nursing 344 - peripheral vascular system

peripheral arterial disease (pad)

• affects non-coronary vessels

• refers to arterial narrowing affecting limbs

• decreased oxygen and nutrients to lower extremities

peripheral arterial disease (pad) symptoms

• pain - sharp

• pulses - absent

• gangrene (death of tissues)

skin assessment for pad

• cool to touch

• pale skin

• absent hair + shiny skin

• thin, dry + scaly skin

• no edema

lesions of pad

• red sores on toes/feet

• punched out appearance

culture and genetics for pad

• risk factor for cad

• pad is genetic and environmental related (SMOKING)

• non-hispanic black ppl have highest risk

peripheral venous disease (pvd)

• pooling of blood in extremities due to inability to bring blood back to heart

• vascular insufficiency

pvd symptoms

• pain - achy and dull

• strong pulse

• lesions - irregular shaped sores

• no gangrene

pvd - skin assessment

• edema present

• warm legs

• yellow/brown ankles

pad vs pvd

• pad: A shape and hang (dangle) patient’s leg

• pvd: V shape and elevate patient’s legs

deep vein thrombosis (dvt)

• blood clot (thrombus) develops in a large, deep vein of limbs

• most commonly in lower limbs

• lead to pulmonary embolism

symptoms for dvt

• throbbing/cramping pain

• redness + edema

• hard/sore veins

• larger calf diameter

causes for dvt

virchow’s triad:

• hypercoagulability

• blood stasis

• vessel injury

diagnosis for dvt

• wells score: low, moderate, high probability

  • high probability: ultrasound

  • low probability: d-dimer blood test

risk factors for dvt

• immobility

• smoking

• diabetes mellitus 2

• high cholesterol

complications for dvt

pe or cva if clots travels to brain or lungs

thrombus or embolus

• thrombus: stationary clot → restricting blood flow

• embolus: detached traveling mass

  • broken off of thrombus

  • causing blockage

pulmonary embolism

• risk factor: diagnosed with dvt

• blood clot obstructs pulmonary artery within lung

• blockage prevents blood flow to alveoli where gas exchange → deadly hypoxia

intermittent claudication

• seen in pad

• pain in calf → after exercising + relieved at rest

• no blood flow to meet demand of muscles during exercise

subjective data

• smoking history

• meds

• leg pain

• color changes on arms/legs

• temp changes

• swelling

• lymph node enlargement

arteries

• complete blockage = death of distal tissue

• partial blockage = insufficient supply

  • ischemia may be apparents when oxygen needs increase

veins characteristics

• low pressure

• valves present

• skeletal muscle + respiratory pump

• wider lumen

arteries characteristics

• high pressure

• no valves

• no pumping action, relies on heart

• thinner lumen

older adults and lymphatics

• loss of lymphatic tissues

• fewer and smaller lymph nodes

pregnancy and lymphatics

• uterus block iliac vein and vena cava draining → blood flow reduced

• venous pressure high

pregnancy and lymphatic results

• dependent edema

• varicose veins

• hemorrhoids