ch. 41: vascular disorders

acute care for PAD

frequent neurovascular checks post surgery, report any changes in neurovascular assessment, monitor for potential complications (bleeding, hematoma, thrombosis, embolization, compartment syndrome), avoid knee-flexed positions, don’t cross legs, avoid extreme temps, turn frequently, avoid prolonged sitting, compression stockings, ensure proper foot care

acute arterial ischemic disorders

sudden interruption in arterial blood supply to a tissue, organ, or extremity that can result in tissue death, symptoms include 6 P’s

symptoms of aortic aneurysm rupture

sweating, pallor, weakness, tachycardia, hypotension, abdominal/ back/ groin/ periumbilical pain, changes in LOC, pulsating abdominal mass, bruit, Grey Turner sign, hypovolemic shock

post op care for aortic aneurysms

• maintain graft patency, ensure normal BP, continuous ECG monitoring, IV fluids, prevent infection (abx)

• urine output monitoring with catheter, monitor BUN/ creatinine

• monitor for paralytic ileus (bowel sounds? passing gas?), NPO until bowel function returns, assess for bowel ischemia as bowel infarction requires immediate surgery

• LOC, PERRLA, facial symmetry, speech

• neurovascular checks, frequent pulse assessment, report signs of embolization/ graft occlusion immediately

aortic dissection

creation of a false lumen between inner lining and middle layer of arterial wall

pre op care for aortic dissection repair

semi fowler’s position and quiet environment to decrease HR and SBP, anxiety and pain management, titrate IV antihypertensives, keep BP and HR at lowest possible level that maintains organ perfusion, VS every 2-3 min, observe for changes in peripheral pulses