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Terms in this set (54)Peripheral vascular disease (PVD) Diseases of blood vessels in the extremities PVD can be divided into 2 types: 1. Arterial Arterial disorders Obstructive: arteriosclerosis obliterans Arterial - obstructive narrowing & occlusive Arterial - vasospastic arterial spasm (vasoconstriction of blood vessels) Venous disorders Deep vein thrombosis PVD patients tend to remain symptom-free until there is 75% to 90% occlusion in key locations of the major arteries and arterioles of the legs. Risk factors for PVD Diabetes & smoking What is an "early sign" of PVD? Aching, cramping, tightness, weakness during exercise Intermittent claudication (IC) muscle pain during exercise from lack of oxygen, progresses to pain at rest, numbness, and paresthesias Paresthesia numbness with tingling sensation Blood viscosity blood becomes thicker, more viscous Lack of treatment for intermittent claudication results in? thrombosis and the potential for gangrene Physical findings of PVD are: -reduced arterial pulsations on palpation Raynaud's Disease Caused by vasospasm and ischemia of arteries in hands, fingers, and toes Sign & symptoms of Raynaud's disease: numbness, tingling, skin tightness, blanching of the skin with vasoconstriction followed by vasodilation Progression of Raynaud's disease begins with fingertips, then hands As Raynaud's attacks subside vasodilation causes redness, rubor to the pale skin Baseline Assessments for Peripheral Vascular Disease -History
of risk factors such as hypertension, high serum lipids When assessing temperature of extremities - ALWAYS compare side-to-side (both) If there is a clot occluding an artery there will be ______, and _________ pain & significant symptoms (THIS IS A MEDICAL EMERGENCY!) In which condition is leg pain produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest? Answer: B Rationale: Intermittent claudication describes the state of temporary decrease in blood supply to the legs producing pain, numbness, and tingling. Upon rest, the pain goes away. It is a condition that may be treated with medication to dilate the blood vessels and supply more oxygenated blood to the muscle. Which assessment finding would the nurse suspect as being related to peripheral vascular disease? Answer: B Rationale: A deficiency of oxygenated blood supply to the legs is manifested by leg pain, cool to cold feet, weak to no pulses, possible edema, and absence of hair growth on the shins. This is caused by ischemia to the tissues and hair follicles on the legs. Patient Education for Peripheral Vascular Disease -Self-care measures
that promote circulation Why is it important to check with the health care provider before elevating extremities? it is contraindicated in patients with arterial insufficiency. What type of goals should you set for control of pain & symptoms? Short-term goals Patient Teaching -Test water temperature before immersing hands and feet How is Raynaud's disease best treated? by avoidance of triggers, such as cold temperatures, emotional stress, and tobacco or other drugs known to induce attacks. Nonpharmacologic Treatment of Peripheral Vascular Disease - Control of diet, reduce hypercholesterolemia Which is a more beneficial and successful type of treatment for PVD, pharmacological or nonpharmacological? Nonpharmacological
Potential Classes of Drugs to Treat Raynaud's Disease -Calcium ion agonists Which calcium ion agonist has the greatest success in reducing the occurrence of spasms? Nifedipine Which drug has been extensively studied and successful in reducing frequency and severity of attacks? Captopril Which agents have moderate success and many adverse effects? Adrenergic antagonists Which drug has adverse effects such as dizziness, headache, and hypotension? Nitroglycerin Drug Class: Hemorheologic Agents Drug: pentoxifylline (Trental) Actions of pentoxifylline (Trental) Increase erythrocyte flexibility, decrease amount of fibrinogen in blood, prevent aggregation of RBCs and platelets *Decreases the viscosity of blood and improves tissue perfusion, which results in increased blood flow. Uses of pentoxifylline (Trental) Treat intermittent claudication Common adverse effects of pentoxifylline (Trental) Nausea, vomiting, dyspepsia; dizziness, headache Serious adverse effects of pentoxifylline (Trental) Chest pain, dysrhythmias, shortness of breath A patient with peripheral vascular disease has been on pentoxifylline (Trental) for 2 weeks. Which statement by the patient indicates a need for further patient teaching about the disease? Answer: C Rationale: Patients with peripheral vascular disease must be cautious in extreme weather like skiing because sensation to the legs is impaired. The patient could experience frostbite and damage to the extremities and not be aware of it. Drug Class: Vasodilators Drug: papaverine hydrochloride Actions of papaverine hydrochloride Vasodilation of the smooth muscles of blood vessels *OTC cold and cough preparations may counteract its effect. Uses of papaverine hydrochloride Treat symptoms of vasospasms, cerebral vascular insufficiency, arteriosclerosis Common adverse effects of papaverine hydrochloride Flushing, tingling, sweating, nausea, vomiting Serious adverse effects of papaverine hydrochloride Hypotension, tachycardia, rash, nervousness
A patient with peripheral vascular disease has been prescribed papaverine. Which symptom is considered a severe adverse effect that requires immediate reporting to the health care provider? Answer: A Rationale: The adverse effects of flushing, sweating, nausea, and vomiting may occur during the initial phase of therapy but should resolve with continued therapy. Hypotension is a more serious adverse effect and should be reported to the health care provider. Blood pressure and pulse should be monitored regularly, especially at the beginning of therapy. Drug Class: Platelet Aggregation Inhibitor Drug: cilostazol (Pletal) Actions of Platelet Aggregation Inhibitor: cilostazol (Pletal) Allow increased levels of cAMP, which result in vasodilation and inhibit platelet aggregation Uses of Platelet Aggregation Inhibitor: cilostazol (Pletal) Treat intermittent claudication Common adverse effects of Platelet Aggregation Inhibitor: cilostazol (Pletal) Dyspepsia (indigestion), diarrhea; dizziness, headache Serious adverse effects of Platelet Aggregation Inhibitor: cilostazol (Pletal) Chest pain, palpitations, dysrhythmias, shortness of breath Therapeutic outcomes of cilostazol (Pletal) improve tissue perfusion, reduce pain, improve tolerance of exercise, and improve peripheral pulses. What fruit/juice does Pletal interact with? Grapefruit Sets with similar termschapter 26 drugs used to treat peripheral vascular…40 terms traci_powers3 Vascular Disorders55 terms rachel_montgomery3 Test #3 PVD & Neuro111 terms smileywileycoyote Sets found in the same folderPharmacology - Study Guide # 2 Questions30 terms chxlystra NUR 145 Pharmacology: CH. 27 (Thromboembolic Disea…44 terms mopatchett Drugs Used To Treat Thromboembolic Disorders (Ch.…149 terms korbynmccombs Drugs Used To Treat Heart Failure (Ch. 28)97 terms korbynmccombs Other sets by this creatorMedical Terminology25 terms mopatchett NUR 145 Pharmacology: Ch. 16 (Anxiety)58 terms mopatchett NUR 145 Pharmacology - Ch. 15 (Parkinson's)40 terms mopatchett NUR 145 Pharmacology - Ch. 14 (Sleep)54 terms mopatchett Other Quizlet setsPhysio Ch 22: Digestive System Pt 260 terms dashka18 Persia Unites Many Lands20 terms christine0129 MS4 year exam 250 terms Mgs114 mktg exam 240 terms tenley_davis1 Related questionsQUESTION what is theophylline (Theo-Dur) used for? 6 answers QUESTION What are the S/SX of Serotonin Syndrome? 15 answers QUESTION One reason why gases are used as general anesthetics is because 4 answers QUESTION What is the pH of the gastric mucosa? 6 answers What are the warning signs of peripheral vascular disease?Peripheral Vascular Disease Symptoms. Buttock pain.. Numbness, tingling, or weakness in the legs.. Burning or aching pain in the feet or toes while resting.. A sore on a leg or a foot that will not heal.. One or both legs or feet feeling cold or changing color (pale, bluish, dark reddish). Loss of hair on the legs.. Impotence.. What are examples of peripheral vascular disease?Peripheral Vascular Disease.. Pulmonary Embolism.. Raynaud's Phenomenon.. Renal Vascular Disease.. Thoracic Aortic Aneurysm.. Varicose Veins.. What are the five classic peripheral signs of PVD?Peripheral signs of peripheral vascular disease are the classic "five P's," as follows:. Pulselessness.. Paralysis.. Paresthesia.. Pallor.. What physical exam findings might you expect if the patient had peripheral vascular disease include arterial and venous findings?Physical findings include abnormal pedal pulses, femoral artery bruit, delayed venous filling time, cool skin, and abnormal skin color. Most patients present with subtle findings and lack classic symptoms, which makes the diagnosis difficult.
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Which assessment finding would the nurse suspect as being related to peripheral vascular disease
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