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Glossary of Cardiovascular Peripheral Vascular Disease

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Pathopysiology of PVD
Decreased circulation leads to tissue ischemia (anarobic metabolism occurs), Pain (skin changes, ulcerations, and edema)
Risk factors PVD
Age, male, + family hx, arteriosclerosis, atherosclerosis, smoking, obesity, HTN, increased stress, and sed. lifestyle
S/S of arterial insufficiency
Pain (intermittent claudication)
Lower extremeties-cool, pale (ruddy when dependant) and decreased cap refill, decreased or absent peripheral pulses, dry scaly shiny skin and hair loss
Diagnostic Tests
Doppler Ultrasound and angiography
Treatment of PVD
Control underlying conditions, lifestyle changes, medication (Trental, Plavix) and surgery.
Buergers (Thromboangiitis Obliterans)
Autoimmune disease-inflammation of peripheral vessels
Buergers info
Incresed risk in young males & heavy smokers
S/S= pain
Tx= improve circulation, lifestyle changes
Raynauds
May lead to thickened fingers, brittle nails
Tx: Medications (vasodilators), lifestyle changes
Venous Disorders
DVT: Phlebitis
Inflammation of the vein
Venous DisordersDVT: Thrombophlebitis
Phlebitis with vessel wall damage, clot (well attached)
Venous Disorders
DVT: Phlebothromosis
Alteration in blood flow leads to clot formation (easily dislodged)
Risk factors for DVT
Stasis of blood flow, irregular blood flow, vascular abnormalities, blood dyscrasins, altered clotting mechanisms
S/S of DVT
Edema, warmth, redness, tenderness, negative tortuous veins, and positive Homan's sign.
Diagnostic tests
&
Treatment
Doppler ultrasound, venogram

Tx:Bedrest, warm moist packs.
Meds: Analgesics & anticoagulants
Heparin
PTT = normal 30-45 seconds
therapeutic range= 45-90 seconds (one and a half to 2 times the normal)
*PTT of 100 or above= spontaneous bleeding*
ANTIDOTE= Protamine sulfate
Coumadin
PT= normal 10-14 seconds
Therpeutic range= 15-28 seconds
*PT greater than 30 seconds = spontaneous bleeding*
ANTIDOTE= Vitamin K
INR 2-3
Drug that breaks up clots
Thrombolytics (Streptokinase)

Surgical tx= thrombectomy
Prevention of DVT
Early ambulation, Ted hose, SCD's, exercise, adequate fluids, assess IV site (change Q72 hrs)

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