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What is an imp regulator of blood flow in peripheral circulation of human body
- sympathetic nervous system (adrenergic), regulating blood flow in peripheral circulation
- ANS: divides into symp and parasymp
- CNS: brain and spinal cord, no regulating effect on peripheral blood flow
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Symptoms of claudication results when
- oxygen demand by muscle exceeds supply
- describes discomfort when oxygen demand in leg muscles is greater than supply
- pain results from hypoxia in working muscle
- other symptoms besides pain: aching, cramping, weakness
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Assessing pedal pulses involves
papating both the dorsalis pedis (top of the foot) and the tibial arteries (inner side of each foot)
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Explain influence of aging on PVD development
- Increased resistance within circulatory system
- As people age, collagen accumulates in the intima of the blood vessels
- this results in stiffer vessels and less flexible
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Main characteristic of PVD is
- decreased blood flow
- slow blood flow is not PVD, probably pump failure
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When assessing the lower extremities of client with PVD, the nurse notes bilateral ankle edema. THe edema is related to
- increased venous pressure
- This results in an increase in capillary hydrostatic pressure, causing a net filtration of fluid out of capillaries into interstitial space
- decreased muscular action also contributes to edema in lower extremities
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Assessing lower extremity pulse; assess whether they are palpable, then assess
quality
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Atherosclerosis results in stenosis of the arteries; what is a result of atherosclerosis
- Formation of aneurysm
- (Arteriosclerosis: hardening of of arteries, involving the endothelial lining and in thickened arterial walls)
- (varicose vein: incompetent valves in venous system)
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Pain related to PVD in atherosclerotic lesions results fom
- fibrous plaque and fatty streaks (yellowish, smooth, fatty streaks)
- Arteriosclerosis: pain from atheromas, calcium plaques, thickening of intima
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Lower extremities with PVD look like: mottled skin, resulting from
- reduction of blood flow to specific area, with decreased oxygen and nutrients
- Other signs: loss of hair and cool, dry skin in lower extremities
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THe nurse is unable to palpate the left pedal pulse. what action to take next?
- use doppler ultrasound device
- ascultation won't help if pulse can't be palpated
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Doppler instrument using to assess peripheral pulse, correct placement of transducer is important because it is difficult to differntiate between
arterial and venous blood flow (capillary and arteriole can't be auscultated with doppler)
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Risk factor for development of atherosclerosis
- High level of LDL;
- LDL is not broken down in the liver but is deposited into intima of blood vessels
- (low triglyceride is desirable)
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Coldness, paralysis, and pallor of foot and ankle indicates what in PVD clients
complete arterial obstruction
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Decreasing anxiety for client with PVD, to decrease or prevent vasoconstriction of
- arteries
- anxiety stimulates SNS: secretion of epi, angiotension, serum proteins that cause vasoconstriction in arteries of peripheral circulatory system
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First priority when PVD client returns to surgical care unit after having femoral-popliteal bypass graft
- assess peripheral pulse
- validate bypass graft is functioning
- then assess and provide client information immediately after surgery
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Buerger's ds symptoms
- inflammation and fibrosis of arteries, veins, and nerves
- slowly developing claudication, cyanosis, coldness, and pain at rest
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Raynaud's ds known as arteriospastic ds and is seen most often in , and associated with..
young women; collagen ds like rheumatoid arthritis and lupus
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raynauds disease is a
- episodic vasospastic disorder of small arteries
- small cutaneous arteries like fingers and toes
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vasoconstriction effect: 3 stage colors
pallor, cyanosis, then red
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Tamsulosin hydrochloride (Flomax)
alpha blocker-smooth muscles in prostate, leading to relaxation of the prostate AND bladder
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terazosin hydrochloride?? selectively for?
- alpha locker, blocks post synaptic alpha receptors
- decreases SYMPathetic tone on vasculature, dilating arterioles and veins
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labetalol: alpha or beta blocker
both
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what facilitiates return of blood from lower extremities, especially when in dependent position
muscular action
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one common cause of PE
DVT,
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187 lbs = __kg?
187 divided by 2.2 = 85
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thrombophlebitis
- inflammation of a vein
- stasis of blood, increased blood coagulability vessel wall injury
- symptoms: pain, swelling, deep muscle tenderness
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Secondary varicosities can result from..
previous thrombophlebitis of deep femoral veins, with subsequent valvular incompetence
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before surgery for known aortic aneurysm, client's pulse pressure begins to widen, suggesting increased widen pulse presure, suggesting aortic valvular insufficiency. if branch of aortic arch is involved, client will have
loss of consciousness
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complication of dissecting aneurysm
cardiac tamponade
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dissecting thoracic aneurysm: sudden and painful "tearing" sensation typically associated with..
sudden release of blood
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contribution of postop paralytic ileus
bowel manipulation, immobility, and pain meds (like morphine/narcotics)
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coumadin hinders...and prolongs..
- hinders hepatic synthesis of Vit K dependent clottic factor
- Prolongs clotting time
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signs of bleeding coumadin
bleeding gums, petechiae, brusies, dark stool, dark urine
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What occurs after radical mastectomy?
- lymph nodes are removed, so there's lymphedema
- this aplasia or absence of lymph nodes... prevents proper lymph drainage, so there's tissue swelling that's caused by obstructed lymph flow in extermity
- NO BP in affected arm to avoid further lymphedema (further obstructed lymph)
- encourage to elevate above level of heart
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migraine headaches is believed ot be caused by
dilation of cranial arteries; disturbance with carotid artery; first there's vasoconstriction then extracranial and intracranial dilate
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