Questions and Answers
What is Peripheral Vascular Disease (PVD)?
What is the Ankle-Brachial Index (ABI)?
A test that compares blood pressure at the ankle with the pressure at the brachial artery using a Doppler probe.
What does plethysmography evaluate?
Arterial blood flow in the lower extremities.
What is the purpose of a Treadmill/Exercise Tolerance Test?
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Arteriography is used to visualize areas of decreased arterial flow on an X-ray.
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What is the main goal of PAD management?
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Which of the following is a risk factor for PAD?
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Match the following medications with their use in PAD management:
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___ is a type of Arteriosclerosis.
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Raynaud's disease is characterized by intermittent vasoconstriction.
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Which of the following are assessment findings for Raynaud's disease?
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What is the primary management strategy for Compartment Syndrome?
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What are the components of Virchow's Triad?
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Warfarin requires consistent vitamin K intake to be effective.
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What is the purpose of using a TED (Thrombo-Embolic Deterrent) hose?
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What is one key management strategy for DVT?
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Study Notes
Peripheral Vascular Disease (PVD)
- Disrupted blood flow in the peripheral blood and lymphatic system affecting oxygen and nutrient delivery
- Includes peripheral arterial disease (PAD) and peripheral venous disease (DVT)
Diagnostic Tests for PAD
- Ankle-Brachial Index (ABI): Compares blood pressure at ankle and brachial artery using a Doppler probe.
- Plethysmography: Assesses arterial blood flow in the lower extremities.
- Treadmill/Exercise Tolerance Test: Evaluates for claudication through walking, noting leg pain due to arterial narrowing.
- Arteriography: X-ray with contrast medium to visualize areas of reduced blood flow.
- MRI: Uses contrast to visualize blood flow through peripheral arteries.
Clinical Tools and Assessments
- Bedside Doppler: Measures difficulty in detecting pulses; identifies differences in bilateral pulses.
- PAD Risk Factors: Includes age (over 65), male gender, family history, African American ethnicity, atherosclerosis, obesity, smoking, diabetes, hypertension, hyperlipidemia, sedentary lifestyle.
Atherosclerosis and Arteriosclerosis
- Atherosclerosis: Slow buildup of lipid particles reducing blood flow; a form of arteriosclerosis.
- Arteriosclerosis: Hardening or thickening of arterial walls; most common arterial disease.
PAD Assessment Findings
- Indicators include decreased/non-palpable pedal pulses, rest pain, hair loss, cold/cyanotic extremities, pallor with elevation, rubor, and intermittent claudication.
Intermittent Claudication
- Pain during exercise due to inadequate oxygen delivery in narrowed arteries.
Management and Goals for PAD
- Aims to reduce symptoms and prevent disease progression through diet, exercise, weight loss, and smoking cessation.
Medications for PAD
- Pentoxifylline (Trental): Reduces platelet aggregation; therapeutic effects seen in 8 weeks.
- Cilostazol (Plavix): Lowers thromboemboli risk.
- Aspirin and Clopidogrel: Antiplatelet agents.
- Additional medications include statins and ACE inhibitors.
Raynaud's Disease
- Functional PAD with intermittent vasoconstriction; more common in women.
- Assessment involves pallor, cyanosis, rubor, and pain.
Buerger's Disease
- Exclusively linked to tobacco use; causes inflammation of smaller vessels.
Critical Limb Ischemia
- Severe, chronic blood flow decrease to lower extremities, potentially leading to infection and limb loss.
Arterial Ulcers
- Characteristics include small, deep, circular wounds with cold skin temperature; often found on feet.
Acute Limb Ischemia (ALI)
- Sudden blood supply interruption usually due to embolism; categorized as an emergency situation with potential for surgery.
ALI Assessment Findings
- Evaluated using Six P's: Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia.
ALI Management
- Anticoagulation (IV heparin), surgical intervention to remove clots.
Surgical Procedures for PAD
- Techniques include Percutaneous Transluminal Angioplasty, Laser-Assisted Angioplasty, Rotational Atherectomy, and Embolectomy to restore blood flow.
Graft Procedures
- Bypass Graft: Reroutes circulation around arterial occlusion.
- Types include Autogenous Graft, Composite Graft, and Synthetic Graft.
Complications and Nursing Care
- Compartment Syndrome: Caused by swelling; expect muscle vessel compression leading to necrosis.
- Leg Revascularization Care: Includes monitoring for graft occlusion and s/s of infection alongside vital signs management.
Venous Thromboembolism (VTE)
- Formation of clots leading to disrupted blood flow; includes DVT and PE.
Virchow's Triad
- Factors contributing to thrombus formation: vessel wall injury, venous stasis, and hypercoagulability.
DVT Assessment and Management
- Signs: swelling, tenderness, warmth, and erythema.
- Management includes anticoagulation therapy, elevation, analgesics, and compression stockings.
Anticoagulation Medications
- Heparin: High alert medication monitored through aPTT levels.
- Warfarin: Prevents blood clotting by inhibiting vitamin K metabolism; requires monitoring of INR.
- Rivaroxaban: Anticoagulant without regular blood monitoring; increased risk of bleeding.
Venous Insufficiency
- Caused by incompetent valves in deep veins, leading to blood pooling and possible venous stasis ulcers.
Varicose Veins
- Dilated, tortuous veins typically affecting the lower extremities due to incompetent valves.
- Management includes lifestyle modifications, compression therapy, sclerotherapy, and potential surgery.
Education and Prevention Strategies
- Promote environment warmth, smoking cessation, regular leg inspections, and maintenance of hydration to prevent DVT and manage venous insufficiency.
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Description
This quiz focuses on nursing care concepts related to Peripheral Vascular Disease (PVD). It includes key terms such as the Ankle-Brachial Index (ABI) and the implications of conditions affecting blood flow. Prepare to enhance your understanding of nursing responsibilities in managing PVD effectively.
