Peripheral Arteries.docx - Peripheral Venous Disorders Most venous occurs in legssome degree of failure to venous blood flowingproper directionSettle in

Peripheral Arteries.docx - Peripheral Venous Disorders Most...

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Peripheral Venous Disorders Most venous occurs in legs some degree of failure to venous blood flowing proper direction Settle in leg veins = Venous Congestion Factors- gravity winning= being on feet too long  Valve imcompetance- disorder of venous insufficeincy CHRONIC VENOUS INSUFFIENCY (CVI) INCOMPETENT VENOUS VALVES PATHO: CAUSED BY LEG VEIN VALVES WEARING OUT BECOMING FLOPPY DON’T CLOSE DURING DISTOLE (RALAXATION) BACKFLOW= LEGS & FEET (VENOUS CONGESTION) NON MOVING BLOOD= VENOUS STASIS ↑HYDROSTATIC PRESSURE EDEMA (MILD/MODERATE DISCOMFORT OVERTIME = -DRY, TIGHT SKIN, BROWNISH DISCOLORATION) EASILY BROKEN TISSUE BONY PROMINECES - HEELS, ANKLES, COCCYX = VENOUS STASIS, ULCERS EX. HYPOOSMOLAR PROBLEMS, HTN, RT SIDE HF, KIDNEY DISEASE FACTORS: AGING, INHERITED PREDISPOSITION OBESITY, PREGNACY, JOB RELATED, POOR MUSCLE TONE, IMMOBILITY /INACTIVITY EX:(MINI MAP)= FLOPPY VALUES HYDROSTATIC PRESSURE DISTAL TO BAD VALUES VENOUS CANNOT RETURN TO HEART ENGORGED PERIPHERAL VEINS PUSHES FLUID OUT TO TISSUE EDEMA DVT (DEEP VENOUS THROMBOSIS) CLOT THAT DEVELOPS ON WALL VEINS (DEEP) THIGH/CALVES DVT ENTERS AREA INFLAMMED/SWOLLEN = THROMBOPHLEBITIS S&S = LOCAL REDNESS PAIN, WARMTH, EDEMA, UNILATERAL,ERYTHEMA EXTREME HARDLY/ NO S&S HIGH RISK: VIRCHOWS TRIAD INJURY TO ENDOTHEILUM STASIS TO BACKFLOW OF CVI, INACTIVITY OF MUSCLES HYPERCOAGULABILTY STATES DEHYDRATION BLOOD MORE CONCENTRATED COAGULOPATHY= CLOT EASILY - SITTING PEOPLE, CAST, BED RIDDEN, PREGNACY, OBESITY, MEDS(DIURETICS), BCP-HOROMONE THERAPY, PRE-EXISTING, SURGERY, CLOTTING PROBLEMS DVT PE DVT LEG IVC RA RV PA STICK IN PULMONARY ARTERIOLES S&S: CHEST PAIN, SOB, HEMOPTYSIS(BLOOD IN SPUTUM, SHOCK) EX: EMBOLUS ENTER PULM ARTERY SMALL ARTERIOLES GET STUCK BLOCK DEOXGENATED BLOOD FROM ALVEOLI FROM OXGENATION SOB IRRITATES ARTERIAL INTIMA INFLAMMATIO BLOOD LEAK IN LUNG TISSUE HEMOPTYICS LARGE PART LUNG INFLAMMED MASSIVE RELEASE OF INFLAMM MEDIATORS SYSTEMIC VASODILATION =>SHOCK TX: ENCOURAGE MOBILITY, ENCOURGE DEHYDRATION, ELEVATE LEGS/ INCREASE VENOUS RETUR PROMOTES NORMAL FLOW, CAREFUL OF SKIN BREAST SWELLING/EDMA ↑RISK OF SKIN INTEGRITY, BLOOD THINNER (HEPARIN, COUMADIN) ASPIRIN TO PREVENT CLOTTING PERIPHERAL ARTERIAL DISEASE ARTERIES: THICK WALLED ACCEPT OXYGENATED BLOOD FROM HEART ALL OVER BODY NORM: MUSCLE TONE AKA VASOMOTOR TONE MUSCULAR ELEMENT CONSTRICT/ DILATE FLEXIBLE COMPLIANT, NOT TOO CONSTRICTED (JUST RIGHT)= GOOD PERFUSION LUMEN- SMOOTH/ PATENT(OPEN) FREE BLOCK=(DELIVERY OF OXYGEN/NUTRIENTS VIA ARTERIAL) DETERMING BY CARDIAC OUTPUT S&S (GOOD) DESIRED BP 110/60 +115/70(NORMAL ↓120/80) PULSE= EVERY HEART,
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CONTRATION CAROTID=NECK, RADIAL=WRIST , PEDAL=DORSALIS PEDIS= ON TOP OF FOOT, POSTERIOR TIBIALS INSIDE MEDIAL, NEXT TO MALLEOLUS (ANKLE) EX: BARELY PALPABLE/ THERAPY= TOO NARROW ARTERIES Bounding pulses= Too full high BP/Fluid overload NORMAL CAP REFILL(NAIL BLANCHING) <2SEC
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  • Fall '14
  • Peripheral Venous Disorders, venous congestion

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