Pharmacology
What pharmacological classes can be used to manage carotid artery disease?
Antiplatelets Anticoagulants
You assumed care of a patient diagnosed with a significant venous stasis ulcer.
Provide 3 possible recommended treatments for this condition.
elevation wound VAC
moist dressing Unna Boot
compression
A patient presents with unilateral calf swelling, erythema and pain. as the PN, you are concerned for a ____________.
Deep Vein Thrombosis
A patient newly diagnosed with Raynaud's diseases asks you why they are supposed to limit their caffeine intake. What is your response?
Caffeine causes vasoconstriction which can further exacerbate the impaired circulation to the distal extremities.
What are the 6 P's for acute limb ischemia?
Pain, Pallor, Pulselessness, Paresthesia, Poikilothermia, Paralysis
The PN knows that the 2 pharmacological treatments to prevent complication from Buerger's Disease include:
Antibiotics Anti-inflammatories
A patient admitted with a TIA has just been ordered a carotid ultrasound. You know that this test is to rule out:
Carotid Artery Disease
What disease is characterized by tight shiny skin and hairless legs due to decreased blood flow to the extremity?
Peripheral artery disease
As a new PN, you are concerned about the risk of developing varicose veins at your first job.
You know that 3 ways to prevent varicose veins include:
compression socks!! weight reduction
elevation exercise
avoid prolonged sitting, standing, leg crossing
In which peripheral vascular disease would you expect paling of the phalanges, edema, and decreased sensory perception?
Raynaud's Disease
A patient has been prescribed lasix.
The PN knows it is important to educate the patient on consuming foods rich in what nutrient?
Provide 3 examples of foods rich in this nutrient.
Potassium
Poor management of Buerger's Disease can ultimately lead to ___________, which results in ____________.
Ulceration or Gangrene
Amputation
***increased inflammation of vessels and poor perfusion leads to death in the skin and tissue of the peripheral extremities.
What disease is characterized by vasospasms exacerbated by stress and cold climates?
Raynaud's Disease
What education is important to provide patients with Chronic Venous Insufficiency? Provide 3 examples.
immediately report injury to affected leg
Elevate legs, even in bed
Don't cross legs
support hose or TEDs
leg moisturizer
Avoid prolonged sitting and standing
You have just performed a lower extremity assessment on a patient. You noted: bilateral lower extremity swelling, hardened, dusky-brown skin around the ankles, and itchy, scaly skin.
You are aware that these are expected findings for which disease process?
Chronic Venous Insufficiency
Your patient is recovering from a AAA repair and is receiving narcotics for pain control.
You realize that this makes your GI assessments even more important, because you know that this places your client at increased risk for:
constipation (straining) and paralytic ileus
During rounds, you note erythema and inflammation of a superficial vein at the site of a peripheral IV. What treatment management do you anticipate?
List 3 management options.
D/C IV NSAIDS
warm, moist heat possible ABX
elevate extremity
What disease is strongly associated with smoking, and presents with paresthesia and pain in the distal portions of the extremities?
Buerger's Disease
What education is important to provide patients with Peripheral Artery Disease? Provide 3 examples.
warm clothing smoking cessation
NON-restrictive clothing avoid crossing legs
avoid the cold cautious heat
do not walk barefoot don't elevate feet
Your patient rings the call light and reports a severe onset of abdominal and back pain. You are concerned for AAA, especially with the patient's smoking and HTN history. What are 2 key assessments will you perform?
inspect abdomen for pulsations
auscultate abdomen for bruit
assess lower extremity pulses
assess lower extremity sensation
Provide 2 pharmacology classes used to manage Raynaud's Disease.
CCB: dilates capillaries
ALPHA BLOCKERS: prevents vasoconstriction
VASODILATORS: promotes vasodilation
SYNTHETIC PROSTAGLANDIN ILOPROST: dilates arterial beds
a patient family member asks you what the purpose of an IVC filter is. What is your answer?
it is placed in the inferior vena cava to catch any blood clots that break off in the lower extremities, to prevent the clots from traveling to the brain, heart, or lungs.
A student PN asks you what the difference between Raynaud's Disease and Buerger's Disease are.
What is your answer, based on the A&P?
Raynaud's: vasospasm of the small arteries, occluding blood flow.
Buerger's: inflammation and swelling of the blood vessels.
A patient with carotid artery disease is irritable that the PN staff are performing q4hr neuro checks.
the PN knows that the purpose of performing neuro assessments on patients with his condition are:
o assess for impaired blood flow to the brain caused by increased calcification and occlusion
OR
to assess for an embolus if part of the clot breaks off and enters the brain's vasculature
In addition to performing a focused assessment of the affected extremity in a patient diagnosed with a DVT, a seasoned PN knows that it is also extremely important to screen for ___________.
a PE. DVTs have a high likelihood of breathing off and becoming a PE.
Do you have any shortness of breath, or chest pain?