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Stack #38872
RRC Maintenance - PVD
| question | answer |
|---|---|
| peripheral arterial disease | result of atherosclerosis which resulting a plaque build-up on the vessel walls that narrows the lumen...eventually the cells will be deprived of O2, toxins will build up and stimulate pain receptors and result in tissue death/ulcers or limb necrosis |
| peripheral venous disease | related to valvular dysfunction -> consist of 2 frail cusps composed of endothelial tissue and competence of valve is dependent upon vein wall integrity...this is prevent backflow of blood. Blood becomes pooled and serous fluid leaks leading to edema |
| defining characteristic of peripheral arterial disease | intermittent claudication, rest pain, ulcers/gangrene |
| What is intermittent claudication? | pain or discomfort associated with exercise, pain is not present at rest and goes away with rest. Results when muscles are not getting enough O2 and stimulates pain receptors |
| Clinical manifestation of peripheral arterial disease? | decreased or absent peripheral pulses, cap refill >3 secs, loss of hair on legs/feet/toes, ulcers located on tips of toes, foot or lateral malleolus, ulcer looks rounded and smooth, minimal drainage, intermittent claudication, rest pain, skin thin, cool |
| Clinical manifestation of peripheral venous disease? | peripheral pulses present - may be diff to palpate with edema, cap refill <3 secs, pitting edema lower leg, ulcer located at medial malleolus and irregularly shaped, M/A-L/A drainage, dull ache/heaviness to calf/thigh, brown/bronze pigment, varicose veins |
| Risk factor for arterial disease | male gender, dyslipidemia, family hx, HTN, Dm, obesity, smoking, sedentary lifestyle, stress |
| risk factors for venous disease | age>40yrs, post-op, venous stasis, previous DVT, car/airplane trip, cardiac disease (MI, HF, cardiomyopathy), pregnancy, trauma, OCP, smoking, malignancy, obesity, estrogen therapy |
| What are 6 P's of arterial assessment? | Pain @ rest, pallor (elevation/dependent), pulselessness, parasthesia, paralysis, poikilothermia (coolness - like a reptile takes on temp of env't) |
| Why do we encourage mobility in those with arterial disease? | promotes development of collateral circulation to bypass occlussion |
| Rationale for raising HOB for PAD | promotes circulation to lower extremities |
| Rational for elevating legs in peripheral venous disease? | promotes venous return and O2 to cells |
| Why do we encourage the use of compression stocking in those with peripheral venous disease? | prevents pooling of blood in extremities and edema |
| What is the purpose of statins? | to decrease serum cholesterol levels |
| What is the purpose of antiplatelet medications like ASA and Plavix (clopidgrel)? | prevention of platelet adherence and development of thrombi/emboli |
| What are anticoagulants use in those the venous insufficiency? | to prevent development of DVT/pulmonary emboli |
| Why are defibrination agents such as trental used in arterial disease? | increases the flexibility of RBCs which enhances movement through microcirculation and prevents the aggregation of RBC and platelets and decreases the viscosity of blood...has potential to increase circulation at capillary level |
Created by:
bella83
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