NP2 pad, vericose veins, etc

  1. 1.Progressive narrowing and degeneration of arteries of neck, abdomen and extemities caused by artherosclerosisi
    Peripheral artery disease
  2. 2.Causative factors for PAD
    • ◦smoking
    • ◦hyperlipidema
    • ◦hypertension
    • ◦diabetes mellitus
  3. 3.Clinical manafestations of pad
    • ◦Intermittent claudation (primary)
    • ◦ Paresthesias
    • ◦Taut shiny skin
    • ◦loss of hair
    • ◦diminished pulses
    • ◦pallor reactive hyperemia
    • ◦Pain at rest when elevated more so at nigh
  4. 4.Antiplatelet agents
    • ◦Aspirin
    • ◦Ticlid
    • ◦Plavix
  5. 5.Ace inhibitors (Ramipril) do what to help with pad
    • ◦ increases..
    • ◦Peripheral blood flow
    • ◦abi
    • ◦walking distance
  6. 6.Trental does what to hel pad
    ◦increases erytherocyte flexibility ◦decreases blood viscosity
  7. 7.What does pletal do to help pad
    increases vasodialation and walking distance
  8. 8.Acute arterial ischemic disorder
    • ◦Complication to pad
    • ◦sudden intrerruption of arterial blood supply that can result into tissue death (due to emobolism, chronic atria fib; thrombus or mi or valve problems)
  9. 9.What are the 6 p's that are a sign of a clot
    ◦Pain ◦Pallor ◦Pulselessness ◦Paresthesia ◦Paralysis (late sign) ◦Poikilothermia (limb adapts to room temp ) ◦Tissure necrosisi and death
  10. 10.What should patients with Raynaud's avoid for symptomatic relief? what if severe?
    • avoid caffine, tobacco, and vasoconstrictive drugs and stress management,
    • ◦Calcuim channel blockers
  11. 11.Virchow's triad with DVT
    ◦ venous stasis ◦damage to inner lining of the vein ◦hyper coagulation of blood
  12. 12.diagnostics for dvt
    ◦ultrasound doppler venous evaluation ◦duplex scans ◦venogram ◦blood work (ptt, pt, inr, d dimer, platelet count)
  13. 13.Medical management of dvt if mild
    ◦bed rest and warm heat to leg ◦elevation of the leg ◦anticoagulation ( long term therapy coumadin, herparin therapy prior to therapeutic levels of coumadin. (low molecular weight heparin or unfractionated heparin) ◦Serial monitoring of pt, ptt and Inr (goal is to have inr 2-3 times normal) ◦Thrombolytic drugs ◦thrombectomy
  14. 14.Nursing management for acute intervention dvt
    ◦heparin, lovenox, tpa ◦monitoring protocols for these drugs ◦monitoring labs ◦monitoring for bleeding ◦assess for respiratory problems ◦know antidotes for medications
  15. 15.If patient is on coumadin, what should be limited? what other things should you educate?
    ◦Vitamin K! ◦Soft toothbrush, no straight razor, bruising
  16. 16.Secondary Varicose veins
    Due to other reasons that genetics (DVT)
  17. 17.Risk therapy for varicose vens
    ◦congenital weak veins ◦femal ◦hormone therapy ◦obesity ◦occupations
  18. 18.treatment with vv
    ◦compression socks ◦walking ◦sclerotherapy-injecting sclerosing agents and/or foaming agent and wraping and teds hose ◦Laser therapy -non invasive, light therapy,( for smaller spider veins) ◦Surgical intervention - For recurrent thrombophlebitits, ligation for the entire vein (usually saphenous) endovenous occlusion w saphenous vein ligation
  19. 19.Education for vv
    ◦dont cross legs ◦avoid constrictive clothing ◦lose weight ◦eduaction on compression stockings
  20. 20.Post surgical care for vv
    ◦check circulation ◦legs elevated immediate post op ◦compression stockings ◦check incision lines
  21. 21.Thromboangiitis obliterans aka
    buergers disease
  22. 22.rare no atherosclerotic recurrent inflammatory vaso-occulsive disorder small and medium size arterioles, veins and nerves
    buergers disease
  23. 23.What does Buergers disease cause
    damage to arterial wal inflammatory process, fibroblast proliferation causing trhormbosis and fibrosisi
  24. 24.Signs and symptoms of buergers disease
    ◦pain can be very severe and radiating ◦numbness and/or tingling ◦skin ulcerations ◦gangrene ◦treatment
  25. 25.Medical management of buergers disease?
    ◦ stop smoking immerdiately and completely ◦medication- ca channel blockers, antiplatelet agents, anticoagulatnts ◦Revasularization- Sympathectomy- does not alter the inflammatory process however ◦amputation
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NP2 pad, vericose veins, etc