NURS 642 Exam 2. Maryville University.
Questions And Answers 100% Correct!!!
Occlusive arterial disease most affects? This can lead to ? - ANSWER the abdominal
aorta and the small- and medium-sized arteries of the lower extremities
leads to absent dorsalis pedis, posterior tibial, and/or po...
NURS 642 Exam 2. Maryville University.
Questions And Answers 100% Correct!!!
Occlusive arterial disease most affects? This can lead to ? - ANSWER the abdominal
aorta and the small- and medium-sized arteries of the lower extremities
Causes of PAD - ANSWER Degenerative or collagen abnormalities ( Marfan's
Syndrome)
Dysplastic disorders (fibromuscular)
Vascular inflammatory processes (arteritis)
Autoimmune conditions
Arteriosclerosis
Obstruction/ Thrombosis
Symptoms of PAD - ANSWER Can be asymptomatic
Intermittent CLAUDICATION: pain/cramping in calf with exercise (due to lactic acid build
up) that is relieved with rest
,Purple coloring of BLE
Calf vs Hip claudication occlusion sites - ANSWER Calf claudication: occlusion at or
proximal to popliteal artery
Hip claudication: occlusion is aortoiliac
Define PAD - ANSWER decreased blood flow to extremities due to atherosclerotic
narrowing or obstruction of vessels
When is PAD a medical emergency or vascular surgeon referral needed - ANSWER if
suspect arterial occlusion or dissecting aneurysm
PAD Type 1, 2, 3 - ANSWER TYPE 1: Arteriosclerosis obliterans (ASO)
TYPE 2: Sudden/acute arterial obstruction: occluding arterial supply, from thrombus or
embolus
TYPE 3: Varicose veins-abnormally distended and tortuous superficial veins, primarily in
distal extremities
Diabetics and onset of PAD. Where are their occlusions? - ANSWER they have earlier
onset of PAD. Occlusions in tibial and popliteal arteries
Claudication severity is assessed by - ANSWER how far a patient can walk before pain
ensues
What can decrease distance when someone has claudication - ANSWER Weather,
meals, and incline may reduce distance
Does claudication occur at rest - ANSWER no!
What is first muscle that can affected in claudication - ANSWER Thigh/butt (Leriches
Syndrome)
Pain at rest results in? - ANSWER severe obstruction in circulation of feet ( recliner
sleeping, hanging feet over edge of bed to help improve circulation to relieve pain)
History of PAD - ANSWER Exertional leg symptoms ( fatigue, aching, numbness, or
pain; record location of symptom: buttock, thigh, calf, or foot)
Poor wound healing in legs or feet
, Pain at rest in lower leg or feet; note whether occurs when patient is recumbent or
upright
Abdominal pain that occurs after eating and is associated with weight loss
Family history thats important for PAD - ANSWER a first degree relative with AAA or
with a brain aneurysm
Physical exam of PAD - auscultation - ANSWER Auscultate carotid arteries bilaterally
for bruits
Auscultate femoral arteries for bruit
Physical exam of PAD - palpation - ANSWER Palpate carotid pulses ( upstroke/pulse
amplitude)
Palpate abdomen ( measure width of aortic pulsation)
PAD is graded based on ? - ANSWER vascular history and PE severity scale:
Fontaines stages or Rutherford's based on symptoms, gangrene, ulcerations
How to diagnose PAD - ANSWER Blanching and pallor of extremity, on raising (raise
60 degrees), check color, then pump foot 20 times; coolness + pallor=obstruction
Then have patient dangle legs over bed; normal: color returns in 10 seconds, venous
filling returns in 15 seconds. In PAD, color and venous return may take up to 40
seconds
Lab tests for PAD - ANSWER Doppler blood flow studies
Arteriography for severe disease, pre-op and with gangrene
MRA used for renal disease
Labs: glucose, lipids, homocysteine, C reactive protein
Ankle- Brachial Index (ABI)
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