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Vascular DisordersMedical Surgical Nursing

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Question Answer
How is renal perfusion status after an aneurysm repair surgery monitored?
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Monitor: hourly urine outputs, fluid intake, daily weights, CVP or PA readings (hydration status), Daily BUN and creatinine studies
A patient who has had an aneurysm repair complains of fatigue, poor appetite and irregular bowel movements. What do you tell them?
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This is expected for up to 4-6 weeks after surgery
What should a patient who is being discharge post-aneurysm surgical repair be told to report immediately to their physician?
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Development of fever over 100, redness, swelling increased pain or drainage around the incision sites
Where does an aortic dissection most commonly occur?
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In the thoracic aorta
An aortic dissection is the result of a tear in the ________ lining of the arterial walls.
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Intima (innermost lining)
What gender is most likely to have an aortic dissection and at what age(s) is the risk greatest?
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Males aged 40-70
What conditions can increase the chance of having an aortic dissection?
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Pregnancy, Marfan's Syndrome, chronic hypertension, or blunt trauma
What are the clinical manifestations of an aortic dissection regardless of the location?
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Sudden, severe tearing/ripping pain in the front of the chest or in the shoulder blades that radiates down the spine into the abdomen or legs.
What are the differences in symptomatology of aortic dissections based on where they occur (aortic arch, ascending aorta, subclavian artery)?
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Aortic arch: neuro symptoms like decreased LOC, dizziness, weak/absent carotid and temporal pulses Ascending aorta: angina, MI, new high-pitched diastolic cardiac murmur, possible LV failure Subclavian: differing pulse quality and BP in the radial, ulnar and brachial pulses on each side
What are the signs/symptoms of an aortic dissection in a pregnant woman?
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Epigastric pain, heart-burn like symptoms
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What are the complications associated with aortic dissection?
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Cardiac tamponade, hemorrhage in the mediastinal, pleural, or abdominal cavities, rupture of a dissection usually results in death
What are things a nurse can do to help a patient with an aortic dissection?
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Keep the bed in semi-Fowler's, keep the environment quiet, admin pain, antihypertensive and antianxiety meds, monitor ECG, monitor peripheral pulses. Vitals may be taken every 3 minutes while attempting to control BP
What is the most common artery impacted by PAD of the lower extremities in patients who don't have diabetes?
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The femoral-popliteal area
What are the most common arteries impacted by PAD of the lower extremities in patients who have diabetes?
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The anterior tibial, posterior tibial and peroneal arteries
What is the classic symptom of lower extremity PAD?
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Intermittent claudication
_________ is ischemic muscle pain that is precipitated by a consistent level of exercise, is reproducible and lasts less than 10 minutes with rest.
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Intermittent Claudication (from lower extremity PAD)
Which artery is effected by lower extremity PAD? Claudication in the calf
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The femoral or popliteal
Which artery is effected by lower extremity PAD? Claudication in the thighs and/or buttocks
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Aortoiliac
Which artery is effected by lower extremity PAD? Erectile dysfunction
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Internal iliac (hypogastric) arteries
_______ occurs in a patient with lower extremity PAD when the foot is raised.
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Elevation pallor
_______ occurs in a patient with lower extremity PAD when the foot is lowered or dangled in a dependent position.
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Reactive hyperemia/dependent rubor
  
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