Card Set Information
Periferal Artery Disease
General info about PAD
--Progressive narrowing & degeneration of arteries
SnSs of PAD
Ischemic muscle ache or pain that is precipitated by a constant level of exercise
--Resolves within 10 minutes or less with rest (claudication)
Thin, shiny, and taut skin
Loss of hair on the lower legs
Diminished/absent pedal, popliteal, or femoral pulses
--Occurs in the fore
--foot or toes and is aggravated by limb elevation
--Occurs from insufficient blood flow
--Occurs more often at night
Complications of PAD
Atrophy of the skin and underlying muscles
Diagnostics for PAD
--Segmental blood pressures
Ankle-brachial index (ABI)
--Done using a handheld Doppler
Magnetic resonance angiography (MRA)
H & P
Include palpation of peripheral pulses
Rx therapy for PAD
Drugs prescribed for treatment of intermittent claudication:
Exercise therapy for PAD
Exercise improves oxygen extraction in the legs and skeletal metabolism
Walking is the most effective exercise for individuals with claudication
--30 to 40 minutes/day
--Will only work if PAD has not progressed to the point of occluding pulses.
Nutritional Therapy for pt w/PAD
Dietary cholesterol less than 200 mg/day
Decrease intake of saturated fat
Soy products can be used in place of animal protein
Alternative, Collaborative therapies for pt w/PAD
--Effective in increasing walking distance for patients with intermittent claudication
Folate, vitamin B6, cobalamin (B12)
--Lowers homocysteine levels
Nursing care of an ischemic limb
Protect from trauma. Pt may not be able to feel feel and are therefore more prone to injury.
Decrease vasospasm. Use warm water, wear socks and shoes.
Maximize arterial perfusion
Intervensional, collaborative procedures
Percutaneous transluminal balloon angioplasty (radiological)
: surgical removal of plaque inside the artery.
Patch graft angioplasty
Acute Intervention for pt w/PAD
Knee-flexed positions should be avoided except for exercise
Turn and position frequently
What to call the MD for?
6 P's of acute and chronic PAD
*Poikilothermia (taking on temp of surrounding environment in affected extremety)
Without intervension, pt may lose leg. Gangrene within hours.
Nursing Intervensions for pt w/AAID
Continuous IV Heparin
Determine potential cause
AKA buerger's disease
Ischemia secondary to inflammatory thrombus, NOT fat!
Small arteries & veins in UE’s or LE’s
-Similar to PAD
What is Raynaud's Syndrome?
Vasospasm secondary to exaggerated SNS response
Occupational related trauma?
--Color changes to fingers, toes, ears & nose
--Episodic paresthesia/ coldness
Management of Raynaud's
Protection from exacerbating factors
--Avoid tobacco products
--Avoid drugs with vasoconstrictive effects
--Test for connective tissue or autoimmune disease
--Dilation of aortic arterial wall
SnSs of TAA and AAA
Aortic Aneurysm: NSG care
Pre-op & post-op care
ABG & F/E monitoring
Meticulous head-toe assessments
DVT Collaborative Care
--Elevation of extremity
: filters DVTs if they travel before they enter the heart.