| Perfusion | Iron-deficiency anemia | PAD | CVI | Patient scenarios/random |
|---|---|---|---|---|
|
Athersclerosis
What condition causes the arteries to harden, causing impaired tissue perfusion?
|
Microcytic and hypochromic
(small and pale)
What is the morphology of RBC in Iron-deficiency anemia
|
Modifiable: smoking, HTN, HLD, DMT2, diet, sedentary lifestyle, obesity
Non-modifiable: Age, men, ethnicity
Name two modifiable risk factors for PAD and 2 non-modifiable
|
Limb to the heart: Vacuum problem
In chronic venous insufficiency the problem lies with pushing blood flow from the heart to the limbs OR pulling blood flow from the limbs to the heart?
|
CK-MB, troponin, EKG, chest X-ray, D-dimmer, ABG, CRP, cardiac cath
You are taking care of a patient who starts displaying signs of a myocardial infarction. What labs and diagnostic tests do you expect the doctor to order? (5)
|
|
smoking, high cholesterol, obesity, and hypertension
Some modifiable risk factors for impaired perfusion are
|
Pregnancy, heavy menses, drinking to much milk, genetics, trauma/bleeding, GI bleed
Name 3 risk factors to iron-def. anemia
|
Avoid heating pad and Hot water bottles- risk for burns
Do not cross the legs
How can we educate the patient with PAD on preventing further tissue damage
|
HF, immobility, females, older, obesity, pregnancy, NURSES, standing for long periods,
Different from PAD, what are risk factors for venous insufficiency? name 3
|
Take with vit C, take at night (slowed gastric movement), take with a small amount of food,
You are working in the OBGYN clinic and you are seeing a female who is 20 wks pregnant. She complains the prenatal vitamin, which includes Ferrous Sulfate, she takes is causing stomach upset. What do you tell her?
|
|
angioplasty, bypass or graft surgery, stent, endarterectomy (surgical removal of plaque)
What are some surgical interventions to prevent impaired local tissue perfusion?
|
Spoon-shaped nails, Cheilitis (fissures on the corners of the mouth), dry brittle nails, fatigue, SOA, activity intolerance, dry and pale mucous membranes, Pica, pallor
Name 6 signs and symptoms of Iron-deficiency anemia
|
Ulcer: pale, even edges, toe, feet, dry, deeper,
Describe the ulcers seen on patients with PAD
|
Dark pigmentation- brown, venous stasis, Weeping, distended veins (varicose veins), dull pain/discomfort with standing- Need to elevate leg, Thick fibrous subq tissue, itchy skin
What are the signs and symptoms of venous insufficiency?
|
Cardiopulmonary program, walking program, skin inspection with wound dressing changes, added nutrients to diet, O2 therapy possibly,
You are taking report on a patient coming up from the emergency department with complaints of burning and prinking sensation in their legs and pain with walking. What types of treatment and interventions will you expect to start on this client? What is the patients diagnosis?
|
|
as age (increases with age), gender (men > women), and genetics/family history.
What are some nonmodifiable risk factors for impaired perfusion?
|
Side effects include constipation, green dark stools, staining teeth
Take on an empty stomach Take with vitamin C Rinse mouth after taking liquid form and take with a straw iron toxicity S&S include N&V, diarrhea, and fatigue
What are four medication education topics for the patient taking iron supplementation
|
walking program increases collateral circulation (walk until pain- rest- and then walk again)- forms new arterial pathways; avoid tight restrictive clothing, revascularization surgery
Name 3 interventions for clients with PAD
|
compression stocking, elevation, Zinc oxide, ACE wrap, thrombectomy (clot removal), surgical ligation (stripping of the veins)
What are interventions or treatments for venous insufficiency?
|
Those are varicose veins caused by the increased pressure of the increased blood volume and cardiac output asserting pressure on the veins. You should prop your legs up when you can, avoid sitting or standing for long periods of time, wear compression stockings
You are caring for a pregnant client in her third trimester. She reports having large veins in her legs that are painful. What education do you give this client.
|
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Middle-age and Older Adults, Men, African-Americans and Hispanics; Infants (with congenital heart defects); Children and Young Adults (due to trauma).
What populations are at increased risk for impaired perfusion?
|
Organ meats, green veggies, red meats, egg yoke, liver, beans
What should the patient include in their diet if low on iron? (4)
|
Coldness in lower extremity, Shiny hairless skin, thicken toenails, diminished pulses (Doppler), REST Pain- sit on side of bed, Paresthesia (burning AND PRICKLING SENSATIONS), dry wound, NO Edema, GANGRENE, amputations, Infections, Intermittent claudication ( pain with walking)
Rubor (red coloration with dangling),
List 6 specific signs and symptoms of PAD
|
Ulcers: uneven wounds, more drainage, EDEMA, medial ankle (malleolus), more shallow/superficial,
What will the ulcers present with in clients with venous insufficiency?
|
Gas exchange, clotting, pain, cognition, acid-base balance, nutrition
Roy Price, a 68-year-old is seen at the Emergency Department with increasing symptoms of dyspnea, fatigue, lightheadedness, dizziness, difficulty sleeping at night, and unexplained weight loss. Roy's wife brought him to the Emergency Department because she was concerned with his unexplained periods of confusion. Roy retired from the Paper Making company 2-years ago after 35 years of service. He has a history of high blood pressure, sleep apnea, and smoking 1.5 packs of cigarettes a day. Roy quit smoking cigarettes 15 years ago. Assessment findings reveal BP 158/94 (115) mmHg; HR 82 beats/min; SpO2 94%; Temperature 98.7°F (37.0°C); Respirations 18; and 2+ pitting edema noted in both feet. Explain and Identify 3 related concepts that apply to Roy’s situation.
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