because blood leaking out before getting to left brachial artery) >15 mm Hc difference is significant |
| Thoracic Aorta Aneurysm | Ascending Aortic arch Descending |
| True aneurysm | - Saccular - Sac or pouch on one side of the arterial wall - Fusiform- Outward budging in all directions |
| False aneurysm | - Pseudoaneurysm - arterial bleed out into the surrounding tissues common cause is leak between vascular graft and natural artery or arterial puncture (usually results from something we do to blood vessel, on insult to vessel (ex: cardiac cath and take out and due to pressure flows between vessel and looks like aneurysm but it's not) |
| Endovascular stent graft Aortic Aneurysm (EVAR) | -Thread in guide wire, device over wire and leave behind, leave wire behind. Leave white part in place to fix inside vessel. Flow goes through white part. -Less invasive, quicker; risk of it being dislodged, blood could seep around it |
| Aortic aneurysm - Nursing Care & Management | -Surgically corrected - incise, remove, graft -Preoperative baseline info is essential; Monitor for signs & symptoms of impending rupture -Postoperative care - nursing process guides care; Cardiovascular status, peripheral pulses, neurological status, GI status, renal perfusion |
| Aortic aneurysm - Potential Nursing Diagnosis | Tissue Perfusion - ineffective related to procedure Decreased Cardiac Output Risk for Deficient Volume Gas Exchange, ineffective related to anesthesia, possible fluid overload, & blood transfusion Readiness for Enhanced Comfort Risk for Infection Deficit Knowledge |
| Aortic Dissection | Tear of intimal layer causing blood to leak between the intima and media ACUTE and LIFE THREATENING! Unknown cause; Marfan's syndrome have higher incidences (more common in younger, males (picture in class) |
| Aortic dissection assessment findings | Severe tearing or ripping pain to mimicking an MI Symptoms can vary depending on location |
| Aortic dissection diagnostics | -Echocardiogram (TEE Transesophageal) -CT / MRA / MRI to determine extent of dissection |
| Aortic dissection nursing care | Medications to lower BP & HTN (ex: vasodilator) - Minimize blood flow & pressure into the media and intima Treat pain & discomfort |
| Venous disorders | Get backflow through damaged valves -Varicose veins -Venous thromboembolis (DVT, PE) -Chronic Venous Insufficiency |
| Varicose veins | Weakened vein walls that can not withstand normal pressure Veins dilate & become tortuous in lower extremities The dilation prevents the valve cusps from closing resulting in an increase in back up and pressure,worsening the condition (continuous cycle) ** Unsightly (cosmetic issues), blood is at risk of clotting Prevention is key |
| Varicose veins nursing care | *Promote venous return -Change positions frequently - Elevate legs above heart *Educate - Avoid increasing pressure (crossing legs, knee highs, garters) -Wear TEDS - Weight loss |
| Venous Thrombosis - Superficial Thrombophlebitis | Inflammation and clot formation in vein. This is superficial instead of DVT (which is deep) Usually a result of having an IV (65% of cases) |
| Superficial Thrombophlebitis assessment findings | Tenderness, redness, warmth & pain Inflammation along the course of the vein (can follow redness) Edema is rare May have high fever |
| Superficial Thrombophlebitis diagnostics | Usually based on appearance May have elevated WBC's and positive blood cultures |
| Superficial Thrombophlebitis nursing diagnoses | Elevate extremity, Warm heat, Pain relievers (NSAID), Reduce inflammation, May need to I & D, Incision and drainage, May need antibiotics |
| Chronic Venous Insufficiency and Venous Leg Ulcers | Aka venous stasis -Valves of the legs are damaged and the blood pools (venous stasis). -Increased hydrostatic pressure in veins causes fluid to leak into tissue (edema) -Red blood cells breakdown & release hemosiderin (causes brown discoloration of lower legs; fibroses- thicken hardened darkened skin around ankles) |
| Chronic Venous Insufficiency and Venous Leg Ulcers Assessement findings | Hyperpigmentation (brownish), Leathery lower extremities, Edema, Ezcema, Ulcerations, Discolored with skin erosion, Variations if infection present, Scarring from healed ulceration |
| Chronic Venous Insufficiency and Venous Leg Ulcers Nursing Care and mgt | Compression therapy is primary treatment (distal to proximal) Dressings (Moist) Nutritional balance (Protein; tight glucose control- DM) Weight reduction Ongoing wound assessment |
| Lymphangitis | -ACUTE inflammation of lymphatic channels -Secondary to bacterial infection (often strep) -Enters through a cut, scratch, *insect bite, surgical wound, or other skin injury -RAPID moving -once bacteria enter lymphatic system, they multiply rapidly & follow lymphatic vessel -Infected vessel becomes inflamed, causing red streaks that are visible below skin surface |
| Lymphangitis assessment findings/treatment | Red streaks following lymphatic vessel; Red & Swollen; Pain; Fever; Chills; General malaise; Aches, headache; Anorexia Treat with antibiotics |
| Lymphedema | Blockage in lymphatic system prevents lymph fluid from draining -Fluid accumulates in and swelling continues -Progresses to fibrosis and irreversible tissue damage Predisposing factors are surgery, cancer, post chemo, radiation, trauma, infection |
| Lymphedema clinical findings | Affected limb is edematous, thickened skin, tight or heavy feeling, decreased ROM (Due to edema), achy discomfort Diagnosis based on patient's history and clinical presentation |
| Lymphedema nursing care and mgt | No cure but, can be controlled with compression garments, limb elevation, exercise and ROM, massage, maintain skin integrity, lymphedema therapist |
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