misc
what are the main clinical manifestations of Peripheral Artery Disease (PAD)?
intermittent claudication (pain that is caused by a constant level of exercise)
paresthesia (numbness or tingling)
reduced blood flow to limb
what is phlebitis?
acute inflammation of the walls of the small cannulated veins of the hand or arm (related to IV)
what is the most common aneurysm?
Abdominal aortic aneurysm
which information would the nurse include when explaining the cause of rest pain with PAD?
a. vasospasm of cutaneous arteries in the feet
b. increase in retrograde venous perfusion to the lower legs
c. decrease in blood flow to the nerves of the feet
d. construction in blood flow to leg muscles during exercise
c. decrease in blood flow to the nerves of the feet
which goal is the first priority of inter professional care for a patient with a suspected acute aortic dissection?
a. reduce anxiety
b. monitor chest pain
c. control BP
d. increase myocardial contractility
c. control BP
what is critical limb ischemia (CLI)?
condition characterized by chronic ischemic rest pain lasting more than 2 weeks, non healing leg ulcers, or gangrene of the leg from PAD
this results from the creation of a false lumen between the intima (inner lining) and the media (middle layer) of the arterial wall
aortic dissection
PAD of lower extremities:
femoral, popliteal most common WITHOUT diabetes
arteries below the _____ most commonly affected WITH diabetes
knee
a patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. which signs suggest that the aneurysm has ruptured?
a. rapid onset of SOB and hemopytosis
b. sudden low back pain and bruising along the flank
c. patch blue mottling on feet and toes and rest pain
d. gradually increasing substernal chest pain and diaphoresis
b. sudden low back pain and bruising along the flank
which treatment would the nurse anticipate for an otherwise healthy person with an initial VTE?
a. IV aragtroban as an inpatient
b. IV unfractionated heparin as an inpatient
c. SQ unfractionated heparin as an outpatient
d. SQ low molecular weight heparin as an outpatient
d. SQ low molecular weight heparin as an outpatient
name the condition/disease:
nonatherosclerotic, segmental, recurrent inflammatory disorder of the small and medium arteries and veins of the arms and legs
thromboangitis obliterates (Buerger's Disease)
interprofessional care of VTE (venous thromboembolism)?
(hint: drugs/devices)
warfarin (don't give with antiplatlets or NSAIDS)
SCDs (don't use with an active VTE- risk of PE)
dissection pain vs MI pain?
dissection pain is more gradual with increased intensity
which person would the nurse identify as having the highest risk for abdominal aortic aneurysm?
a. 70 yr old man with high cholesterol and HTN
b. 40 yr old woman with obesity and metabolic syndrome
c. 60 yr old man with renal insufficiency who is physically inactive
d. 65 yr old woman with high homocysteine levels and substance abuse
a. 70 yr old man with high cholesterol and HTN
a patient was just diagnosed with acute arterial ischemia in the left leg secondary to atrial fibrillation. which early clinical manifestation must be reported to the provider promptly?
a. paralysis
b. cramping
c. paresthesia
d. referred pain
c. paresthesia
what are the characteristics of Raynaud's Phenomenon?
disorder of small cutaneous arteries (fingers and toes most common)
change in color of fingers, toes, ears, and nose (white, blue, or red)
coldness, numbness, throbbing, aching pain, tingling, swelling
what is a complication of an aortic dissection?
cardiac tamponade
what is cardiac tamponade
enough fluid accumulates in the pericardial sac compressing the heart and leading to a decrease in cardiac output and shock
which clinical manifestations can the nurse expect to see in both patients with Buerger disease and Raynaud phenomenon? (SATA)
a. intermittent low grade fevers
b. sensitivity to cold temperatures
c. gangrenous ulcers on fingertips
d. color changes of fingers and toes
e. episodes of superficial vein thrombosis
b, c, d
the patient reports tenderness over a leg vein. the nurse assess warmth and a palpable cord in the area. which complication would the nurse plan to prevent?
a. pulmonary embolism
b. pulmonary HTN
c. postthrombotic syndrome
d. venous thromboembolism
d. venous thromboembolism
often asymptomatic
frequently detected on routine physical exam
pulsatile mass in periumbilical area slightly left of midline
bruit auscultated over aneurysm
Abdominal Aortic aneurysm
what are signs of an aneurysm rupture?
diaphoresis, pallor, weakness, tachycardia, hypotension, changes in LOC, pulsating abdominal mass, and abdominal/back/groin/periumbillical pain
what to frequently monitor on a patient with PAD?
skin color and temp
cap refill
presence of peripheral pulses
movement of extremity
which clinical findings would the nurse expect in a person with an acute lower extremity VTE? (SATA)
a. pallor and coolness of foot and calf
b. mild to moderate calf pain and tenderness
c. grossly decreased or absent pedal pulses
d. unilateral edema and induration of the thigh
e. palpable cord along a superficial varicose vein
b, d
the assistive personnel suggests applying compression stockings to a patient with peripheral vascular disease. which assessment finding would indicate that applying compression stockings could harm the patient?
a. leg pain at rest
b. high BP
c. dry, itchy, flaky skin
d. elevated blood glucose
a. leg pain at rest