Podcast
Questions and Answers
Which of the following is the primary mechanism behind the signs and symptoms of peripheral arterial disease (PAD)?
Which of the following is the primary mechanism behind the signs and symptoms of peripheral arterial disease (PAD)?
- Increased venous pressure in the peripheral limbs.
- Inflammation of the endothelial lining of peripheral veins.
- Narrowing of arteries, reducing blood flow to peripheral limbs. (correct)
- Increased lymphatic drainage in the lower extremities.
Which of the following physiological processes is initially disrupted in the development of arteriosclerosis, a key factor in PAD?
Which of the following physiological processes is initially disrupted in the development of arteriosclerosis, a key factor in PAD?
- Enhanced lymphatic absorption in arterial walls.
- Increased production of red blood cells.
- Endothelial dysfunction due to damaging factors. (correct)
- Reduced elasticity of venous valves.
A patient with peripheral arterial disease (PAD) reports experiencing leg pain that is relieved by sitting and dangling their legs. What physiological principle explains this?
A patient with peripheral arterial disease (PAD) reports experiencing leg pain that is relieved by sitting and dangling their legs. What physiological principle explains this?
- Sitting decreases metabolic demand of leg muscles.
- Dangling the legs decreases hydrostatic pressure, improving arterial flow. (correct)
- Lying flat increases collateral circulation to the legs.
- Elevation of the legs promotes venous return, reducing pain.
A patient with peripheral arterial disease (PAD) reports experiencing increased leg pain at night. Which of the following best explains this phenomenon?
A patient with peripheral arterial disease (PAD) reports experiencing increased leg pain at night. Which of the following best explains this phenomenon?
A patient with PAD experiences severe pain in the calf muscle during exercise, which is relieved by rest. Which term accurately describes this symptom?
A patient with PAD experiences severe pain in the calf muscle during exercise, which is relieved by rest. Which term accurately describes this symptom?
During a physical examination of a patient with suspected PAD, what clinical finding is most indicative of chronic arterial insufficiency?
During a physical examination of a patient with suspected PAD, what clinical finding is most indicative of chronic arterial insufficiency?
An ankle-brachial index (ABI) is ordered for a patient with suspected PAD. If the ankle systolic blood pressure is 90 mmHg and the brachial systolic blood pressure is 120 mmHg, what does this ABI suggest?
An ankle-brachial index (ABI) is ordered for a patient with suspected PAD. If the ankle systolic blood pressure is 90 mmHg and the brachial systolic blood pressure is 120 mmHg, what does this ABI suggest?
When educating a patient diagnosed with PAD about lifestyle modifications, which intervention should be given the highest priority?
When educating a patient diagnosed with PAD about lifestyle modifications, which intervention should be given the highest priority?
What is the primary goal of managing intermittent claudication in patients with peripheral arterial disease (PAD)?
What is the primary goal of managing intermittent claudication in patients with peripheral arterial disease (PAD)?
Which medication is commonly prescribed to reduce the risk of thrombotic events in patients with peripheral arterial disease (PAD)?
Which medication is commonly prescribed to reduce the risk of thrombotic events in patients with peripheral arterial disease (PAD)?
Which statement best explains the pathophysiology of heart failure (HF)?
Which statement best explains the pathophysiology of heart failure (HF)?
What is the significance of ejection fraction (EF) in the context of heart failure (HF)?
What is the significance of ejection fraction (EF) in the context of heart failure (HF)?
Which of the following is a key distinction between heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)?
Which of the following is a key distinction between heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)?
Why does left-sided heart failure often lead to pulmonary congestion and edema?
Why does left-sided heart failure often lead to pulmonary congestion and edema?
Which clinical manifestation is specifically characteristic of acute decompensated heart failure (ADHF) and requires immediate intervention?
Which clinical manifestation is specifically characteristic of acute decompensated heart failure (ADHF) and requires immediate intervention?
A patient with heart failure reports paroxysmal nocturnal dyspnea. What physiological mechanism explains this?
A patient with heart failure reports paroxysmal nocturnal dyspnea. What physiological mechanism explains this?
Why is monitoring daily weight important for patients with chronic heart failure?
Why is monitoring daily weight important for patients with chronic heart failure?
What dietary recommendation is typically included in the management plan for chronic heart failure (HF)?
What dietary recommendation is typically included in the management plan for chronic heart failure (HF)?
What is the rationale for using diuretics in the management of heart failure (HF)?
What is the rationale for using diuretics in the management of heart failure (HF)?
Which classification of medications may be used in heart failure patients who cannot tolerate ACE inhibitors?
Which classification of medications may be used in heart failure patients who cannot tolerate ACE inhibitors?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. Which of his medications increases his risk of developing a pulmonary embolism?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. Which of his medications increases his risk of developing a pulmonary embolism?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. The patient is complaining of right sided chest pain. He states that he is short of breath. His vital signs are: BP 98/60; P 120; R 24; Pulse oximeter reads 86%, so you start him on 6L 02 by nasal cannula (NC). You identify faint crackles in the posterior bases bilaterally. The heart monitor on lead II shows nonspecific T wave changes. What order should take priority?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. The patient is complaining of right sided chest pain. He states that he is short of breath. His vital signs are: BP 98/60; P 120; R 24; Pulse oximeter reads 86%, so you start him on 6L 02 by nasal cannula (NC). You identify faint crackles in the posterior bases bilaterally. The heart monitor on lead II shows nonspecific T wave changes. What order should take priority?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. He has a spiral CT scan of the lungs. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." Which of the follow symptoms is unique to fat embolisms?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. He has a spiral CT scan of the lungs. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." Which of the follow symptoms is unique to fat embolisms?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. He has a spiral CT scan of the lungs. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." Which is the best explanation for his risk of developing a Pulmonary Embolism?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. He has a spiral CT scan of the lungs. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." Which is the best explanation for his risk of developing a Pulmonary Embolism?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. He has a spiral CT scan of the lungs. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." You are the nurse caring for the patient and you are monitoring his lab values. What lab value should you monitor closely as a result of his receiving heparin?
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. He has a spiral CT scan of the lungs. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." You are the nurse caring for the patient and you are monitoring his lab values. What lab value should you monitor closely as a result of his receiving heparin?
Which statement accurately describes a similarity between fat embolisms and blood clot embolisms in the lungs?
Which statement accurately describes a similarity between fat embolisms and blood clot embolisms in the lungs?
Which anticoagulant medication is most commonly administered initially in acute pulmonary embolism cases due to its rapid onset of action?
Which anticoagulant medication is most commonly administered initially in acute pulmonary embolism cases due to its rapid onset of action?
After the patient is stable, the physician plans to switch the patient 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture from heparin to an oral anticoagulant. Which of the following requires patient education?
After the patient is stable, the physician plans to switch the patient 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture from heparin to an oral anticoagulant. Which of the following requires patient education?
A 68-year-old retired painter, S.P., presents with right leg calf pain that began approximately 2 years ago, worsening in the last 4 months. The pain is exercise-induced and relieved by rest. Based on this information, what is the most likely initial diagnosis?
A 68-year-old retired painter, S.P., presents with right leg calf pain that began approximately 2 years ago, worsening in the last 4 months. The pain is exercise-induced and relieved by rest. Based on this information, what is the most likely initial diagnosis?
S.P., a 68-year-old with PAD, has smoked 2-3 packs of cigarettes per day for 45 years. How does smoking contribute to the pathophysiology of S.P.'s PAD?
S.P., a 68-year-old with PAD, has smoked 2-3 packs of cigarettes per day for 45 years. How does smoking contribute to the pathophysiology of S.P.'s PAD?
S.P., a 68-year-old with PAD, has a history of coronary artery disease (CAD), hypertension (HTN), peripheral artery disease (PAD), and osteoarthritis. Which combination of these conditions most directly contributes to the development of PAD?
S.P., a 68-year-old with PAD, has a history of coronary artery disease (CAD), hypertension (HTN), peripheral artery disease (PAD), and osteoarthritis. Which combination of these conditions most directly contributes to the development of PAD?
S.P., a 68-year-old with PAD, reports increased hip pain with exercise that is not promptly relieved by rest and is sometimes worse than other days; which risk factor would the nurse attribute to these symptom?
S.P., a 68-year-old with PAD, reports increased hip pain with exercise that is not promptly relieved by rest and is sometimes worse than other days; which risk factor would the nurse attribute to these symptom?
Which of the following signs would the nurse expect to find during an assessment of S.P.'s lower extremities, consistent with his diagnosis of PAD?
Which of the following signs would the nurse expect to find during an assessment of S.P.'s lower extremities, consistent with his diagnosis of PAD?
S.P. is scheduled for an ankle-brachial index (ABI) test. What instructions should the nurse provide to a patient, S.P., prior to an ABI test?
S.P. is scheduled for an ankle-brachial index (ABI) test. What instructions should the nurse provide to a patient, S.P., prior to an ABI test?
Which aspect of patient teaching is most important to emphasize to a hypertensive patient, S.P., being switched from aspirin to clopidogrel?
Which aspect of patient teaching is most important to emphasize to a hypertensive patient, S.P., being switched from aspirin to clopidogrel?
A client had quadruple coronary artery bypass graft (CABG x4) three years ago. What medication is best for management?
A client had quadruple coronary artery bypass graft (CABG x4) three years ago. What medication is best for management?
Select the three conditions best supported by the information presented about the 68-year-old painter being evaluated in the clinic.
Select the three conditions best supported by the information presented about the 68-year-old painter being evaluated in the clinic.
Identify three priorities for a nurse responding to a client who is restless and complaining of chest pain
Identify three priorities for a nurse responding to a client who is restless and complaining of chest pain
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." In what situation a thrombolytics such as alteplase (Activase) be beneficial for this patient
A 76-year-old male is two days post-op from an open reduction and internal fixation (ORIF) of a right femur fracture. The interpretation of the results read "strongly suggestive of a pulmonary embolus (PE)." In what situation a thrombolytics such as alteplase (Activase) be beneficial for this patient
S.P., a 68-year-old retired painter with known PAD, reports that he still smokes 2 packs a day. How does smoking contribute to the progression of S.P.'s PAD?
S.P., a 68-year-old retired painter with known PAD, reports that he still smokes 2 packs a day. How does smoking contribute to the progression of S.P.'s PAD?
S.P., who does not have ankle edema, is scheduled for an ankle-brachial index (ABI) test. What should the nurse instruct S.P. to do to prepare for this test focusing on modifiable factors?
S.P., who does not have ankle edema, is scheduled for an ankle-brachial index (ABI) test. What should the nurse instruct S.P. to do to prepare for this test focusing on modifiable factors?
M.M. a 76 year old male is diagnosed with a pulmonary embolism (PE) and is being treated with heparin. Considering their age and post-operative status, what is the primary rationale for using heparin over other anticoagulants in the initial management of M.M.'s PE?
M.M. a 76 year old male is diagnosed with a pulmonary embolism (PE) and is being treated with heparin. Considering their age and post-operative status, what is the primary rationale for using heparin over other anticoagulants in the initial management of M.M.'s PE?
M.M. a 76 year old male is diagnosed with a pulmonary embolism (PE). The health care provider is considering using thrombolytics such as alteplase (Activase). What aspect of M.M.'s case would be most concerning regarding the use of thrombolytic therapy?
M.M. a 76 year old male is diagnosed with a pulmonary embolism (PE). The health care provider is considering using thrombolytics such as alteplase (Activase). What aspect of M.M.'s case would be most concerning regarding the use of thrombolytic therapy?
M.M. is started on Warfarin for management of the pulmonary embolism. Besides taking the medication at the same time each day and the importance of consistent blood work, what dietary education points are important to convey?
M.M. is started on Warfarin for management of the pulmonary embolism. Besides taking the medication at the same time each day and the importance of consistent blood work, what dietary education points are important to convey?
Flashcards
Peripheral Arterial Disease (PAD)
Peripheral Arterial Disease (PAD)
Narrowing of the arteries supplying peripheral limbs, reducing blood flow.
Endothelial dysfunction
Endothelial dysfunction
Disruption of the endothelial muscle in the arteries, often due to damage from hypertension or other factors, leading to clot formation and stenosis.
Major cause of PAD
Major cause of PAD
Building plaques in arteries, blood clots, or emboli.
Risk factors for PAD
Risk factors for PAD
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Intermittent Claudication
Intermittent Claudication
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Critical limb ischemia
Critical limb ischemia
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Dependent Rubor
Dependent Rubor
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Arterial Brachial Index (ABI)
Arterial Brachial Index (ABI)
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Acute Limb Ischemia Management
Acute Limb Ischemia Management
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Critical Limb Ischemia Management
Critical Limb Ischemia Management
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Intermittent Claudication Management
Intermittent Claudication Management
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PAD Management - Surgical
PAD Management - Surgical
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Heart Failure (HF)
Heart Failure (HF)
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HF Characterized by:
HF Characterized by:
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Primary Risk Factors for Heart Failure
Primary Risk Factors for Heart Failure
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Heart Failure Classification
Heart Failure Classification
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Heart Failure with Reduced Ejection Fraction (HF-REF)
Heart Failure with Reduced Ejection Fraction (HF-REF)
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Heart Failure with Preserved Ejection Fraction (HF-PEF)
Heart Failure with Preserved Ejection Fraction (HF-PEF)
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Decreased filling results in
Decreased filling results in
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HF Onset
HF Onset
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Left-Sided Heart Failure
Left-Sided Heart Failure
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Right-Sided Heart Failure
Right-Sided Heart Failure
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Acute Decompensated Heart Failure (ADHF)
Acute Decompensated Heart Failure (ADHF)
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Pulmonary Edema Manifestations
Pulmonary Edema Manifestations
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Clinical Manifestations of Chronic HF
Clinical Manifestations of Chronic HF
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Complications of Heart Failure
Complications of Heart Failure
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Diagnostic studies for HF
Diagnostic studies for HF
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ADHF Treatment goal
ADHF Treatment goal
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Decreasing Intravascular Volume in ADHF
Decreasing Intravascular Volume in ADHF
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Gas exchange improvement in ADHF
Gas exchange improvement in ADHF
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Chronic HF Treatment goal
Chronic HF Treatment goal
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Chronic HF, Non-pharmacological: Oxygen
Chronic HF, Non-pharmacological: Oxygen
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Drug management of chronic HF
Drug management of chronic HF
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Diuretics used in HF
Diuretics used in HF
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Spironolactone (Aldactone)
Spironolactone (Aldactone)
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Eplerinone (Inspra)
Eplerinone (Inspra)
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Administration of Oxygen
Administration of Oxygen
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What is a PE
What is a PE
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Manifestations of PE
Manifestations of PE
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Manifestations of PE
Manifestations of PE
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Manifestations of PE
Manifestations of PE
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PE Impact & Pathophysiology
PE Impact & Pathophysiology
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Anticoagulant in PE
Anticoagulant in PE
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Nursing Interventions for PE
Nursing Interventions for PE
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Study Notes
Peripheral Arterial Disease (PAD)
- PAD involves the narrowing of arteries that supply blood to peripheral limbs, resulting in reduced blood flow.
- Endothelial dysfunction is the initial stage of arteriosclerosis and involves the disruption of the endothelial muscle in arteries due to damaging factors like hypertension or scratches.
- Damage leads to clot formation and stenosis, causing blood vessels to lose distensibility.
- The primary cause of PAD is the buildup of plaques in arteries, known as arteriosclerosis, as well as blood clots or emboli.
Risk Factors for PAD
- Smoking
- Hyperlipidemia
- Hypertension
- Diabetes
- History of cardiac disease
Signs and Symptoms of PAD
- Patients prefer to dangle their legs to alleviate ischemia, as blood flow improves when legs are dependent, while elevation causes pain due to impeded blood flow.
- Sharp pain worsens at night due to the horizontal position affecting blood flow, alleviated by dangling the legs.
- Intermittent claudication causes severe crampy pain during exercise, relieved by rest, commonly in the calf muscle but can occur in buttocks or thighs; advanced cases may experience pain even at rest.
- Critical limb ischemia presents as burning pain at night.
- Extremities are cold, with thin, dry, scaling skin, hairless toes, and thick toenails.
- Pulses are weak on palpation or absent, requiring a handheld Doppler.
- Dependent rubor causes a deep red color when the limb is lower than the rest of the body.
- Lack of edema, paraesthesia.
- Potential presence of leg ulcers at the end of feet, top of feet, or lateral malleolus.
- Lesions appear deep with noticeable margins, minimal drainage, no tissue granulation, and can be pale, necrotic, or black due to impacted perfusion.
Diagnosis of PAD
- Arterial Brachial Index (ABI) compares blood pressure in the arm versus the leg; a lower leg pressure indicates blockage, with ABI = Ankle BP/Brachial BP <0.9 indicating PAD.
- Angiography
- Duplex ultrasound
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