Peripheral Vascular Disorders

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The flashcards below were created by user Prittyrick on FreezingBlue Flashcards.


  1. Assessment
    • History
    • - watch for risk factor: atherosclerosis, DM, venous disorders, birth control pills
    • Biological & demographics data
    • - age: older
    • - occupation: people who stand (nursing, hair dresser, clerks) or people who abuse their fingers- raynaud's disease
    • Chief complaint, frequency, duration
  2. Assessment Arterial
    • Intermittent claudification- doesnt happen all the time
    • - result of ischemia
    • - similar to angina
    • - relieved with dependent position
    • - "claudication distance"- how far can you walk
    • Cause- decrease blood flow
    • s/s: pain, numbness, cramping, tingling
  3. Assessment Arterial 2
    • thin, shiny, hairless skin
    • thick toe nails- fungal infection
    • cool skin, dec or absent pulses
    • mild/absent edema
    • small painful ulcers on toes, pressure pts, heels: punched out, dry, black/necrotic
  4. Assessment Venous
    • dull, aching pain
    • not associated with rest/excerise
    • heaviness in legs cramps at night
    • inc risk with long standing, multiple pregnancies, abdominal obesity
    • may have varicose veins
    • - venous pressure
  5. Assessment venous 2
    • Increased pressure gradients caused obstructed venous return, veins engorge, increasing capillary pressure, causing edema, blood flow slows and tissues become hypoxic (blood leaks out)
    • Ulcers develop in lower 1/3 of legs
    • exercise & elevation help venous return & collateral circulation- poor venous return
  6. Assessment venous- edema
    • Edema worsens thru day, improves over night
    • edema pitting at first, then scarring develops & pitting disappears
    • skin changes
    • - erythema (early)
    • - thick brawny skin- stasis ulcers, stasis dermatitis (this is classic, looks like an old tan)
    • - dry, flaky skin
  7. Hemosiderin: discoloration
    • RBC leaking out- Heme gives it the brawny color
    • chronic venous problem
  8. Assessment PMH
    • CAD
    • HTN
    • VTE- DVT
    • varicose veins
    • smoking
    • DM
    • Fam hx- DM, CAD, HTN, PVD
  9. Assessment- inspection
    • lower extremity color, temp
    • turgor
    • ulcers, scars
    • capillary refill
  10. Assessment inspection 2
    • hair distribution
    • muscle atrophy
    • venous pattern- varicose veins
    • edema
  11. assessment- palpation
    • dorsal surface of hand, compare sides
    • Pulses- mark if difficult to find- 2+
    • ** bilateral & compare except carotids
    • document rate, rhythm and quality
    • - 0 absent
    • - 2+ norm
    • - 1 + weak
    • - 3+ bounding
  12. assessment- horman's sign
    • AVOID USING
    • reliability varies false +/-
    • superfical phlebitis, achilles tendonitis can cause + horman's sign
    • doppler studies more accurate
  13. assessment- auscultation
    • stethoscope/doppler
    • correct fit- too small false high, too big false low
    • record both arms- document higher one
    • check for bruits at pulse points- if blood is bouncing off the wall
  14. assessment - diagnostic test
    • BP
    • - MAP Mean Arterial Pulse
    • SBP + 2DBP/3
    • - normal between 70-100
    • - < 60-65 End organ damage- not being perfused

    • Ankle-brachial index (ABI)
    • - SBP with doppler of Dorsal pedal or posterial tibal (lower extremity)
    • - ABI: systolic ankle pressure/systolic brachial pressure
    • - ankle pressure usually greater than brachial because it is further away.
  15. Assessment- ABI
    • > 1 norm
    • < 0.9 insuffiency
    • - no good blood flow to the periphery
  16. Assessment diagnostic 2
    • *** US most sensitive and specific for DVT
    • CT scan/MRI- vessels and aneurysms
    • Exercise testing
    • - 5 min mild claudification
    • - 1 min severe claudification
  17. Contrast angiography
    • NPO 2-6 hrs before, document pulses
    • Nsg care after like cardiac cath
    • complications- allergic reactions, thrombus/emboli formation, vessel peforation, renal failure
    • check VS, pulses, csm
  18. Contrast venography
    • Nsg care before- document pulses, clear liquid x 3-4 hrs
    • Nsg care after- pressure dsg to site
    • - BR x 2hrs if femoral vein used
    • - IV hydration x 8-24 hrs
    • - check site, extremity as with angiography
    • - check pulse, csm
    • look for DVT or at  valves
  19. Vascular endoscopy
    • flexible fiberoptic scope
    • Can ID thrombus, plaque
    • can angioplasty, stent
    • nursing care after, similar to angiography
    • similar to PTCA check pulses

Card Set Information

Author:
Prittyrick
ID:
330141
Filename:
Peripheral Vascular Disorders
Updated:
2017-04-05 20:57:58
Tags:
PVD
Folders:

Description:
arterial v venous
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