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33 - Concepts of Care for Patients With Vascular ProblemsAce Your Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
33 - Concepts of Care for Patients With Vascular Problems
42 Picmonics to Learn | 1 hr 12 mins
High Blood Pressure Response
- Characteristics
- Atria Release Atrial Natriuretic Peptide
- Vasodilation
- Antagonizes Aldosterone
- Na+ and Water Excreted
1 min
Blood Pressure Classification (JNC 7)
- Classifications
- Normal
- Systolic (<120)
- Diastolic (< 80)
- Prehypertension
- Systolic +20 (120-139)
- Diastolic +10 (80-89)
- Stage 1 Hypertension
- Systolic +20 (140-159)
- Diastolic +10 (90-99)
- Stage 2 Hypertension
- Systolic + > 20 (160)
- Diastolic + > 10 (100)
- Hypertensive Crisis
- Systolic > 180
- Diastolic > 110
4 mins
Primary Hypertension Risk Factors
- Excessive Alcohol Consumption
- High Sodium Diet
- Dyslipidemia
- Obesity
- People of African Descent
- Advanced Age
- Vitamin D Deficiency
- Reduced Nephron Number
- Diabetes
- Lack of Physical Activity
2 mins
Hypertension Assessment
- Mechanism
- Essential Hypertension
- Secondary Hypertension
- Assessment
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Diagnosis
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Nursing Considerations
- Take BP Both Arms
- Common in African Americans
2 mins
Pheochromocytoma
- Cause/Mechanism
- Adrenal Medulla Tumor
- Increased Catecholamines
- Assessment
- Episodic Hypertension
- Diaphoresis
- Abdominal or Chest Pain
- Interventions
- Surgery
- Antihypertensives
- Phenoxybenzamine
- Metyrosine (Demser)
- Considerations
- Do Not Palpate Abdomen
3 mins
Hypertension Intervention
- Lifestyle Modifications
- Weight Reduction and Exercise
- Diet Changes
- Relaxation Techniques
- Smoking Cessation
- Medications
- Encourage Self Monitoring
1 min
Hypertension Medications
- Diuretics
- ACE Inhibitors
- Angiotensin Receptor Blockers (ARBs)
- Beta Blockers
- Dihydropyridine Calcium Channel Blockers
2 mins
Hydrochlorothiazide HCTZ
- Mechanism of Action
- Inhibits Reabsorption NaCl and H2O
- Indications
- Edema
- Mild to Moderate Hypertension
- Side Effects
- Hypokalemia
- Hyponatremia
- Dehydration
- Hyperglycemia
- Gout
- Contraindications
- Sulfa Allergy
- Pregnancy and Breastfeeding
1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Mechanism of Action
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Indications
- Hypertension
- Heart Failure
- Side Effects
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Nursing Considerations
- Slowly Change Position
- Do Not Stop Abruptly
2 mins
Angiotensin II Receptor Blockers (ARBs)
- Ends in "-sartan"
- Mechanism of Action
- Blocks Angiotensin II Receptor
- Indications
- Hypertension
- Side Effects
- Angioedema
- Contraindications
- Renal Artery Stenosis
- Pregnancy
1 min
Beta Blockers
- "-olol" suffix
- Mechanism
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Indications
- Hypertension
- Heart Failure
- Angina Pectoris
- Contraindications
- Asthma and Heart Block Patients
- Nursing Considerations
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
2 mins
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
2 mins
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
1 min
Spironolactone (Aldactone)
- Mechanisms
- Inhibition of Aldosterone
- Potassium Retention
- Indications
- Hypertension
- Edema
- Heart Failure
- Side Effects
- Hyperkalemia
- Endocrine Effects
- Consideration
- Avoid Potassium Supplements
2 mins
Statins
- Rhabdomyolysis
- Hepatotoxicity
- HMG-CoA reductase inhibitors
- Decrease LDL
- Decrease Triglycerides
- Increase HDL
2 mins
Atorvastatin (Lipitor)
- Characteristics
- -statin Suffix
- Mechanism
- HMG-CoA Reductase Inhibitors
- Indications
- High Cholesterol
- Side Effects
- Hepatotoxicity
- Rash
- Rhabdomyolysis
- Myopathy
- Considerations
- Monitor Liver Enzymes
- Administer at Bedtime
- Avoid Grapefruit
2 mins
Ezetimibe
- Indications
- Hyperlipidemia
- Mechanism of Action
- Cholesterol Absorption Blocker
- Decreases LDL
- Side Effects
- Diarrhea
- Increased LFT Values
1 min
Peripheral Artery Disease (PAD)
- Mechanism
- Atherosclerosis
- Assessment
- Intermittent Claudication
- Pain with Exercise
- Paresthesias
- Arterial Ulcers
- Critical Limb Ischemia
- Amputation
- Consideration
- Ankle-Brachial Index (ABI)
2 mins
Arterial Ulcer Assessment
- Absent or Decreased Pulses
- Intermittent Claudication
- Sharp Pain
- Dependent Rubor
- Well Defined Edges
- Over Bony Areas
- Smooth, Shiny Skin
- Toes, Heels, Lateral Lower Legs
- Cool
2 mins
Arterial Ulcer Interventions
- Saline Dressing
- Structured Exercise Programs
- Fibrinolytics
- Antiplatelet Medication
- No Caffeine, Nicotine
- Surgery
1 min
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
2 mins
Clopidogrel (Plavix)
- Mechanism
- ADP Receptor Antagonist
- Prevent Platelet Aggregation
- Indications
- Acute Coronary Syndrome (ACS)
- Prevention of Thrombotic Events
- Side Effects
- Bleeding
- Thrombotic Thrombocytopenic Purpura (TTP)
- Pancytopenia
- Abdominal Pain
- Considerations
- Withhold Before Surgery
2 mins
Alteplase
- Mechanism
- Tissue Plasminogen Activator
- Indications
- Thrombosis
- Side Effects
- Bleeding
- Contraindications
- Intracranial Hemorrhage
- Internal Hemorrhaging
- Considerations
- Minimize Bleeding
- Monitor for Shock
- Antidote
- Aminocaproic Acid
2 mins
Abdominal Aortic Aneurysm (AAA) Assessment
- Mechanism
- Atherosclerosis
- Assessment
- Bruit
- Pulsation in Abdomen
- Abdominal or Lower Back Pain
- Tearing Pain
- Diagnosis
- Ultrasound
- Considerations
- Rupture
- Shock
- Surgical Repair
1 min
Compartment Syndrome Assessment
- Mechanism
- Trauma
- Increased Pressure
- Compressed Nerves and Blood Vessels
- Assessment
- 1 or more of 6 P's
- Ankle-Brachial Index (ABI)
- Considerations
- May take Days to develop
- Early Detection
- Ischemia
- Damage often Irreversible
2 mins
Compartment Syndrome Interventions
- Interventions
- Frequent Neurovascular Assessments
- Evaluate Pain
- Do Not Elevate Extremity
- Remove or Loosen Restrictive Items
- Fasciotomy
- Amputation
- Considerations
- Infection
- Monitor Urine Output
2 mins
Superficial Thrombophlebitis
- Cause/Mechanism
- IV Catheter Irritation
- Assessment
- Erythema
- Cord-like Vein
- Edema
- Interventions
- Remove IV Catheter
- Elevate
- Warm Compress
- Considerations
- Rotate Sites Q3 Days
- Aseptic Technique
2 mins
Venous Thromboembolism (DVT) Assessment
- Mechanism
- Venous Wall Inflammation caused by Thrombus
- Assessment
- Tenderness
- Edema
- Warmth
- Asymmetry
- Considerations
- Could be Asymptomatic
- Monitor for Pulmonary Embolism
58 secs
Venous Thromboembolism (DVT) Interventions
- Anticoagulants
- Prevention Education
- Frequent Ambulation
- Leg Exercises
- Compression Stockings or SCD's
- Avoid Nicotine and Oral Contraceptives
- Surgery
1 min
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
1 min
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
1 min
Heparin Induced Thrombocytopenia (HIT)
- Pathophysiology
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Symptoms
- Thrombocytopenia
- Diagnosis
- Serotonin Release Assay (SRA)
- Treatment
- Stop Heparin, Start Direct Thrombin Inhibitor
2 mins
Enoxaparin (Lovenox)
- Mechanism of Action
- Inhibits Clotting Factors
- Factor Xa
- Indications
- Clot Formation Prevention
- Side Effects
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Considerations
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Antidote
- Protamine Sulfate
2 mins
Warfarin (Coumadin)
- Mechanism of Action
- Inhibits Clotting Factors
- Indications
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- Assessment
- PT/INR Levels
- Observe for Bleeding
- Contraindications
- Pregnancy
- Nursing Considerations
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
2 mins
Warfarin Antidotes
- Antidotes
- Vitamin K
- Fresh Frozen Plasma
59 secs
Vitamin K1 (Phytonadione)
- Mechanism
- Synthesizes Clotting Factors II, VII, IX, X
- Indications
- Hypoprothrombinemia
- Newborn Prophylaxis
- Bleeding from Warfarin Overdose
- Side Effects
- Shock
- Kernicterus
- Cardiac Arrest
- Considerations
- Bile Salts required for Intestinal Absorption
- Increased Risks with IV Administration
2 mins
Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment
- Venous Stasis Ulcer
- Uneven Edges
- Dull Persistent Pain
- Medial Malleolus
- Necrotic
- Normal Pulses
- Lower Leg Edema
- Bronze-Brown Pigmentation
- Warm
- Pruritus
2 mins
Chronic Venous Insufficiency (Venous Stasis Ulcer) Interventions
- Frequently Elevate Legs
- Avoid Standing/Sitting for Long Periods of Time
- Elastic Compression Stockings
- Bilayer Artificial Skin
- Daflon
- Wound Dressings
- Proper Foot and Leg Care
2 mins
Varicose Veins Assessment
- Cause
- Increased Venous Pressure
- Incompetent Valves
- Assessment
- Telangiectasias
- Small Reticular Veins
- Dilated and Tortuous Veins
1 min
Varicose Veins Interventions
- Laser Therapy
- Sclerotherapy
- Removal of Saphenous Vein
- Considerations
- Avoid Prolonged Standing
- Elastic Compression Stockings
2 mins
