Exam (elaborations)
NURS 621 MIDTERM EXAM STUDY GUIDE LATEST UPDATED AND RATED A.
- Course
- Institution
NURS 621 MIDTERM EXAM STUDY GUIDE LATEST UPDATED AND RATED A.
[Show more]
Content preview
NURS 621 MIDTERM EXAM STUDY GUIDE LATESTUPDATED AND RATED A.
Dx: Peripheral Vascular/artery disease H&P
✔✔H&P:
• Atherosclerosis (most common cause)
• Risks: >50y, smoking, DM, overweight, male, sedentary life, HTN, high
cholesterol, fam hx heart or vascular disease, CAD, AA
• Virchow's triad: hypercoagulable state, vascular wall injury, circulatory
stasis
• 5 P's: pain, pallor, pulselessness, paralysis, paresthesia (3,4,5 surgial
emergency)
• Pulses
o 0 = no pulse
o 1+ = thread pulse
o 2+ = normal
o 3+ = bounding
o 4+ = aneurysm
PVD/PAD DDX
✔✔DDx:
• Intermittent claudication
o Cramping, gradual onset, consistent, relieved by standing still. Affects
buttock, thigh, calf, usually one leg
• Venous Claudication
o "bursting" pain. Gradual onset or immediate. Relieved by elevation of
leg. Affects whole leg, usually one
• Neurogenic Claudication
,o Electric shock-like pain. Can be immediate and inconsistent. Relieved by
sitting down and bending forward. Poorly localized, can affect whole leg,
often bilateral
PAD/PVD
✔✔Lab/diagnostics:
• Ankle-Brachial Index
o BP in arms and ankles checked using regular BP cuff and Doppler.
Pressure in ankle is compared to pressure in arm to determine how well
blood is flowing. Index determined by dividing ankle systolic BP by arm
systolic BP
o >1.3 = noncompressible arteries
o 1-1.29 = normal
o 0.91-0.99 = borderline
o 0.41-0.90 = mild-to-mod PAD
o 0-0.4 = severe PAD
• CBC, chem profile
• EKG - r/o cardiac abnormalities
• Inflammatory blood markers - D dimer, homocysteine, CRP, interleukin 6
• Doppler studies - not 100%
• MRI
• CT
• Angiography
PAD / PVD TX PLAN
✔✔Tx plan:
• Stop smoking
, • Lifestyle mod
• Diet-low in cholesterol and fat
• Meds
o Decrease cholesterol and BP
o Decrease blood viscosity - pentoxifylline, dipyridamole, or warfarin
o Antiplts - ASA 81 to 425, ticlopidine, clopidogrel
• Exercise training
• Vascular surgery - revascularization
o Angioplasty, stents, grafts, thrombolytics
• Interventional radiology
• Gene-based therapy
o Direct gene transfer by IM injection of DNA encoded with vascular
growth factors
Follow-up:
Education:
✔✔RESOURCES
DVT H&P
✔✔H&P:
• Risks: genetic clotting disorders, immobility, prolonged bedrest,
inactivity, paralysis, injury/trauma, surgery, dehydration, oral
contraceptives, hormonal replacement, overweight, tobacco use,
cancer/malignancy, prolonged sitting, fam hx or DVT or PE, 60+, HF/CV
conditions, inflammatory bowel diseases, pregnancy/postpartum, varicose
veins
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller AcademicAllure. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
76800 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now