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Med-Surg Chapter 37- Vascular Disorders
Terms in this set (21)
What is peripheral artery disease and what does it result in? PAD
it involves thickening of artery walls, this results in progressive narrowing of the arteries of the upper and lower extremeties
What is the leading cause of PAD?
What is atherosclerosis?
a gradual thickening of the intima [the innermost layer of the arterial wall] and media [middle layer of the arterial wall]
Generally, the severity of the clinical manifestations depends on what?
the site and extent of the blockage and the amount of collateral circulation
What is the classic symptom of lower extremity PAD?
ischemic muscle pain that is caused by exercise, resolves within 10 min or less with rest and is reproducible
The ischemic pain is a result of what?
the buildup of lactic acid from anaerobic metabolism
As many as one third of patients with PAD report classic claudication symptoms. The remaining patients have what symptoms?
either no symptoms or present with atypical leg symptoms such as:
What is paresthesia?
numbness or tingling in the toes or feet that may result from nerve tissue ischemia
In people with lower extremity PAD what does the skin of the legs look like?
the skin becomes thin, shiny, and taut, and hair loss occurs on the lower legs
Segmental blood pressures
a diagnostic study for PAD
are obtained [using doppler ultrasound and a sphygmomanometer] at the thigh, below the knee, and at ankle level while the patient is supine
A drop in segmental BP of greater than what suggests PAD?
30 mm Hg
Ankle-brachial index [ABI]
a PAD screening tool
it is performed using a hand-held doppler. The ABI is calculated by dividing the ankle systolic BP's by the higher of the left and right brachial systolic BP's
In older adults and those with diabetes, what can result in a falsely elevated ABI?
the arteries often are calcified and noncompressible
What is essential to reduce the risk of CVD events, PAD progression, and death?
What is a major risk factor for PAD and increases the risk of amputation in these patients?
Aggressive __________ management is essential for all patients with PAD
What medications are used for symptomatic patients with PAD?
What agents are critical for reducing the risks of CVD events and death in PAD patients
What combination is not typically recommended?
antiplatelet therapy with aspirin and clopidogrel
Teach patients with PAD to maintain a BMI of what and a waist circumference of what?
less than 25kg/m2
waist: less than 40 inches for men an dless than 35 inches for women
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