avoid cold temps, adequate protection, no smoking, vasodilators, ntg, ca channel blockers and beta blockers, pain control
surgery - sympathectomy
pain, heat, redness, edema, + homans
venous thrombosis causes
damage to endothelial lining of vein
pelvis and lower extremities
dx ven throm
s/s and venogram
tx ven throm
meds, br, compression stockings, elevate legs, ankle/leg exercises, surgery
what does vein look like
warm, red, swollen, painful when down
Sudden onset of severe pain, extremity is cold, pale or cyanotic, c/o numbness and tingling; pain will be more severe when elevated
dx art throm
exam for pulses, Doppler, MRI, angiogram
tx art throm
must be immediate, leg in dependent position, BR, warm wraps, meds, and surgery
If you palpate a pulse below the extremity affected
you will not feel a pulse
: COLD, PALE TO CYNATOIC, NUMBNESS, PAIN WHEN UP
- commonly will see clots in, most common varicose vein
Surgery for varicose veins, why would it be important to elevate early?
Prevent blood clots and stimulate circulation
inner layer has tear and blood collects between the inner and middle layers or aneurysm
s/s dis aneurysm
may have pain near structures-if bronchial-difficulty swallowing
dx diss aneur
exam and pt collapses
tx diss aneur
bypass, replacement, antihypertensives, Jennifer also stated clipped off or stent
occlusion of coronary artery
touchy time for mi pts
onset to day 3
risk for dysrhythmias
angina vs mi
mi more sever and longer
Thrombolytics or Fibrolytics agents
are used to dissolve a clot and reduce effects of MI
After MI valsulva maneuver is dangerous to the patient can cause
When patient has dsyrhythmias-
patient has decreased cardiac output, reduced coronary artery blood flow, has an increased oxygen need
Electrical impulses start at the
less than 60
more than 100
Atrial Fibrillation what happens there?
Atrium quivers so there is rapid atrial activity.
Complete heart block
atrium and ventricles function independently, without relationship to each other. Atrium and ventricles pump whenever they want
has no P wave. Only serious when having multiple runs of PVC is when it leads to a serious event
Cardioversion is usually done with patient
awake just given sedative. Used to terminate rapid dysrhytmias.
Patient in Ventricular fibrillation, what do they need?
is a microbial infection that affects the lining of the heart and its valves.
Buerger’s disease in men,
stop smoking and the disease will go away.
Patient with aortic aneurysm what vital sign would you monitor closely?
Blood pressure will drop due to rapid blood loss
S/S of angina-
substernal and described as viselike, burning, squeezing or smothering; may radiate into arm, shoulder, jaw, neck, or epugastrium. May have nausea, vomiting, diaphoresis, or dyspnea. Lasts only a few minutes. Relieved by rest or nitroglycerine
Unstable angina- also called crescendo angina or preinfarction angina. Pain is more severe, occurss at rest or with minimal exertion. Often NOT relieved with nitroglycerine. These patients are at higher risk for myocardial infarction and are often hospitlized for diagnostic workup and treatment
Key difference between stable and unstable angina is stable goes away with rest unstable doesn’t!
heavy constrictive pain below or behind the sternum, pain may radiate to arms, back, neck, or jaw, diaphoresis, light-headed, n/v, dyspnea, cold, clammy skin, feelings of impending doom, woman and diabtetics atypical sx