Chapter 20: Peripheral Vascular System and Associated Lymph Flashcards Preview

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Flashcards in Chapter 20: Peripheral Vascular System and Associated Lymph Deck (30)
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1
Q

femoral artery

A

under the inguinal ligament

2
Q

posterior tibial artery

A

behind the medial malleolus of the foot

3
Q

Peripheral Vascular System and Associated Lymph History (Subjective Data)

A

A. Leg pain or cramps
B. Skin changes on extremities (arms and legs), color, temperature or sores
C. Swelling in the extremities
D. Smoking hx
E. Medications
F. (Lymph node enlargement/swollen glands)

4
Q

Peripheral Vascular System and Associated Lymph Physical Exam/Assessment (Objective Data)

A
  1. Inspect and Palpate Arms

2. Inspect and Palpate Legs

5
Q

Inspecting Arms

A

note symmetry, color of skin, nail beds, temperature, texture, turgor, presence of edema, lesions or clubbing

6
Q

Palpating Arms

A
  1. Check capillary refill
  2. Palpate radial pulse bilaterally.
  3. Palpate brachial pulses
  4. Modified allen test
7
Q

Palpate radial pulse bilaterally for

A

note rate and equal force; grade force.

8
Q

Grade force for radial pulse

A
4+ bounding
3+ increased
2+ normal 
1+ weak
0 absent
9
Q

Palpate brachial pulses for

A

note any nodes (epitrochlear- usually not palpable)

10
Q

Modified Allen Test

A

not routine; compress both radial and ulnar arteries with your thumbs while client forms a fist, continue to compress the arteries then have client open their hand, release pressure on ulnar artery, the palm should turn pink promptly (~2-5 seconds) (crude test and subject to error)

11
Q

Inspect legs for

A
  • skin color
  • symmetry (if asymmetrical consider DVT)
  • hair distribution
  • venous pattern
  • swelling or atrophy
  • skin lesions/ulcers
  • edema
12
Q

Palpate legs for

A
  • the femoral artery

- popliteal pulse, posterior tibial and dorsalis pedis pulse

13
Q

Palpate the femoral artery for

A

grade the force, for inguinal lymph nodes

14
Q

If pitting edema, present grade on the scale

A

1+ mild pitting, slight indentation, no perceptible swelling of the leg
2+ moderate pitting, induration subsides rapidly
3+ deep pitting, indentation remains for a short time, leg looks swollen
4+ very deep pitting, indentation lasts a long time, leg is very swollen

15
Q

Common PVR and Lymph Abnormalities

A
A. Raynaud’s Syndrome
B.	Lymphedema
C.	Arteriosclerosis/Ischemic Ulcer
D.	Venous Stasis/Ulcer
E.	Varicose Veins
F.	Deep Vein Thrombophlebitis
G.	Aneurysm
16
Q

Raynaud’s Syndrome

A

-abrupt episodes of decreased circulation in the hands and sometimes the feet

17
Q

Raynaud’s Syndrome results in

A
  • Results in color change (pallor to cyanotic) from exposure to cold (most common), vibration, or stress.
  • Pain and numbness evident with decreased circulation stages, may feel burning and throbbing with increased blood supply to dilated capillaries.
18
Q

Lymphedema

A

abnormal drainage of lymph causes protein rich lymph to build up in the interstitial spaces which further raises local colloid oncotic pressure and promotes more fluid leakage

19
Q

Arteriosclerosis/Ischemic Ulcer

A

build up of fatty plaques on intima (atherosclerosis) plus hardening and calcification of arterial wall (arteriosclerosis)

20
Q

Venous Stasis/Ulcer

A

following acute deep vein thrombosis or following chronic incompetent valves in deep veins

21
Q

Varicose Veins

A

incompetent valves permit reflux of blood, producing dilated, tortuous veins

22
Q

Deep Vein Thrombophlebitis

A

a deep vein is occluded by a thrombus, causing inflammation, blocked venous return, cyanosis and edema

23
Q

Aneurysm

A

a sac formed by dilation in the artery wall

24
Q

Claudication distance

A

the number of blocks walked or stairs climbed to produce pain.

25
Q

PAD

A

blood flow cannot match muscle demand during exercise therefore people feel muscle fatigue or pain when walking.

26
Q

Risk factors for PVD

A

diabetes and smoking

27
Q

PVD

A

coolness occurs, varicose veins

28
Q

Edema is bilateral when

A

the cause is generalized (heart failure)

29
Q

Edema is unilateral when

A

it is the result of a local obstruction or inflammation

30
Q

Indicators for malnutrition

A

thin, shiny, atrophic skin; thick-ridged nails; loss of hair; ulcers; gangrene