PAD/Cardic

Vascular, peripheral circulation,/ structural and infectious cardiac disorders​

byVM

​Arterial Disorders

Arteriosclerosis ( ​Harding of the arteries)

Atherosclerosis (accumulation of lipids, calcium, blood components, carbohydrates, and fibrous tissue on the intimal layer of the artery)

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​Most common direct result:

            stenosis of lumen, obstruction by thrombosis, aneurysm, ulceration, and rupture

Multiple Choice

The nurse is taking a health history of a new patient. The patient reports experiencing pain in his left lower leg and foot when walking. This pain is relieved with rest. The nurse notes that the left lower leg is slightly edematous and is hairless. When planning this patient's subsequent care, the nurse should most likely address what health problem?

• Coronary artery disease (CAD)

• Intermittent claudication

• Arterial embolus

• Raynaud's disease

​Peripheral Arterial Occlusive Disease

Intermittent claudication: poor arterial blood flow to lower extremity,​

​Assessments:

 

Medical Management : Phramacologic, surgical

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​Nursing:

Multiple Choice

A nurse is caring for a client following an arterial vascular bypass graft in the leg. What should the nurse plan to assess over the next 24 hours?

• Peripheral pulses every 15 minutes after surgery

• Ankle-arm indices every 12 hours

• Blood pressure every 2 hours

• Color of the leg every 4 hours

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​maintain adequate circulation through the arterial repair

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​Education at home

Multiple Choice

The client is admitted for surgical repair of an 8-cm AAA. Which sign/symptom would make the nurse suspect the client has an expanding AAA?

• Weakened radial pulses

• Complaints of Low Back Pain

• Decreased urine output 

• Increased in Abdominal Girth 

Aneurysms:​

​sack or dilation that makes a weak point in the wall of an artery. from trauma, disease or congenital weakness.

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​Thoracic aortic or abdominal aortic (AAA)

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​mostly no symptoms, may find a pulsatile mass in mid/upper abd

​use a CTA to measure size, location,

​they are monitored, endograft may be done to repair,

​worry of rupturing

Multiple Choice

Which nursing dx is most significant in planning the care for a client with Raynaud’s disease?

• Acute Pain

• Self-Care Deficit

• Disturbed Sensory Perception

• Activity Intolerance

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​Raynauds: intermittent arteriolar vasoconstriction. Of hands and toes

​blue to red

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​what to teach and avoid?

Multiple Choice

small, circular, deep ulcerations on the tips of toes or in the webspaces between the toes

• Arterial insufficiency Ulcers

• Venous insufficiency Ulcers

• Stage I pressure ulcer

Multiple Choice

typically large, superficial, and highly exudative discolored area ulcers

• Venous insufficiency ulcer

• Arterial insufficiency ulcer

• Maceration  

​Venous vs Arterial insufficiency

Understand the cause,

SS

Treatments

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​Prevention of ulcers and care

Multiple Choice

client with aortic stenosis is reluctant to have valve replacement surgery. A nurse is present when the health care provider talks to the client about a treatment that is less invasive than surgery which will likely relieve some of the client's symptoms. What treatment option has been discuss

• Balloon percutaneous valvuloplasty

• Antibiotic therapy

• Placement of an heterograft valve

• Placement of a homograft valve

​Valve replacement vs repairs

valvuloplasty repair of the valve: balloon , annuloplasty (ring) leaflet repair, or chordoplasy (tendon repair)

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Mechanical valve replacement:

Vs

Tissue:

Heterograft: from an animal

Homograft/ allograft

From human cadavers

Autograft: own pulmonic valve seen in youth, replace aortic valve

Multiple Choice

A 38 year old male with a history of IV drug use presents to the ER with complaints of fever, and a rash on his chest. Labs:  elevated WBC, ESR, and CRP. Based on his signs and symptoms what do you suspect he could be experiencing?

• Endocarditis

• Rheumatic endocarditis

• Myocarditis

• Pericarditis  

​Infectious Heart Disease

​Infective Endocarditis

Rheumatic Endocarditis

​Myocarditis

​Pericarditis

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​be able to compare and contrast,

​s/s, diagnostic studies, treatment