NR462 FINAL EXAM

Cigarette smoking Hyperlipidemia Hypertension Diabetes mellitus Family History

What are some risk factors for PVD?

Nonhealing arterial ulcers and gangrene

What are the most serious complications of PVD?

- cool to the touch - pain - hair loss - pallor - weak pulse

What are the signs/symptoms if someone has an arterial problem?

Aortoiliac artery Femoral artery Popliteal artery Tibial artery Peroneal artery

What arteries can peripheral artery disease (PAD) affect?

peripheral vascular disease

What disease involves progressive narrowing and degeneration of arteries of neck, abdomen, and extremities

Retrograde blood flow Pooling of blood in legs & swelling

What does the damage of valves in veins lead to?

injuries often go unnoticed by patient

What is an important side effect of paresthesia in the toes/feet?

dark red discoloration when foot or leg is not elevated caused by damaged blood vessels. When elevated it becomes pale.

What is dependent rubor?

Ischemic muscle ache or pain that is precipitated by a constant level of exercise

What is intermittent claudication?

atherosclerosis

What is the leading cause of PVD?

Antiplatelet agents

What kind of medications might a patient with PVD be on?

- excessive bruising - nosebleeds - bloody stool

What signs might we look for before discharging a patient on anti platelet agents?

- diminished pulses in the leg - delayed cap refill - PALLOR OF FOOT WITH LEG ELEVATION/RUBOR WHEN LOWERED

When assessing a patient with PVD, what might we notice about the blood flow to their extremities?

- Thin, shiny, taut - Loss of hair

When assessing a patient with PVD, what would their skin look like?

thrombus

Which comes first, a thrombus or an embolus?

Laser

Which treatment option for varicose veins fades the appearance of veins?

Endoscopic vein surgery

Which treatment option for varicose veins involves a small video camera inserted in your leg to visualize and close varicose veins, and then removes the veins through small incisions?

Vein stripping

Which treatment option for varicose veins involves an outpatient procedure surgical removal vein removal?

Catheter-assisted procedures

Which treatment option for varicose veins involves heated catheter destroying the vein by causing it to collapse and seal shut?

Sclerotherapy

Which treatment option for varicose veins involves injecting a saline solution closes those veins?

Ambulatory phlebectomy

Which treatment option for varicose veins removes smaller varicose veins through a series of tiny skin punctures?

Damage to valves in veins

Why does venous insufficiency happen?

The blood is pooling in the surrounding tissues

Why would you see edema with chronic venous insufficiency?

Both

Do clots form in arteries or veins?

C

A client with a history of angina and intermittent claudication reports pain in both legs with a need to stop and rest after ambulating down the hall. Which statement by the nurse best addresses this concern? A) "You are experiencing leg pain because of venous congestion." B) "You are experiencing pain due to inadequate removal of carbon dioxide from the tissues in the legs." C) "The pain is probably related to inadequately oxygenated blood getting through the arteries into the muscles of your legs." D) "The pain is related to atherosclerosis that is the same problem causing your angina."

B

A pregnant client who stands for long periods while working in a factory visits the prenatal clinic at 35 weeks' gestation, stating, "The varicose veins in my legs have really been bothering me lately." Which instruction would be most helpful? A) Perform slow contraction and relaxation of the feet and ankles twice daily. B) Take frequent rest periods with the legs elevated above the hips. C) Avoid support hose that reach above the leg varicosities. D) Take a leave of absence from your job to avoid prolonged standing.

Resolves within 10 minutes or less with rest

How quickly does claudication resolve?

60s to 80s

In which age group will we generally see PVD?

B

Knee-high sequential compression devices have been prescribed for a newly admitted client. The client reports new pain localized in the right calf area that is noted to be slightly reddened and warm to touch upon initial assessment. What should the nurse do first? A) Offer analgesics as ordered, and apply the compression devices. B) Leave the compression devices off, and contact the health care provider (HCP) to report the assessment findings. C) Massage the area of discomfort before applying the compression devices. D) Leave the compression devices off, and report the assessment findings to the oncoming shift.

Tissues are not getting enough O2 and nutrients

Why would you see the following complications due to PVD? Atrophy of the skin and underlying muscles Delayed healing Wound infection Tissue necrosis Arterial ulcers

Yes, because the arteries are unaffected

Would you have a pulse with chronic venous insufficiency?

paresthesia

___________ is numbness or tingling in the toes or feet. It produces loss of pressure and deep pain sensations, and injuries often go unnoticed by patient

Pain at rest (occurs in the forefoot or toes) Aggravated by limb elevation Occurs from insufficient blood flow Occurs more often at night

What are some clinical manifestations of advancing PVD?

Emboli formation Infection Thrombosis Trauma fracture Vasculitis

What are some common causes of PVD?

Digital subtraction angiography (DSA) Angiography Doppler ultrasound Plethysmography

What are some diagnostic tests for PVD?

Goal- Health Promotion Goal-Promote circulation- ambulate Goal: adequate tissue perfusion Goal: relief of pain Goal: intact, healthy skin on extremities

What are some nursing goals for PVD?

- standing in same position - obesity - pregnancy - thrombophlebitis

What are some possible risk factors for people with venous insufficiency?

- Ineffective tissue perfusion - Impaired skin integrity r/t impaired circulation - Pain

What are some priority nursing diagnoses for PVD?