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Vascular DisordersMedical Surgical Nursing

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What are the causes of secondary Raynaud's phenomenon?
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Autoimmune conditions like SLE, RA, or scleroderma
What drug is the most common one prescribed to treat Raynaud's phenomenon?
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Nifedipine (calcium Channel blocker)
What is the most common disorder of the veins?
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A venous thrombosis
Where do DVTs most commonly occur?
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In the iliac or femoral veins
Why are DVTs considered a serious surgical complication?
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It can embolize to the lungs causing a pulmonary embolism
What is Virchow's triad?
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A cluster of symptoms related to the development of venous thrombosis. -venous stasis -damage to the endothelium -hypercoagulability of the blood
________ is when venous valves are dysfunctional or the muscles of the extremities are inactive leading to reduction in normal venous blood flow.
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Venous stasis
What are some medical interventions that lead to endothelial damage (a risk factor for venous thrombosis)?
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Venipuncture, IV therapy like antibiotics, potassium, chemo or hypertonic solutions like parenteral nutrition or contrast dye, an IV catheter in the same site for 72 hours or more.
Which types of medications are known to cause hypercoagulability and increase the risk of DVT formation?
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Corticosteroids, quinine, oral contraceptives coupled with smoking
What genetic hypercoagulability state is linked with the development of DVTs during pregnancy?
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Factor V Leiden
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What vascular disorder? A palpable, firm subcutaneous cordlike vein. Tender to the touch, reddened, and warm. Accompanied by a mild temp and leukocytosis.
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Superficial thrombophlebitis
What is the most common cause of superficial thrombophlebitis in the upper extremities?
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IV insertion or an intralumenal cannulation of a vein
What is the most common cause of superficial thrombophlebitis in the lower extremities?
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Trauma to the varicose veins from pregnancy or long-standing venous insufficiency
Where does infectious/suppurative thrombophlebitis typically occur and what are the s/s?
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At the site of IV insertion, s/s: high grade fever, septal pulmonary emboli, elevated WBC
What nursing interventions should be used to assist a patient with superficial thrombophlebitis?
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Elevate the affected extremity to promote venous return and reduce edema, apply warm, moist heat. Remove IV if it is the cause. If it suppurative, the affected tissue is excised and any abscesses drained
What are the possible findings in a patient with a DVT?
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Unilateral leg edema (maybe), extremity pain, warm skin, erythema, 100.4 temp., if calf is involved there will be tenderness, (+) Homan's sign.
How are the signs that the inferior vena cava (IVC) is involved in a DVT?
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The lower extremities will be edematous and cyanotic
How are the signs that the superior vena cava (IVC) is involved in a DVT?
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Swelling of the upper extremities, neck, face, and back
Chronic venous insufficiency is a complication of a DVT that involves valvular destruction, increased pigmentation, ulceration and limb cyanosis when placed in a dependent position. How long after a DVT is this normally detected?
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Several years after a DVT
What is the easiest and least expensive method for preventing DVTs?
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Early mobilization. Patients on bed rest should reposition frequently, dorsiflex their feet, and rotate their ankles every 2-4 hours
________ exert 18 mm Hg of pressure on the legs to promote venous blood flow, prevent venous dilation, and stimulate fibrinolytic activity in patients at risk for developing DVTs.
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Ted hose/antiembolism stockings
  
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