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Vascular Disorders

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mlinnie's version from 2018-11-09 22:19

Section

Question Answer
Aneurysmsdilation of an artery due to a weakness in the arterial wall Arterial Occulusive Disease
Raynaud's Phenomenonis a arteriopastic disease; disorder of small cutaneous arteries causing vasospasm. usually affects the fingers bilaterally.
Cause of Raynaud's Diseaseunknown, but may be triggered by stress, cold and it usually occurs in women
Assessment Findings for Raynaud'sAntihypertensive Agents: Reserpine (Serpasil); Alpha-Adrenergic Blocking Agents: Phenoxygenzamine (Dibenzyline), Tolazoline (Piscoline); Vasodilators
Nursing Interventions for Raynaud's DiseaseTeach client: manage stress, cessation smoking, avoid caffeine, avoid extreme temperatures, protect self from cold
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Question Answer
Buerger's Disease "Thromboangitis Obliterans"blocking of the medium and small arteries, usually in the legs and feet. The disease only occurs in smokers
Assessment Findings for Buerger's DiseaseIntermittent claudication; numbness and tingling of toes; weak or absent peripheral pulses; ischemic ulceration; can lead to gangrene
Management of Buerger's DiseaseStop smoking, Analgesic
Nursing InterventionsMonitor peripheral pulses and blanch test; provide foot care;
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Question Answer
Vericose Veinsdilation of superficial veins of the legs and feet.
Caused byincompetent valves (incompetence, vavular) in the superficial veins, increased pressure in veins causing them to distend
Risk Factorsstanding for long periods, pregnancy
Assessment Findingspain after period of standing, foot and ankle swelling at end of day, distended leg veins
Managementobjective: to reduce pain and halt underlying condition; medical: sclerotherapy (injection of sclerosing agent that causes vein thrombosis) ; surgical: vein ligation (vein stripping)
Nursing Interventionspost-operative care includes: application of elastic stocking or bandages & elevation of leg
Teach clientnot to cross legs; to elevate legs as much as possible; to avoid prolonged sitting or standing ; avoid anything that impedes venous return ; overweight clients should lose weight
Deep Vein Thrombosis "DVT" clotting in a deep vein
Causes of DVTimmobilization; sepsis; hematological disorders and clotting disorders; malignancies; CHF; MI; Obesity; Pregnancy, Fractures, Venipuncture, Surgies: orthopedic, neurologic, urologic, and gynecologic; Risk of Pulmonary Embolus
Managementbed rest; anticoagulant therapy to prevent new clots; thrombolytic therapy to dissovle thrombus; compression stockings; surgery - thrombectomy
Nursing Interventions Monitor findings of Pulmonary Embolus, bedrest, avoid prolonged immobility
Venous Stasis Ulcerschronic skin and subcutaneous ulcers usually found on legs, ankles or feet.
Causes of Venous Stasis Ulcers Chronic Venous insufficiency ; incompetent valves; pressure of blood pooling causes capilaries to leak; lcer begins as a small, inflamed, tender area
Assessment Findings of Venous Stasis Ulcersopen skin lesion with irregular border; skin around ulcer usually brown and leathery; pain in affected area
Management of Venous Stasis Ulcercorrect venous hypertension and both prevent and correct ulceration; local wound care; antibitotics and analgesics; surgery(debridement; skin grafing; removal of veins)
Nursing Interventionskeep legs elevated with feet above level of heart at all times; apply elastic bandages; cleanse and dress ulcer
Teach client toreport any signs of inflammation; avoid trauma to affected limb; provide skin care; apply elastic bandages
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Question Answer
Arterial Stasis Ulcersinsufficient blood supply in the arteries, usually in legs; may be acute or chronic
Causes of Acute Arterial Occlusive DiseaseEmbolism, Thrombosis and Trauma
Common cause of Acute Arterial Occlusive DiseaseFemoral artery
Assessment Finding for Arterial Occlusive DiseasePain in affected limb ; cyanosis in affected limb ; paresthesia in affected limb
What can occur if Arterial Occlusive Disease goes untreatedGangrene
Management of Arterial Occlusive DiseaseAnticoagulants (don't use straight razor use electric razor; use soft toothbrush; avoid alcohol; report signs of bleeding, red or black bowel; headaches, rashes, red or pink-tinged urine, sputum; Avoid trauma)
Surgical treatment includesEmbolectomy; Bypass of affected artery; amputation of limb; PTCA
Chronic Arterial Occlusive Disease caused byArteriosclerosis obliterans, aneuryss, hypercoaguability states, tobacco use
Assessment Finding for Chronic Arterial Occlusive DiseaseIntermittent claudication which indicates mild to moderate obstruction; Pain at rest indicates severe obstruction
What will the affected limb look likeedema; paresthesia; weak or absent pulses; skin: waxy hairless, cool, pale, cyanotic
What affect may it have on menImpotence
Management of Chronic Arterial Occlusive DiseaseAnticoagulatns to prevent blood clots ; vasodilators ; antiplatelets to prevent platelet aggregation; Pentoxifylline (Trental) which increases blood flow by thinning blood
Surgical Treatment for Chronic Arterial Occlusive Diseaseedarterectomy; femora-popliteal bypass; sympathectomy; amputation; laser coronary angioplasty; peripheral angioplasty
Teaching for clients with Acute or Chronic Arterial Occlusive Diseasechange positions frequently; avoid crossing legs; avoid any constrictive clothing on legs; avoid trauma to lower extremities ; foot care; place legs in dependent position to increase blood flow
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