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Vascular and Circulation Disorders
Medsurg I Nursing
53
Nursing
Undergraduate 3
04/11/2014

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Cards

Term
Ankle-Brachial Index
Definition
  • ratio of the anke systolic pressure to the brachial systolic pressur
  • measures arterial disease that provides quantification of degree of stenosis
Term
Arteriosclerosis
Definition
  • proces whereby the muscle fibers and endothelial lining of small arteries and arterioles thicken
Term
Atherosclerosis
Definition
  • inflammatory process involving accumulation of lipids, calcium, blood componenets and carbs on the intima layer of the large artery
Term
Angioplasty
Definition
  • an invasive procedure that uses a balloon-tipped catheter to dilate a stenotic area of a blood vessel
Term
Duplex Ultrasonography
Definition
  • combines B-mode grayscale imaging of tissue organs and vessels with capabilities of estimating velocity changes by the use of the pulsed Doppler
Term
Characteristics of Arterial Insufficiency
Definition
  • sharp, unrelenting constant pain
  • dependant rubor, loss of hair over feet, nails thicken
  • diminished or absent pulses
Term
Characteristics of Venous Insufficiency
Definition
  • aching, cramping pain
  • pulses are present, but can be hard to palpate
  • skin is thick and tough, may be reddish blue
Term
Intermittent Claudication
Definition
  • pain, discomfort or fatigue caused by the inability of the arteries to support adequate blood flow to the tissues
  • pain is majoritively felt upon movement or physical activity
Term
Rubor may be observed w/in _____ to _____ after the extremity is placed in a dependent position.
Definition
  • 20 seconds - 2 minutes
Term
If a pulse cannot be palpated, always palpate the pulse _____ to the site.
Definition
  • proximal
Term
ABI Ranges
Definition
  • Normal ABI - 1.0
  • Claudicated ABI - 0.90 - 0.50
  • Ischemic ABI - less than 0.50
  • Severe Ischemic and tissue loss ABI - 0.40 or less
Term
Angiography
Definition
  • used to diagnose: occlusive arterial disease r/t surgery, aneurysm
  • inject radiopaque contrast agent to visualize the vessels
  • the patient may experience a warm sensation, irritation from the needle
Term
Magnetic Resonance Angiography
Definition
  • MRI programmed to isolate blood vessels
  • contraindicated in metal implants, tattoos
Term
Contrast Phlebography (Venography)
Definition
  • injection of radiopaque isotope to diagnosis if thrombus is present
  • if present, segment of vein will show up unfilled
  • injection may cause inflammation and be briefly painful
Term
Lymphoscintigraphy
Definition
  • injection of radioactive colloid SC into second interdigital space
  • exercise the limb to facilitate the colloid by the lymphatic system and images are obtained
Term
If there a lymphatic leak r/t lymphoscintigraphy, what color is the drainage?
Definition
  • blue from the incision; clearing the system takes days
Term
What is the most common disease of the arteries?
Definition
  • arteriosclerosis
Term
Pathophysiology of Atherosclerosis
Definition
  • caused by malnutrition and fibrosis of organs w/o sufficient blood
  • tissue cells needs sufficient nutrients, w/ reduction --> fibrous ---> impairs blood flow
Term
Where does atherosclerosis commonly develop?
Definition
  • where arteries branch into smaller vessels
  • males have more below the knee, women above the knee
Term
Atherosclerosis: Fatty Streaks
Definition
  • yellow and smooth, protrude slightly from the artery and composed of lipids
  • can be found in all age groups
  • do not usually cause clinical symptoms
Term
Atherosclerosis: Fibrous plaques
Definition
  • composed of smooth muscle, collagen, plasma and lipids
  • white and yellow and protrude into various degrees of the artery; can completely obstruct
  • mostly in abdominal, popliteal, coronary and internal coratid arteries
Term
Modifiable Risks of Atherosclerosis and PAD
Definition
  • nicotine use
  • diet
  • HTN
  • Diabetes
  • stress, sedentary lifestyle
Term
Nonmodifiable risks of Atherosclerosis and PAD
Definition
  • increasing age
  • female gender
  • familial predisposition/genetics
Term
Inflow procedure vs. Outflow procedure
Definition
  • Inflow - improve blood supply from the aorta into the femoral artery; diseases of the aorta
  • Outflow - provide blood supply to vessels below the femoral artery; diseases of the peripheral arterial occlusive
Term
Patients with PAD
Definition
  • keep lower extremities in neutral, dependent position
  • elevate the extremities elevated if venous insufficiency
Term
Hypertensive Urgency
Definition
  • situation in which blood pressure is very elevated but there is no evidence of impending or progressive organ damage
Term
What medications are recommended for the treatment of hypertensive urgencies?
Definition
  • beta-adrenergic blockers (ie. labetalol)
  • ACE inhibitors (ie. captopril)
  • alpha2-agonists (ie. clonidine)
Term
Hypertensive Emergency
Definition
  • blood pressures are extremely elevated and must be lowered immediately to prevent damage to the organs
Term
Therapuetic goals of hypertensive emergencies
Definition
  • lower mean blood pressure by 20-25% w/in first hour
  • reduce BP with 160/100 mm Hg w/in six hours
Term
Monotherapy
Definition
  • treatment with a single agent
  • helps simplify regimen and lessen costs
Term
Rebound Hypertension
Definition
  • occurs suddenly if antihypertensive medications are suddenly stopped
Term
Glomular Filtration Rate (GFR)
Definition
  • flow rate filtered fluid through the kidney, an indicator of renal function
Term
Isolated systolic hypertension
Definition
  • a condition most commonly see in the older adult which the systolic pressure is greater than 140 and diastolic is within normal limits
Term
Primary Hypertension
Definition
  • denotes high blood pressure from an unidentified cause
  • also called essential hypertension
Term
Secondary Hypertension
Definition
  • high blood pressure from an identified cause such as renal disease
Term
Classification of Blood Pressures
Definition
  • Normal: <120/<80
  • Prehypertension: 120-139/80-89
  • Stage 1: 140-159/90-99
  • Stage 2: >160/>100
Term
Causes of Hypertension
Definition
  • increased sympathetic nervous system activity
  • increased renal reabsorption of sodium, chloride and water
  • decreased vasodilation of the arterioles
  • resistance to insulin action
Term
For patients with uncomplicated hypertension, what are the initial medications?
Definition
  • diuretics
  • betablockers
  • OR BOTH
Term
Lifestyle modifications to prevent and manage hypertension
Definition
  • weight reduction and daily exercise
  • DASH diet (fruit, veggies, low-fat dairy, low salt - no more than 2 grams of sodium a day)
  • moderation of alcohol consumption
Term
Foods appropriate for the DASH diet
Definition
  • grain products - 7/8 servings
  • fruits and vegetables - 4/5 servings
  • low-fat/fat-free dairy - 2/3 servings
  • meat, fish - >2 servings
  • nuts, seeds - 4/5 servings weekly
Term
Promoting Vasodilation and prevent vascular compression
Definition
  • applying warm applications, such as heating pads or hot water bottles, blankets or hot baths
  • avoid tight clothing
  • minimize emotional stress
  • avoid nicotine and tobacco products, avoid alcohol intake
Term
Hallmark symptom of PAD is _____?
Definition
  • intermittent claudication
  • aching, cramping or induced fatigue/weakness that occurs with some degree of exercise and relieved with rest
Term
Maintaining Tissue Integrity
Definition
  • well-fitting, sturdy shoes and slippers; do not go barefoot
  • neutral soaps and body lotions; do not apply lotion between the toes
  • do not scratch or rub the skin, pat wet skin dry, trim finger/toe nails
  • good nutrition
Term
Peripheral Arterial Occlusive Disease
Definition
  • occurs most often in the legs
  • tends to extend from the aorta to below the renal arteries to the popliteal artery
  • frequently seen in diabetes and older patients
Term
Assessment of Diagnostic Findings of PAD
Definition
  • cool, pale extremities when elevated or cyanotic, ruddy extremities when dependent
  • ulcers, gangrene or muscle atrophy may occur
  • peripheral pulses may be diminished or absent
Term
Pentoxifylline (Trental)
Definition
  • treatment of symptomatic claudication
  • increases increased erythrocyte flexibility, lowers fibrin and inhibits neutrophil adhesion/activation
Term
Cilostazol (Pletal)
Definition
  • vasodilator
  • inhibits platelet aggregation
  • contraindicated in patients with a history of CHF or ejection fraction <40%
Term
____ improve endothelial fxn in patients with PAD.
Definition
  • statins; not enough evidence to support whether or not symptoms of claudication are decreased
Term
The distal outflow must be at least ____% patent for the graft to remain patent.
Definition
  • 50%
Term
Left sided heart failure causes?
Definition
  • accumulation of blood in the lungs and reduction in foward flow
  • results in inadequate arterial flow to the tissues
Term
Aneurysm
Definition
  • localized sac formed at a weak point at the wall within an artery; sacular or fusiform
  • most common cause is atherosclerotic changes in the aorta
  • if ruptures, can lead to hemorrhage and death
Term
Aortioliac Disease
Definition
  • when collateral circulation develops, pts with stenosis or occlusion of aortoiliac segment can be symptomatic
  • may complain of buttock or lower back pain and have decreased/absent femoral pulses
  • men can experience impotence
Term
Upper Extremity Arterial Oclusive Disease
Definition
  • arterial occlusions of the upper extremities
  • cause less severe symptoms because of collateral circulation is better in the arms
  • rare
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