vascular assessment
What test compares the systolic blood pressure at the ankle with the systolic blood pressure of the arm?
Ankle-Brachial Index (ABI)
What is the hallmark symptom of peripheral artery disease?
INTERMITTENT CLAUDICATION
What are the 6 Ps of acute arterial occlusion?
Pain
Pallor
Pulselessness
Paresthesia
Poikilothermia
Paralysis
Which type of ulcer is associated with absent pulses, pallor, dry/shiny skin, and loss of hair?
Arterial ulcer
What is the difference between primary and secondary hypertension?
Primary HTN: No identifiable cause
Secondary HTN: Has a direct/identifiable cause, such as renal disease, sleep apnea, or pregnancy.
Name 3 things the nurse assesses during a vascular assessment
Pulses, Color, Temperature, Capillary refill, Sensation, Pain, Edema, BP, Symmetry, Strength
How would a nurse describe intermittent claudication to a patient?
Aching, cramping, fatigue, or weakness that occurs with exercise/activity.
What is an embolus?
Something that breaks off and travels through the bloodstream.
Which type of ulcer is associated with edema and thickened skin?
Venous ulcer
Name 3 lifestyle modifications recommended for hypertension.
Weight reduction, DASH diet, Decreased sodium intake, Regular physical activity, Reduced alcohol consumption
What laboratory tests are important when evaluating vascular disease?
C-reactive protein (CRP), Fasting Lipid profile, CBC
What is the difference between arteriosclerosis and atherosclerosis?
Arteriosclerosis: hardening of the arteries.
Atherosclerosis: accumulation of lipids, calcium, blood components, and fibrous tissue on the inner layer of the artery, forming plaques/atheromas.
A patient with atrial fibrillation suddenly develops a cold, pale, painful leg with an absent pulse.
What should the nurse suspect?
Arterial embolus/acute arterial occlusion
Which condition causes fluid accumulation in the tissues and can result in compression?
Lymphedema
Name 4 medication classes used to treat hypertension.
Thiazide diuretics, ACE inhibitors, ARBs, Calcium channel blockers, Loop diuretics, Beta blockers
A client reports bilateral calf pain when walking that stops after resting. Which additional finding would BEST support the nurse’s suspicion of peripheral arterial disease?
A. 3+ pitting edema that worsens throughout the day
B. Brown pigmentation around both ankles
C. Pain decreases when the legs are placed in a dependent position
D. Warm skin with palpable 2+ pedal pulses
C. Pain decreases when the legs are placed in a dependent position
A patient reports aching and cramping in the calf while walking. The pain improves when the patient stops exercising. The patient has decreased peripheral pulses.
What condition should the nurse suspect?
A. Venous ulcer
B. PAD
C. Lymphedema
D. Raynaud’s syndrome
B. Peripheral Artery Disease
A patient suddenly develops severe chest and back pain described as “ripping and tearing.” The patient’s BP is different between the two arms.
What is the priority concern?
A. PAD
B. Aortic dissection
C. Venous ulcer
D. Raynaud’s phenomenon
B. Aortic dissection
A client with chronic lymphedema suddenly develops increased swelling, redness, warmth, and tenderness of the affected extremity and reports chills. What complication should the nurse suspect?
A patient has a BP of 182/122. Which statement correctly distinguishes a hypertensive crisis from a hypertensive emergency?
A. Crisis always means there is organ damage; emergency means there is not
B. Hypertensive emergency involves evidence of tissue/organ damage, while hypertensive urgency does not
C. Hypertensive urgency always requires surgery
D. There is no difference between hypertensive urgency and emergency
B. Hypertensive emergency involves evidence of tissue/organ damage, while hypertensive crisis does not
When assessing a patient’s carotid arteries, the nurse hears a whooshing sound over the vessel with the stethoscope. What abnormal finding has the nurse identified?
A bruit
The nurse is caring for a patient with PAD. Which patient statement indicates the need for further teaching?
A. “I should participate in regular physical activity.”
B. “My medications can help reduce my vascular risk.”
C. “I should pay attention to changes in my feet and skin.”
D. “Since I have PAD, I should avoid all physical activity.”
D “Since I have PAD, I should avoid all physical activity.”
Why: Exercise is included as part of PAD management in your study material.
A hospitalized patient suddenly develops shortness of breath, sharp chest pain that worsens with inspiration, tachycardia, and anxiety after being immobile for several days. What potentially life-threatening vascular complication should the nurse suspect?
A pulmonary embolism
The nurse is assessing a client with suspected chronic venous insufficiency. Without being told the diagnosis, the nurse wants to distinguish it from arterial disease.
What three assessment findings would the nurse expect to find with venous insufficiency?
edema, warm skin, and brown/reddish-brown discoloration of the lower legs
The nurse receives four patients. Which patient requires the most immediate attention related to hypertension?
A. A patient with BP 150/92 who reports no symptoms
B. A patient with BP 165/98 who states they forgot their medication this morning
C. A patient with BP 185/122 and evidence of tissue/organ damage
D. A patient with BP 142/88 who is being educated about a DASH diet
C. A patient with BP 185/122 and evidence of tissue/organ damage
The patient’s BP meets the hypertensive crisis range, and the presence of tissue/organ damage makes it a hypertensive emergency.