1-MedSurg > Module 7 Ch. 27 > Flashcards

Module 7 Ch. 27 Flashcards

(51 cards)

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1
Q

What does the right side of the heart do

A

pumps blood through the lungs to pulmonary circulation

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2
Q

What does the left side of the heart do

A

pumps blood to all other body tissues through systemic circulation

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3
Q

What is the driving force that moves blood vascularly

A

contraction of ventricles

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4
Q

What is the function of the vascular system

A
  • Supplying the circulatory needs of tissues
  • maintaining blood flow and pressure
  • providing capillary filtration and reabsorption
  • hemodynamic resistance
  • peripheral vascular regulating mechanisms
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5
Q

What can happen when vessels become stiffened in older adults

A
  • increased peripheral resistance
  • impaired blood flow
  • increased left ventricular workload
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6
Q

How can you do an assessment of the vascular system

A
  • Health Hx (intermittent cladication, rest pain, location of pain)
  • Physical assessment (skin, nails, loss of hair, pallor, ulcerations)
  • Pulses
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7
Q

What is intermittent claudication

A

pain with walking, stops with rest

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8
Q

What is rest pain

A

pain with rest, often occurs at night

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9
Q

What are some diagnostic tests todo with vascular system

A
  • Doppler US
  • Ankle brachial index
  • Exercise testing
  • Duplex ultrasonography
  • CT scan
  • Angiography/MRA
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10
Q

What is a continuous wave doppler US

A

Hand held US device used to detect blood flow
- Helps characterize the nature of peripheral vascular disease

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11
Q

What is assessment of a patient with peripheral vascular problems

A
  • Health HX
  • Medications
  • Risk factors
  • Signs and symptoms of arterial insufficiency
  • Claudication and rest pain
  • Color changes
  • Weak or absent pulses
  • Skin changes and skin breakdown
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12
Q

What are some goals with peripheral vascular problems

A
  • Increased arterial blood supply
  • Decrease in venous congestion
  • Promotion of vasodilation and prevention of vascular compression
  • Relief of pain
  • Maintain of tissue integrity
  • Adhere to self care program
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13
Q

What are some ways to improve peripheral arterial circulation

A
  • Positioning: body parts below heart level
  • Exercise program and activities
  • Temp
  • stop smoking and nicotine intake
  • Reduce stress
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14
Q

What are some arterial disorders

A
  • Arterio/Atherosclerosis
  • Peripheral artery disease
  • Upper extremity arterial disease
  • Aortoiliac disease
  • Aneurysms
  • Arterial embolism/arterial thrombosis
  • Raynauds
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15
Q

What is arteriosclerosis

A
  • Hardening of arteries
  • Muscle fibers and endothelial lining become thickened
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16
Q

What is atherosclerosis

A

Hardening of large arteries
- Accumulation of lipids, calcium, blood forming plaques

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17
Q

What are the most common arteries affected by arterio and atherosclerosis

A
  1. Abdominal
  2. Coronary
  3. Popliteral
  4. Carotid
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18
Q

What are some modifiable risk factors for atherosclerosis and Peripheral artery disease

A

nicotine use
diabetes
hypertension
hyperlipdemia
diet
stress
sedentary lifestyle

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19
Q

What are some nonmodifiable risk factors for atherosclerosis and Peripheral artery disease

A

age
genetics
family hx

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20
Q

What are peripheral artery disease hallmark symptoms

A
  • Intermittent claudication
  • Aching
  • Cramping
  • Inducing fatigue or weakness
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21
Q

What is pain associated with with peripheral artery disease

Study These Flashcards
A

critical ischemia of the distal extremity and is described as persistant, aching or boring

22
Q

What are some meds for peripheral artery disease

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A
  • Phosphodiesterase III inhib (Cilostazol for caludication)
  • Antiplatelet agent (Asprin/Clopidogrel to prevent thromboemobli)
  • Statins (reduce severity in intermittent claudication)
23
Q

What are some medical interventions for peripheral artery disease

Study These Flashcards
A
  • Surgery
  • Bypass graft to reroute blood flow around occlusion
24
Q

What are some things for nursing management of peripheral artery disease

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A
  • Lower extrem. below heart for atrial
  • Lower extrem. above heart for venous
  • Encourage walking
  • Maintain warm temps
  • Discourage nicotine
  • Encourage loose clothes
25
What is an aneurysm
localized sac or dilation formed at a week point in the wall of artery - Common forms are sccular and fusiform
26
What is a saccular aneurysm
aneurysm projects from only one side of vessel
27
what is a fusiform aneurysm
entire arterial segment becomes dilated then it forms
28
What is a thoracic aortic aneurysm
- Most common site for dissecting aneurysms - Emergency situation, commonly associated with high morbidity/mortality rates
29
What are some clinical manifestations of thoracic aortic aneurysm
- Constant pain when supine - Dyspnea - Frequent cough - Dysphagia - Hoarseness - Stridor *based on the pressure the aneurysm is giving*
30
What are some medical management for thoracic aortic aneurysm
- Control BP and correct risk factors - Beta blockers - Repair of aneurysm
31
What is an abdominal aortic aneurysm
- Affects men more than women - Untreated outcomes may cause rupture and death
32
What are some clinical manifestations of abdominal aortic aneurysm
- Can feel heart beat in abd. when laying - Feel an abd. mass/ throbbing -Severe back/abd pain (persist/intermittent) - Rupture is rapidly fatal
33
What are some signs an abdominal aortic aneurysm is leaking
- constant, intense back pain, falling BP and decreasing Hct
34
What is the medical management for abdominal aortic aneurysm
- Antihypertensives - Diuretics - Maintain BP - Endovascular and surgical management
35
What is the nursing management for abdominal aortic aneurysm
- Post op care if they got it surgical grafting - Pt must lay supine for 6 hrs - HOB can be elevated to 45 after 2hrs - VS and doppler to assess peripheral pulses
36
What is raynauds phenomenon
- Intermittent arterial vasoocculsion of toes and fingertips
37
What are some manifestations of raynauds phenomenon
sudden vasoconstriction resulting in color changes, numbness, tingling and burning pain
38
What is venous thromboembolism
blood clots form in the deep veins, usually in the legs (deep vein thrombosis or DVT) and can travel to the lungs (pulmonary embolism or PE)
39
What is some nursing management for venous thromboembolism
- Anticoagulants (warfarin and heparin) - Clot removal
40
What are some nursing managements for venous thromboembolism
- Reduce discomfort - Encourage exercise - Avoid sitting for over an hr - Promote home and community care
41
What are some preventative measures for venous thromboembolism
- Erly ambulation and leg exercises - Compression stockings - weight loss - stop smoking - regular exercise
42
What is a pulmonary embolism
Obstruction of the pulmonary artery or one of the branches by a thrombus
43
What is the most common sign of a pulmonary embolism
dyspnea is one others are: chest pain, anx, fever, tachycardia, cough, diaphoresis
44
What are some diagnostic tests for pulmonary embolism
- Chest XR, ECG, pulse ox, ABGs, D-dimer, V/Q scan - MDCTA
45
What is assessment for someone with leg ulcers
- HX of condition - Assess pain, edema, peripheral pulses - treatment depending on ulcer type - Assess for presence of infection
46
What is lymphangitis
inflammation or infection of lymphatic channels
47
What is lymphadenitis
inflammation or infection of lymph nodes
48
What is lymphedema
tissue swelling related to lymphatic obstruction
49
What are some signs and symptoms of cellulitis
localized swelling/redness, fever, chills, sweating
50
What is the treatment for cellulitis
oral or IV antibiotics
51
What are some nursing interventions for cellulitis
- elevate area 3-6 inches above heart level - Warm, moist packs every 2-4 hrs - Educate on skin and foot care
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