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Peripheral System Flashcards

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1
Q

what is peripheral arterial disease ?

A

affects non coronary arteries and usually refers to arteries suppling the limbs.
caused by atherosclerosis

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2
Q

what is peripheral venous disease?

A
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3
Q

whats the grading for radial pulses?

A

3+ increased, full, bounding
2+ normal
1+weak
0 absent

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4
Q

whats the grading for edema?

A

1+ mild pitting, slight indentation, no perceptible swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, legs look swollen
4+ Very deep pitting, indentation lasts a long time, leg is grossly swollen and distored.

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5
Q

how to check for pretibial edema?

A

firmly depress the skin over the tibia or the medial malleolus for 5 seconds and release.

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6
Q

what is bilateral edema associated with? both sides

A

heart failure, diabetic neuropathy, and hepatic cirrhosis.

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7
Q

what is unilateral edema associated with? only on one side is affected

A

occurs with occlusion of a deep vein.

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8
Q

what occurs for both unilateral or bilateral edema?

A

lymphatic obstruction

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9
Q

what is the modified allen test?

A

is used to evaluate the adequacy of collateral circulation before cannulating the radial artery.

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10
Q

how to assess the modified Allen test?

A

-Firmly occlude both the ulnar and radial arteries of one hand while the person to open the hand without hyperextending it
-Then release pressure on the ulnar artery while maintaining pressure on the radial artery
-Adequate circulation is suggested by a palmar blush, a return to the normal color of the hand less than 7 seconds. (normal)

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11
Q

what is abnormal finding for the allen test?

A

pallor that persists or a sluggish return to color suggest occlusion of the collateral arterial flow.

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12
Q

where is the popliteal pulse found?

A

behind the knee. anchor your thumbs on the knee and curl your fingers around into the popliteal fossa.

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13
Q

where is the femoral pulse found ?

A

just below the inguinal ligament halfway between the pubis and anterior superior iliac spines. Groin area.

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14
Q

where is the dorsalis pulse found?

A

requires a light touch. lateral to and parallel with the extensor tendon of the big toe.

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15
Q

where is the posterior tibial pulse found?

A

curve your fingers around the medial malleolus.

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16
Q

how to check for pretibial edema?

A

firmly depress the skin over the tibia

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17
Q

what does the arteries do?

A

to supply oxygen and essential nutrients to tissues.

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18
Q

what is another word for veins?

A

also called capacitance vessels their ability to stretch.

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19
Q

what is intermittent claudication?

A

is there pain while walking. Pain in specific muscle group by walking and how long does it take to relieve the pain when resting.

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20
Q

arterial disease causes symptoms and sign of what?

A

oxygen deficit

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21
Q

venous disease causes symptoms and signs of what?

A

metabolic waster build up

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22
Q

the patient complains of pain in calf, lower leg, what does this indciate?

A

chronic venous symtoms

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23
Q

the patient complains of deep muscle pain, usually in calf, but may be in lower leg or dorsum of foot.

A

chronic arterial symptoms

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24
Q

what are the character of chronic arterial and acute arterial? think of period

A

Chronic arterial are intermittent claudication, the patient states like cramp, numbness, and tingling. ‘’ Feeling of cold’’
Acute arterial is throbbing

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25
what is intermittent claudication?
26
what are the location of chronic arterial and acute arterial?
for chronic is complains of deep muscle pain, usually in calf, but may be in lower leg or dorsum of foot. acute arterial varies distal to occlusion and may involve entire leg
27
what is the on set and duration of chronic arterial disease and acute arterial disease? on set what do you feel
for chronic it is chronic pain, onset gradual after excretion acute arterial sudden onset (one hour)
28
what are the aggravating factors of chronic arterial disease and acute arterial disease?
chronic arterial disease- activity such as walking, stair, a specific number of blocks that it takes to produce pain, elevation acute arterial disease- .....
29
what are the relieving factors of chronic arterial disease and acute arterial disease?
chronic arterial disease- rest like standing for two minutes and dangling of the legs acute arterial disease- ....
30
what are the symptoms like skin, pluses of chronic arterial disease and acute arterial disease? the frist 3 and then 6 PS
chronic arterial disease- low ankle-brachial index, cool, pale skin, diminished pulses, pallor of elevation acute arterial disease- the six P = pain, pallor, pulsenessness, parenthesis, poikilothermic (coldness), paralysis
31
what types of patients are at risk for chronic arterial disease and acute arterial disease?
Chronic - older and middle age adults african americans have twice than other racial groups. smoking is acute -
32
what racial group is the higest risk of Chronic arterial disease?
African American
33
for acute arterial disease, who are at risk like conditions or trauma?
patients with vascular surgery arterial procedure abdominal aneurysm trauma like injury at the arteries chronic atrial fibrillation
34
for Arterial disease, which conditions and habits make the patient at risk of this?
Smoking is the strongest risk with Diabetes. hypertension hypercholesterolemia obesity chronic kidney disease
35
who are at risk of chronic / acute venous disease?
patients with job that required prolonged standing or sitting prolonged bed rest obesity multiple pregnancies
36
patients with history of heart failure, varicosities, thrombophlebitis are at risk of what?
peripheral chronic venous disease
37
people that have veins crushed by trauma or surgery are at risk of what?
peripheral chronic venous disease
38
character = aching, tiredness, feeling of fullness indicates what
chronic venous disease
39
what percentage of DVTs occurs in the upper extremities?
1 to 4%
40
character = moderate to intense, sharp, deep muscle tender to touch.
acute venous disease
41
what is the onset and duration of chronic and acute venous disease? like when is it worse day?
chronic - chronic pain increases end of day. acute- sudden onset (within one hour)
42
what are the aggravating factors of chronic and acute venous disease?
chronic- prolonged standing, sitting acute- pain increase with palpation
43
what are the symptoms of chronic and acute venous disease? like how do you legs look like
chronic- edema varicosities weeping ulcers at ankles acute- red warm, swollen leg, dilated viens.
44
what relieves chronic and acute venous disease?
chronic-elevation, lying, walking acute- pain meds
45
you assess a patient with 4+ edema of the right calf. what is the best way to document this findings?
very deep pitting, indentation lasts a long time and the foot is glossy, swollen .
46
Raynaud phenomenon occurs?
in hands and fee that is a results from exposure to cold, vibration and stress
47
for pulse amplitude, a pt who just finished running on a treadmill.
3+
48
a patient with acute occlusion of the right leg. what is for pulse amplitude
0
49
what is 3+ in pulse?
increased full, bouding
50
what is the expected pulse amplitude with pt with septic shock with hypotension?
1+ weak
51
a patient with good health indicate with number of pulse?
2+ normal
52
what condition is from thin shiny, hairless skin?
peripheral artery disease
53
chronic venous insufficiency causes what to the skin?
brown discoloration
54
acute deep vein thrombosis indicates what to the skin and limps?
red, warm skin unilateral edema
55
what happens to the hair and pulses with PAD?
hair loss bilateral diminished pulses
56
varicose viens are associated with? think of c and v
Chronic venous insufficiency
57
what type of ulcer is after acute DVT and characterized by bleeding and uneven edges?
Venous (Statis) ulcer
58
these ulcer occur at toes, well defined edges, no bleeding?
Arterial (Ischemic) Ulcer
59
diabete ulcer is what
Neuropathic ulcer
60
describe what diabete ucler may become
they can be infected, heal poorly, become chronic.
61
arterial ulcer are common with what?
smoking, diabetes, hyperlipidemia and hypertension
62
what ulcer occur in the medial mallelous?
Venous Ulcer
63
what are superficial varicose veins?
normal leg veins have dilated as a result from chronic increased venous pressure.
64
What are deep vein thrombophlebitis?
a deep vein is occluded by a thrombus, causing the inflammation, blocked venous return, cyanosis, edema
65
what to tender to palpation, increased warmth, swelling, redness?
Deep Vein Thrombophlebitis
66
what is dilated, tortuous veins? think go tort like dinsour is super var as far
Superficial Varicose Veins
67
the patient reports itchying, tingling, pain in veins? disnour is itchy
Superficial varicose veins
68
to evaluate the leg veins, what position should the patient be?
standing
69
what is the profile sign?
this means to view the finger from the side. this helps look for cubbing.
70
what is the normal nail edge?
160 degrees
71
what conditions can skew your findings (effect capillary refills) ?
a cool evironment decreased body temp cigarette smoking, peripheral edema anemia
72
a 3+ boudning pulse occurs with what conditions?
hyperkinetic exercise anxiety fever anemia hyperthyroidism
73
for a 1+ weak '' thready'' pulse occurs with conditions?
with shock Peripheral arterial disease
74
refills greater than one to two seconds indicate what?
Vasoconstriction deceased cardiac output ( heart failure)
75
in a healthy person what is not palpable?
the ulnar pulse
76
when should you palpate the brachial pulse?
when the nurse suspect arterial insufficiency
77
where do you palpate the epitrochlear lymph nodes?
medial to the condyle of the humerus
78
how many lbs of pressure do you need for the test of allen test?
11 lbs
79
for the allen test, what super hero do you think of?
the flash, think of him grabbing your radial and ulnar artery.
80
for the allen test which artery if let go of first?
the ulnar artery
81
pallor is associated with what?
Vasoconstriction the blood vessels tighten causing no blood flow
82
erythema is associated with what?
vasodilation, the widening of the blood vessels
83
if the nurse suspects DVT or asymmetric when inspecting the calfs, what must the nurse do first?
she must measure the calf with nonstretchable tape measure.
84
arterial ischemia what happens with the foot?
a unilateral cool foot or leg sudden temp drop as you move down the leg.
85
what artery is below the inguinal ligament halfway between the pubis and anterior superior iliac spines?
the femoral arteries
86
when the nurse is assessing for the fermoral artery in what position does the nurse ask the patient to be in?
to bend their knee to the side like a frog like position.
87
what must the nurse do to assess the popliteal pulse?
the nurse must anchor your thumbs on the knee and curl your fingers around into the popliteal fossa.
88
what pulse is at the medial malleolus?
the posterior tibial
89
the posterior tibial is where ?
the foot bottom side
90
what pulse is lateral to and parallel with the extensor tendon of the big toe?
the dorsalis pedis
91
how much sec should the nurse depress on the tibial to check for pretibial edema?
5 seconds
92
in a healthy person, there should be no what on the pretibial edema?
no indentation unless you are standing all day or pregnant
93
what is pitting edema 2+
2+ Moderate pitting, indentation subsides rapidly
94
what is pitting edema 4+
4+ Very deep pitting, indentation lasts a long time, leg is grossly swollen and distored.
95
what is pitting edema 1+
1+ mild pitting, slight indentation, no perceptible swelling of the leg
96
what is pitting edema 3+
3+ Deep pitting, indentation remains for a short time, legs look swollen
97
What is the epitrochlear node?
is in the antercubital fossa and drains the hand and lower arm.
98
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