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Adult Health: PVD pt 1: PAD

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PAD subjective assessment

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Last updated

1 year ago

Date created

Mar 1, 2020

Cards (23)

Section 1

(23 cards)

PAD subjective assessment

Front

-Sx appear after 75% narrowing -intermittent claudication --> rest pain (later, indicates severe disease)

Back

PAD: Extensive Management

Front

(if conservative management doesn't work then:) -PTA: balloon-tip catheter inflated to compress plaque -Bypass -Thrombolytic meds -Amputation: for advanced atherosclerosis & gangrene)

Back

Lower extremity PAD

Front

primarily caused by ATHEROSCLEROSIS also caused by: ~trauma ~embolism ~thrombosis ~vasospasm (ex: Raynauds) ~inflammation ~autoimmunity (ex: LUPUS)*

Back

S/S of PAD

Front

6 P's: -pain -pallor -paresthesia (decreased peripheral sensation) -pulselessness -paralysis -poikilothermia (leg assumes environmental temp)

Back

ABI

Front

a diagnostic test for PAD (others include doppler ultrasound, angiography, MRA/CTA, exercise) ratio = LE BP/UE BP

Back

2 hrs

Front

after arterial surgery, promote circulation by: -REPOSITIONING pt q _____ -tell them NOT to CROSS legs -encourage progressive activity

Back

ABI 0.5-0.9

Front

mild-moderate arterial insufficiency (claudication)

Back

PVD (Peripheral Vascular Disease)

Front

consists of diseases/disorders of blood vessels that impact blood flow/result in poor perfusion to body tissues: Includes: 1. Peripheral Artery Disease (PAD) 2. Peripheral Venous Disorders (PVD)

Back

ABI < 0.5

Front

Moderate insufficiency (ischemic rest pain)

Back

PAD pharmacologic Therapy

Front

-Cilostazol (improves itermittent claudication up to 150%) - inhibits platelet aggreggation -aspirin & clopridogrel (antiplatelet meds) -statins (improve endothelial function)

Back

ABI =or< 0.4

Front

severe insufficiency (severe ischemia or tissue loss)

Back

Risk factors for Atherosclerosis & PAD:

Front

-Nicotene -diet -HTN -diabetes -hyperlipidemia -stress -sedentary life -increasing age -female gender -genetics

Back

heart attacks & strokes

Front

Pts w PAD tend to die from ________.

Back

Peripheral Artery Disease (PAD)

Front

-cause: mainly atherosclerosis leading to narrowed arteries -problem: not getting flow to the tissues -biggest concern: heart & brain

Back

PAD objective assessment

Front

-cool, pale, cyanotic w elevation -shiny atrophic skin (high risk for breakdown) -absent pulse -bruits -decreased cap refill -lost innervation of foot -sparse hair growth

Back

numbness or pain

Front

in a pt who is post-op for arterial surgery, SUDDEN _____ in the LEG could be a SIGN OF GRAFT FAILURE or CLOT BREAKING FREE

Back

Teaching for PAD

Front

-STOP SMOKING -keep feet BELOW <3 level -avoid restrictive clothes -walking program -INSPECT FEET DAILY, pro foot care -dependent feet = blood flow to legs -meds: aspirin, trental, pletal, HTN/DM/CHOLEST meds -AVOID CROSSING LEGS

Back

T

Front

T/F: lifestyle modifications are the key to preventing atherosclerosis/PAD

Back

Pharmacologic therapy for PAD

Front

-Cilostazol (Pletal) - vasodilator --> inhibits platelet aggregation -Aspirin - antiplatelet -Clopdidogrel (Plavix) - antiplatelet -Statins - improve endothelial function (may decrease claudication)

Back

arterial surgery: post-op care

Front

1. assess/report skin color/T changes DISTAL to surg site q 2-4 hr 2. Peripheral pulses (absence may indicate thrombosis) 3. assess wound: drainage,redness, swelling 4. promote circulation 5. give analgesics

Back

Arterial ulcers

Front

-deep -well-circumscribed -on toes or distal foot

Back

ABI > 1.0

Front

no arterial insufficiency

Back

Conservative PAD management

Front

(for mild --> moderate PAD) -exercise therapy -diet mod -smoking cessation -control co-morbidities -pharmacologic

Back