Peripheral Arterial Disease Overview
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Questions and Answers

What is the primary reason to avoid vitamin K in the diet when under anticoagulation treatment?

  • It alters INR levels. (correct)
  • It slows down the metabolism of drugs.
  • It increases blood clot formation.
  • It increases the risk of bleeding.

    • What is a serious side effect associated with the use of unfractionated heparin?

  • Hypertension
  • Heparin-Induced Thrombocytopenia (HIT) (correct)
  • Acute Kidney Injury
  • Hemorrhagic Stroke

    • Which factor distinguishes LMWH from unfractionated heparin?

  • It is administered solely through intravenous methods.
  • It has no contraindications for use.
  • It has a more predictable pharmacokinetic profile. (correct)
  • It requires regular PTT monitoring.

    • What is the antidote for Dabigatran, a direct thrombin inhibitor?

    <p>Idarucizumab (A)</p> Signup and view all the answers

    Which of the following is a long-term side effect of unfractionated heparin use?

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

    What is the most serious complication resulting from prolonged ischemia?

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

    Which of the following characteristics is NOT typically associated with arterial ulcers?

    <p>Smooth and well-defined margins (C)</p> Signup and view all the answers

    What is indicated when there is uncontrolled pain and spreading infection in a patient?

    <p>Restoration of adequate blood flow (D)</p> Signup and view all the answers

    What is the primary complication associated with Peripheral Arterial Disease (PAD)?

    <p>Tissue damage due to reduced blood flow (D)</p> Signup and view all the answers

    Which diagnostic study is primarily used to calculate the Ankle-Brachial Index (ABI)?

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

    What is the primary function of Cilostazol (Pletal) as a drug therapy for intermittent claudication?

    <p>Inhibiting platelet aggregation and increasing vasodilation (C)</p> Signup and view all the answers

    Which symptom is considered the hallmark sign of arterial vascular disorder in patients with PAD?

    <p>Intermittent claudication (A)</p> Signup and view all the answers

    Which drug therapy is used to reduce symptoms of Peripheral Artery Disease (PAD)?

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

    Which of the following is NOT a typical assessment finding in individuals with PAD?

    <p>High blood pressure in the thigh (C)</p> Signup and view all the answers

    How does daily exercise impact survival rates for individuals with claudication?

    <p>Increases survival rates (A)</p> Signup and view all the answers

    Which factor is considered a significant risk factor for the development of Peripheral Arterial Disease?

    <p>Age greater than 60 (A)</p> Signup and view all the answers

    What characterizes rest pain in the context of PAD?

    <p>Numbness and pain that occurs in a dependent position (A)</p> Signup and view all the answers

    What aspect contributes to women experiencing a faster decline in mobility compared to men?

    <p>Differences in vascular disease progression (D)</p> Signup and view all the answers

    What is the most common underlying cause of Peripheral Arterial Disease?

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

    Which finding indicates inadequate blood flow in the lower extremities due to PAD during a physical examination?

    <p>Elevational pallor accompanied by dependent rubor (B)</p> Signup and view all the answers

    What role does paresthesia play in the assessment of PAD?

    <p>It signifies peripheral vascular occlusion. (C)</p> Signup and view all the answers

    What is the primary treatment method for phlebitis?

    <p>Removal of IV (C)</p> Signup and view all the answers

    What are the manifestations of venous thromboembolism (VTE)?

    <p>Unilateral edema and dilated superficial veins (C)</p> Signup and view all the answers

    How does hypercoagulability of blood contribute to VTE?

    <p>It increases the likelihood of clot formation. (A)</p> Signup and view all the answers

    Which risk factor is associated with venous stasis?

    <p>Chronic heart failure (B)</p> Signup and view all the answers

    What is the role of graduated compression stockings in VTE prevention?

    <p>They enhance venous return and reduce pooling. (D)</p> Signup and view all the answers

    What distinguishes deep vein thrombosis (DVT) from superficial vein thrombosis?

    <p>DVT typically has more severe symptoms. (C)</p> Signup and view all the answers

    What is the typical initial approach for diagnosing VTE?

    <p>Venous ultrasound (B)</p> Signup and view all the answers

    Which of the following is a contraindication for using anticoagulants in patients with existing VTE?

    <p>History of peptic ulcers (B)</p> Signup and view all the answers

    What is a common risk factor for venous thromboembolism related to hormonal influences?

    <p>Childbearing age taking estrogen-based birth control (D)</p> Signup and view all the answers

    Which treatment is NOT indicated for patients with extensive symptomatic proximal VTE?

    <p>Graduated compression stockings (B)</p> Signup and view all the answers

    What is a primary complication associated with sclerotherapy?

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

    What is a significant risk factor for developing chronic venous insufficiency?

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

    Which of the following is the main pharmacological therapy for chronic venous insufficiency?

    <p>Pentoxifylline (A)</p> Signup and view all the answers

    What symptom is most commonly associated with venous leg ulcers?

    <p>Discoloration of the lower leg (A)</p> Signup and view all the answers

    Which nursing intervention is NOT appropriate in the postoperative management of venous procedures?

    <p>Using hot compresses on the surgical site (B)</p> Signup and view all the answers

    What lifestyle change can help manage varicose veins?

    <p>Avoiding weight gain (B)</p> Signup and view all the answers

    What is the recommended position for a patient with chronic venous insufficiency to alleviate symptoms?

    <p>Elevating the legs above the heart (B)</p> Signup and view all the answers

    Which type of therapy utilizes direct injections to obliterate varicose veins?

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

    What serious complication can arise from a long-standing venous insufficiency?

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

    Study Notes

    Peripheral Arterial Disease (PAD)

    • Chronic condition marked by partial or total arterial occlusion, leading to lower extremity tissue damage due to insufficient oxygen and nutrients.
    • Most common cause of PAD is atherosclerosis, characterized by arterial plaque buildup.

    Risk Factors

    • Tobacco use and atherosclerosis increase risk.
    • Diabetes and hypertension (HTN) are significant contributors.
    • High cholesterol and age over 60 are also key factors.

    Assessment & Symptoms

    • Intermittent Claudication: Primary indicator; results in muscle pain due to inadequate blood flow.
    • Rest Pain: Numbness or burning in the lower extremities, often occurring at night relieved by hanging the legs down.
    • Lower Extremity Symptoms: Discomfort in back/buttocks, dry/scaly skin, loss of hair, cold and discolored skin, thickened toenails, and reduced peripheral pulses.
    • Elevational Pallor: Skin turns pale when legs are raised, exhibiting reddish color when dependent.

    Complications

    • Prolonged ischemia can lead to skin and muscle atrophy, delayed healing, wound infections, tissue necrosis, and non-healing arterial ulcers or gangrene.
    • Collateral circulation can mitigate gangrene risk, often seen in the elderly.
    • Severe cases may necessitate amputation if blood flow is not restored.

    Arterial Ulcers

    • Typically found on toes or pressure points, appearing pale or cyanotic with irregular margins.
    • Often painful, especially at night; surrounding skin may be shiny and tight.

    Diagnostic Studies

    • Doppler Ultrasound: Maps blood flow; detects significant pressure drops indicating PAD.
    • Ankle-Brachial Index (ABI): Compares ankle and arm blood pressures; a lower ABI suggests PAD.
    • Angiography/Magnetic Resonance Angiography (MRA): Imaging techniques for vascular occlusive diseases.

    Drug Therapy

    • ACE Inhibitors: Effective for reducing PAD symptoms (e.g., Ramipril).
    • Antiplatelet Agents: Aspirin and Clopidogrel to prevent clotting complications.
    • Intermittent Claudication Treatments: Cilostazol promotes vasodilation; Pentoxifylline improves blood flow and reduces viscosity.
    • Exercise: Walking for 30-45 minutes, three times a week is beneficial for claudication management.

    Blood Pressure Medications

    • Calcium channel blockers and vasodilators are used to alleviate symptoms and improve circulation.
    • For severe cases: prostacyclin infusion and surgical debridement might be necessary.

    Phlebitis

    • Acute inflammation of small veins due to IV use, manifests as pain, warmth, and swelling.
    • Treatment involves removing the IV, elevating the limb, and using NSAIDs for inflammation.

    Venous Thrombosis

    • Formation of clots within veins; may lead to deep vein thrombosis (DVT) or superficial vein issues.
    • Venous thromboembolism (VTE) poses a risk of clots traveling to the lungs (pulmonary embolism).

    Venous Stasis

    • Occurs from dysfunctional valves leading to inactive muscle extremities affecting blood flow.
    • At-risk groups include the obese, pregnant, and those with chronic heart failure or prolonged immobility.

    VTE Characteristics

    • Manifestations: Unilateral edema, pain, and redness in the lower extremities along with dilated veins.
    • Diagnostic Tests: Blood tests (e.g., D-Dimer), ultrasound for venous compression, and CT or MR venography for detailed imaging.

    Prevention & Treatment

    • Early mobilization and compression stockings aid in preventing VTE.
    • Anticoagulation therapy is critical for management, using drugs like Warfarin, Heparin, and Direct Thrombin Inhibitors.

    Varicose Veins

    • Caused by dilated superficial veins from increased venous pressure; risk factors include obesity and prolonged standing.
    • Symptoms include heaviness and pain, especially after long standing periods, relieved by movement and leg elevation.

    Chronic Venous Insufficiency (CVI)

    • Abnormalities leading to edema, skin changes, and ulcers due to underlying venous issues.
    • Nursing management includes compression therapy, elevation plans, appropriate nutrition, and monitoring for infections.

    General Management

    • Educate about proper leg care, nutritional needs, and activity to prevent complications.
    • Regular assessments and adjustments to treatment plans based on individual conditions are necessary for effective management.

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    Vascular Disorders PDF

    Description

    This quiz covers peripheral arterial disease (PAD), a chronic condition characterized by arterial occlusion that affects lower limb circulation. Learn about its causes, risk factors, and the impact of atherosclerosis on tissue health. Test your knowledge on this critical vascular disorder.

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