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N105 Cardiac Ch 38
Interventions for Clients with Vascular Problems
82
Nursing
Undergraduate 1
03/31/2012

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Cards

Term
Thickening/Hardening of wall
Definition
Arteriosclerosis
Term
Plaque is composed of
Definition
fats and platelets
Term
Occlusion or Rupture of a artery
Definition
Stroke
Term
Risk fxs for Arteriosclerosis
Definition
Untreated HTN, genetics, high LDL cholesterol, smoking, stress, age, hyperglycemia
Term
+2 in radial and +1 in brachial is
Definition
normal
Term
S/S of Arteriosclerosis
Definition
diminished pulses, bruit, delayed capillary refill, tone of color change, dark circles,
Term
What is the normal capillary refill
Definition
less than 3 sec
Term
Normals for
Total Cholesterol
LDL
HDL
Definition
< 200
<100
>40
Term
For Arteriosclerosis - What is the first thing you would do?
Definition
Term
#1 chronic disease that results Heart Disease related to untreated HTN, diabetes, poor diet, lack of exercise
Definition
Arteriosclerosis
Term
Step one diet is
Definition
less than 30 % fat
Saturated less than 10%
less than 300 mg cholestorol daily
Term
US Normal Daily Diet
Definition
30% calories from fat
Term
Step 2 diet
Definition
less than 7 % saturated fat
equal or less than 200 mg daily cholesterol
Term
How does smoking affect cholesterol
Definition
lowers HDL
Term
How can you exercise decrease cholesterol
Definition
30 minutes a day 3 to 4 times per week
Term
HTN is a result of
Definition
Cardiac Output x peripheral resistance and hormonal control, SNS
Term
Heart Rate x Stroke Volume
Definition
Cardiac Output
Term
What are the body's control mechanisms of high b/p
Definition
Arteroil Baroreceptor System
Regulation of Fluid Volume
Renin Angiotensin System
Vascular Autoregulation
Term
Malignant HTN
Definition
above 200/130 - out of control
Term
Essential HTN
Definition
Don't know why - 90%
Term
high b/p as a result of renal failure or dysfunction of adrenal medula or adrenal cortex
Definition
Secondary HTN
Term
s/s of htn
Definition
light headedness, headaches,
Term
Increases Risk of HTN
Definition
Retinal - eye damage, kidney damage,
Term
In diagnosing Htn what all should be done
Definition
several readings under different circumstances, teach check b/p at home, check peripheral pulses, rule out secondary due to medications
Term
Nursing Diagnosis for HTN
Definition
Knowledge deficient r/t unfamiliar info
Risk for Ineffective Therapy
Term
Knowledge Deficient for htn r/t unfamiliar info
Definition
lifestyle alterations, low sodium diet to reduce fluid, no canned/processed foodds, reduce wt, moderation of alcohol intake, exercise, relaxation therapy, avoid tobacco & caffeine
Term
Tobacco and Caffiene are
Definition
Vassoconstrictors
Term
Drug Therapy for htn
Definition
diuretics
calcium channel blockers
Term
What drugs are calcium channel blockers
Definition
ACE Inhibitors, ARB, Beta adrenergic blockers, central alpha agonists
Term
Diuretics for HTN
Thiazide
Definition
most frequent - increase excretion of water, sodium, potassium. works at convoluted tubule
Term
HCTZ
side effects
Definition
diuretic - uses htn and edema
Side Effects are Hypokalemia and increased uric acid - don't use with diabeties and gout. Take in morning can make you feel light headed so rise slowly
Term
Loop Diuretics
works how
side effects
Definition
Lasix and Bumex
increases amount of fluid loss.
hypokalemia, hyperglycemia, tinitis, rash, photosensitivity
Term
What drug interacts with loop diuretics
Definition
corticosteroids
Term
What are the patient eductions for loop diuretics
Definition
increase potassium foods, limit sun, daily weights, I and Os
Term
How do Calcium Channel Blockers work

Conditions they are prescribed?
Definition
counteracts arrhythmias by blocking of Calcium access to the cells of the heart

Angina and htn
Term
What affects to Calcium Channel Blockers have on heart?
Definition
decrease contracity
decrease contactility/excitablity
decrease oxygen needs
Term
Verapamil, Isoptin are
Definition
Channel Blockers
Term
Propinolol, Inderal, Tenormin are

Effects on the heart
Definition
Beta Blockers

decrease heart rate, force of contraction and rate of conduction
Term
How do beta blockers work?
Definition
combats arrhythmias by inhibiting adrenergic (SNS) receptors
Term
Side Effect of Beta Blockers that would cause to quit taking
Definition
sexual disfunctions -
Term
PAD - Peripheral Arterial Disfunction
Definition
Disorders that alter the natural flow of blood through the arteries and veins of peripheral circulation
Term
PAD causes an increased risk of
Definition
angina, MI, Stroke
Term
What are the symptoms that come in each stage of PAD
Definition
1. No sign
2. Intermittent Claudification
3. Pain at Rest
4 Hair Loss and dry scaly mottled skin with thickened toenails
5. Muscle Atrophy
Term
Intermittent Claudification
Definition
walk then pain from hypoxia. Rest Pain goes away. KEY - it is reproducable
Term
Occur in lower legs around ankles b/c of debris in tissues
Definition
venous ulcers
Term
Arteriography risk
Definition
bleeding
Term
Plethymography
Definition
graft and tracing
Term
Arterial problems what do you do?
Definition
Do not elevate, no caffiene or nicotene, keep extremities warm (no direct heat), socks and shoes to prevent injuries, avoid emotional stress, drg therapy
Term
Percutaneous Transluminal Angioplasty
Definition
Balloon Catheter with Stint Insertion
Term
Drug that promotes circulation
Definition
Trentol
Term
Drugs that prevents blood/platelets from sticking together
Definition
Plavix, Aspirin = Anti coagulants
Term
Procedure to clear blockages

2. remove a clot or remove plaque formation
Definition
Angioplasty

2. Atherctomy
Term
What do you do for compartment sydrome
Definition
loosin clothing and elevate to heart level
Term
What is most common cause of occlusion
Definition
Embolus
Term
Acute Peripheral Arterial Occlusion s/s
Definition
sudden dramatic onset of severe pain, extremity is cold
Term
The 5 Ps of Neurovascular Assessment
Definition
Pain - Both
Pallor - Vascular
Pulselessness - Vascular
Peresethia - Neuro
Paralysis - Neuro
Term
Triple A
Definition
Abdominal Aortic Aneuryism
100% fatal if outside hospital
Term
Aneurysim - monitor
Definition
Monitor for Pain, if there is a change = may need to repaired if leaking.
Term
Buerger's Disease
Definition
Uncommon, problems with small and medium arteriols and veins, results from escemia. Increased in young men who smoke
Term
Smoking inflammes the vessels causing
Definition
scar tissue - fibrosis
Term
clears blockages - may or may not put in a stint
Definition
Angioplasty
Term
Remove clot or removal of plaque formation
Definition
Atherectomy
Term
What do you do for Compartment Sydrome
Definition
Loosen clothing and elevate to heart level
Term
Arteriography Risks
Definition
Hemorrhage, Thrombosis, Embolus, Death
Term
Segmental Systolic Blood Pressure Measurements
Definition
Measurements of b/p in thigh, calf, and ankles
Term
Ankle-Brachial Index
Definition
divide ankle blood pressure by brachial blood pressure < 0.9 indicates arterial disease
Term
Plethysmography
Definition
provides graphs and tracings of arterial blood flow in limb
Term
How do you naturally promote vasodilation?
Definition
keep extremity warm, avoid exposure to cold, wear socks, drink adequate fluids, avoid emotional stress caffeine and nicotine
Term
Hemorheologic Agents
Definition
increase flexibity of RBC, inhibits platelet aggregation
Term
Post procedure care of Angioplasty
Definition
observe for bleeding at puncture site
monitor distal, v/s, client on bedrest for limbs straight for 6 to 12 hours unless collagen plugs are used to seal vessel, anticoagulants used during and after, antiplatelet for 1 to 3 mo or aspirin on permanent basis
Term
Arterial Revascularization
Definition
bypass from aorta to iliac or femoral arter (abdominal incision) or from axillary to femoral artery (no body cavity incision)
Term
Arterial Revascularization Interventions
Definition
assess graft occlusion - monitor extremity every 15 minutes for 1st hour then hourly for
Coughing Deep breathing, incentive, NPO 1day then clear liquids, Sterile Dressing, observe induration, erythema, tenderness, warmth, edema, drainage, fever
Term
Acute Peripheral Arterial Occlusion
S/S
Definition
Sudden dramatic severe pain, extremity is extremely cold Assess the 6 P's
Term
Interventions for Acute Peripheral Arterial Occlusion
Definition
Prompt Treatment, Anticoagulant Therapy, Surgical Thrombectomy or embolectomy to remove occlusion
Term
Postop for Acute Peripheral Arterial Occlusion
Definition
Monitor for improved color, temperature, pulse and reduce pain
Term
Aneurysms of Central Arteries occur
Definition
at points in larger arteries where there is no support from skeletal muscle - Most common area are abdominal Aortic Aneurysms - 75% and Thoracic- 25%
Term
S/S of Hemorrhagic Shock
Definition
hypotention, diaphoresis, mental obtundation, oliguria, dysrhythmias, abdominal distention
Term
Interventions for Buerger's Disease
Definition
No smoking, no cold, promote vassodilation
Term
S/S of Buerger's Disease
Definition
neuropathy - numbness with pain,
Extreme sensitivity seaseto cold
Term
Raynaud's Disease
Definition
caused by vasospasms of arterioles and arteris of upper and lower extremities can be associated with connective tissue disease and smoking. Tx = drug therapy to aid in vassospasms, minimize cold exposure, warm clothes
Term
DVT
Definition
Deep Vein Throbosis - Thrombus - blood clot developing most often in legs - associated with stasis of blood flow, endothelial injury and hypercoagulability - Virchow'
Term
Interventions for Buerger's Disease
Definition
No smoking, no cold, promote vassodilation
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