Cardiovascular Peripheral Vascular Disease
Terms
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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
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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
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Incresed risk in young males & heavy smokers
S/S= pain
Tx= improve circulation, lifestyle changes - Raynauds
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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)
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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.
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Diagnostic tests
&
Treatment -
Doppler ultrasound, venogram
Tx:Bedrest, warm moist packs.
Meds: Analgesics & anticoagulants - Heparin
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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
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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
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Thrombolytics (Streptokinase)
Surgical tx= thrombectomy - Prevention of DVT
- Early ambulation, Ted hose, SCD's, exercise, adequate fluids, assess IV site (change Q72 hrs)