Vein System
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Questions and Answers

Which factor does not directly facilitate venous blood flow?

  • Arterial blood pressure (correct)
  • Right atrial pressure
  • Thoracic pressure changes during respiration
  • Skeletal muscle contractions

A patient with prolonged immobility is at risk for deep vein thrombosis (DVT). Which mechanism primarily contributes to thrombus formation in this scenario?

  • Reduced lymphatic drainage
  • Venous stasis (correct)
  • Increased arterial blood pressure
  • Increased red blood cell production

Why are venous valves more numerous in the distal legs compared to proximal veins?

  • To facilitate greater oxygen exchange in the peripheral tissues.
  • To accommodate higher blood volume in the lower extremities.
  • To counter the effects of gravity and prevent backflow in the longer venous columns. (correct)
  • To withstand higher hydrostatic pressures from arterial flow.

A patient diagnosed with a pulmonary embolism (PE) most likely has a thrombus originating from which location?

<p>Deep veins of the thigh (D)</p> Signup and view all the answers

What is the primary purpose of using a vena cava filter in a patient with recurrent pulmonary embolism?

<p>To prevent emboli from reaching the lungs. (B)</p> Signup and view all the answers

Which of the following is the best explanation for why malignancy is considered a risk factor for DVT?

<p>Cancer cells release procoagulant factors, increasing the risk of clot formation. (B)</p> Signup and view all the answers

A patient presents with chronic leg swelling, skin discoloration, and venous ulceration. These findings are most consistent with which condition?

<p>Post-phlebitic/post-thrombotic syndrome (A)</p> Signup and view all the answers

Why is early ambulation encouraged as a preventative measure against pulmonary embolism (PE)?

<p>It promotes venous return through skeletal muscle contractions, reducing venous stasis. (A)</p> Signup and view all the answers

Chronic venous insufficiency, when caused by varicose veins or vein valve incompetence, can directly contribute to which of the following conditions?

<p>Venous stasis ulcers due to inadequate venous return. (B)</p> Signup and view all the answers

The right lymphatic duct is responsible for draining lymph from which specific regions of the body?

<p>The right arm, right side of the head, and right side of the thorax. (C)</p> Signup and view all the answers

Which pressure range is typically associated with compression stockings used for general support and mild venous insufficiency?

<p>15-20 mm Hg (C)</p> Signup and view all the answers

What is the primary underlying cause of peripheral artery disease (PAD)?

<p>Atherosclerosis causing narrowed arteries and reduced blood flow. (A)</p> Signup and view all the answers

Which of the following is the MOST typical description of the pain associated with intermittent claudication?

<p>A cramping, vice-like pain that occurs with activity and is relieved by rest. (D)</p> Signup and view all the answers

Why does dangling the foot off the bed often alleviate rest pain associated with peripheral artery disease?

<p>It uses gravity to enhance arterial blood flow to the foot improving perfusion. (D)</p> Signup and view all the answers

Which of the following components makes up lymphatic fluid?

<p>Water and small amounts of dissolved proteins, mainly albumin. (C)</p> Signup and view all the answers

What is the primary purpose of using compression wraps or sleeves in managing lymphedema?

<p>To apply external pressure, promoting lymphatic drainage and reducing swelling. (B)</p> Signup and view all the answers

Which of the following Ankle Brachial Index (ABI) values would suggest the presence of peripheral artery disease?

<p>0.75 (C)</p> Signup and view all the answers

An arterial duplex study is ordered for a patient. Which of the following is NOT a typical indication for this diagnostic test?

<p>Evaluating for venous insufficiency (C)</p> Signup and view all the answers

During an arteriogram with run-off, contrast dye is injected to visualize blood vessels. Where is the contrast medium typically injected?

<p>Right femoral artery (B)</p> Signup and view all the answers

A patient with a short focal lesion in a large vessel is being considered for a procedure to manage peripheral artery disease. Which of the following would be the MOST suitable initial approach, assuming good run-off?

<p>Angioplasty (D)</p> Signup and view all the answers

A patient has an ABI of 1.4. Which of the following is the MOST likely interpretation of this result?

<p>Non-compressible vessels (A)</p> Signup and view all the answers

A peripheral vascular bypass (PVB) is planned for a patient with severe peripheral artery disease. Which of the following arteries would NOT be a target for this procedure?

<p>Coronary artery (D)</p> Signup and view all the answers

Which of the following diagnostic tests uses high-frequency sound waves and blood pressure cuffs to measure blood flow in the arteries of the arms and legs?

<p>Arterial Duplex/Ultrasound (C)</p> Signup and view all the answers

Which of the following is NOT evaluated for in an Arteriogram?

<p>Varicose Veins (C)</p> Signup and view all the answers

A client is suspected of having pulmonary artery hypertension. Which initial assessment finding would suggest this condition?

<p>Chest X-ray indicates enlarged pulmonary arteries and a prominent right heart border. (B)</p> Signup and view all the answers

A patient with pulmonary artery hypertension (PAH) is prescribed iloprost, a prostacyclin analog. What is the primary mechanism of action of this medication in treating PAH?

<p>Promoting vasodilation and inhibiting platelet aggregation. (C)</p> Signup and view all the answers

A patient with a history of chronic hypoxemia secondary to severe COPD is at risk for developing Cor Pulmonale. What is the underlying mechanism that connects chronic hypoxemia to the development of Cor Pulmonale?

<p>Hypoxemia induces pulmonary vasoconstriction, increasing resistance in the pulmonary circulation. (A)</p> Signup and view all the answers

A patient with pulmonary hypertension is prescribed bosentan. Which instruction is most important for the nurse to emphasize regarding this medication?

<p>&quot;It's important to have monthly blood tests to monitor liver function.&quot; (D)</p> Signup and view all the answers

A formerly healthy construction worker developed pulmonary hypertension following exposure to asbestos. What is the most likely underlying cause of the patient's pulmonary hypertension?

<p>Obliteration of the vascular bed due to remodeling from chronic inflammation and fibrosis. (D)</p> Signup and view all the answers

A patient with pulmonary hypertension is being discharged. Which of the following lifestyle modifications is most important for the nurse to reinforce?

<p>Avoid air travel and decongestant medications. (B)</p> Signup and view all the answers

A patient is diagnosed with Cor Pulmonale secondary to chronic bronchitis. Besides supplemental oxygen, which of the following medications would directly target the underlying cause of pulmonary hypertension in this patient?

<p>Inhaled corticosteroids to reduce airway inflammation. (D)</p> Signup and view all the answers

A patient with long-standing pulmonary hypertension develops right ventricular hypertrophy. What compensatory mechanism is the right ventricle employing, and how does this adaptation eventually contribute to heart failure?

<p>Hypertrophy; increases the force of contraction to overcome pulmonary resistance, eventually leading to increased oxygen demand and ischemia. (C)</p> Signup and view all the answers

Flashcards

Vein Structure

Thinner walls, less elasticity, less muscle fiber, and valves.

Factors Affecting Venous Blood Flow

Gravity, skeletal muscle contractions, thoracic/abdominal pressure, arterial flow, right atrial pressure and vein valves.

Vein Valves

Tiny bicuspid valves that prevent backflow, most numerous in the distal leg.

Deep Vein Thrombosis (DVT)

A blood clot that forms in a deep vein, often in the leg.

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DVT Risk Factors

Age, travel, prior VTE, pregnancy, malignancies, inherited hypercoagulable states, medical illness, acute hospitalization, nursing home confinement, MI, stroke, CHF, respiratory insufficiency, spinal cord injury, septic shock, nephrotic syndrome, major trauma, Orthopedic procedures, abdominal pain, central venous cannulation, Pacemaker insertion, Oral Contraceptives/ HRT, Chemotherapeutic Agents.

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Post-Thrombotic Syndrome

Chronic swelling, stasis dermatitis, and venous ulcers, often after a DVT.

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Pulmonary Embolism (PE)

Occlusion of a pulmonary vessel, often by a thrombus from deep veins.

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PE Prevention

Bed exercises, frequent position changes, early ambulation, pneumatic calf compression, prophylactic anticoagulation, vena cava filter.

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Peripheral Artery Disease (PAD)

A condition where arteries narrow, reducing blood flow to limbs.

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Ankle Brachial Index (ABI)

Ratio of ankle to arm systolic blood pressure; assesses PAD.

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Normal ABI value

Normal ABI range.

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Arterial Duplex/Ultrasound

Ultrasound to visualize and measure blood flow in arteries with blood pressure cuffs.

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Arterial Duplex Indications

Screen, monitor, or diagnose aneurysms, occlusions, clots, carotid disease, varicose veins and venous insufficiency

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Arteriogram

X-ray imaging of blood vessels to evaluate aneurysm, stenosis, or occlusion.

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Arteriogram with Run-off

An arteriogram that visualizes the abdominal aorta and arteries of the lower extremities, with contrast dye.

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Vascular Bypass

Surgical procedure to reroute blood flow around a blocked artery in the periphery.

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Pulmonary Artery Hypertension (PAH)

Elevated pressure in the pulmonary arteries (mean PAP > 25 mmHg at rest).

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Common Cause of PAH

Most commonly caused by underlying respiratory disease or hypoxemia.

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Causes of Pulmonary Artery Hypertension

Pulmonary artery vasoconstriction, Elevated left ventricular pressure, Increased blood flow through the pulmonary circulation, Obliteration or obstruction of the vascular bed, Active constriction of the vascular bed produced by hypoxemia or acidosis

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Pathophysiology of Pulmonary Artery Hypertension

Overproduction of vasoconstrictors and decreased production of vasodilators

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Result of Pulmonary Artery Hypertension

Increased resistance to blood flow in pulmonary arteries, leading to increased pressure.

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Cor Pulmonale

Right ventricular enlargement and failure due to pulmonary hypertension.

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Indications of PAH

Enlarged pulmonary arteries and right heart border on chest x-ray; right ventricular hypertrophy on ECG.

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Treatment for Pulmonary Artery Hypertension

Oxygen, Diuretics, Anticoagulants, Avoidance of contributing factors (air travel, decongestants, NSAIDs, pregnancy, tobacco)

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Chronic Venous Insufficiency

Inadequate venous return over a long period, often due to varicose veins or valve issues.

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Venous Stasis Ulcers

Open sores on the skin due to poor blood flow, commonly seen in chronic venous insufficiency.

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Lymphatic Fluid

Water and small amounts of dissolved proteins, primarily albumin, that circulates in the lymphatic system.

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Right Lymphatic Duct

Drains lymph from the right arm and right side of the head and thorax.

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Thoracic Duct

Receives lymph from all areas of the body except the right arm and right side of the head and thorax.

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Intermittent Claudication

Pain that comes on with activity and is relieved with rest, due to reduced blood flow in PAD.

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Rest Pain (PAD)

Pain present even at rest, often relieved by dangling the foot, indicating severe PAD.

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