Objective 19 and 20.txt

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Objective 19 and 20.txt
2013-09-02 14:30:01
Objective 19 20

Objective 19 and 20
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  1. Peripheral blood flow
    flow rate=change in P/R
  2. Hemodynamic resistance
    blood viscosity and vessel diameter
  3. Characteristics of arterial and venous insufficiency
    intermittent claudication, changes in skin and appearance, pulses, aging changes
  4. Pulses in insufficiency
    arterial-diminished or absent; venous-hard to find due to edema
  5. Intermittent claudication is the hallmark symptom for
    arterial insufficiency
  6. Venous legs are
    achy and crampy
  7. Stage 1 of PAD
    asymptomatic; no claudication is present; may be bruit or aneurysm; pedal pulses are decreased or absent
  8. State 2 of PAD
    Claudication-muscle pain, cramping or burning occurs with exercise and is relieved with rest
  9. Stage 3 of PAD
    Rest pain-pain can awake pt at night; numbness, burning, toothache-type pain; distal part of the extremity; pain relieved by putting extremity in dependent position
  10. Stage 4 of PAD
    Necrosis or gangrene; ulcers on toes, forefoot and heel; gangrenous odor is present
  11. Usually have minimal leg edema unless leg is in dependent position constantly to relieve pain
  12. Causes of atherosclerosis
    HTN, smoking, cholesterol
  13. Care of pt with PAD
    health history, meds, risk factors, S/S of arterial insuffiency
  14. Nursing diagnoses for PAD
    altered peripheral tissue perfusion, chronic pain, risk for impaired skin integrity, knowledge deficit, risk for infection
  15. Nursing goals for PAD
    increased blood supply, manage pain to increase leg activities
  16. Improvement of peripheral arterial circulation
    exercises, positioning, temperature, stop smoking, stress reduction, avoid certain cold medications
  17. Med mgmt. of PVD
    prevention, exercise, medications trental and pletal, antiplatelet agents, surgical mgmt