Avoid crossing legs and wearing restrictive clothing

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Avoid crossing legs and wearing restrictive clothingoElevate legs/feet but avoid raising above the heart levelextreme elevation slows arterial blood flow to the feetPromote vasodilation oAvoid cold exposure to the affected extremity with warm socks and room temperaturemodulationoAvoid applying direct heat (heating pad, hot water) to the limboAvoid emotional stress, caffeine, and nicotine (can cause vasoconstriction)Drug therapyHemorheological agents Pentoxifylline (Trental)oAntiplatelet agents ASA, Clopidogrel (Plavix)Control BPInvasive nonsurgical proceduresoPercutaneous transluminal angioplasty (PTA)oAtherectomySurgical managementoArterial revascularizationPeripheral Venous Disease (2 questions)Condition that alters the natural flow of blood through the veins of the peripheral circulationThree health problems result in PVD:oVenous thromboembolism (VTE) Both deep vein thrombosis and pulmonary embolismoDefective valves lead to venous insufficiencyVenous insufficiency results from prolonged hypertension and phlebitis whichstretch the veins and damage valvesLeads to swelling, venous stasis ulcers, and cellulitisoSkeletal muscles do not contract to help pump blood in the veinOccurs when weight-bearing is limited or muscle tone decreasesHAVE SOME KNOWLEDGE ON DVTCare of Patients with Acute Coronary SyndromesAngina Pectoris (1 question)Chest pain caused by a temporary imbalance between the coronary arteries’ ability to supply oxygen and the cardiac muscle’s demand for oxygenIschemia (lack of oxygen) that occurs is limited in duration and does not cause permanent damageTwo types: stable and unstableChronic Stable Angina23
Chest discomfort that occurs with moderate to prolonged exertion in a pattern that is familiar to the patientFrequency, duration, and intensity of symptoms remain the same over several monthsResults in only slight limitation of activity and is usually associated with a fixed atherosclerotic plaqueUsually relieved by nitroglycerin or rest; managed with drug therapySubsternal chest discomfortRadiating to the left armPrecipitated by exertion or stress (or rest in variant angina)Relieved by nitroglycerin or restLasting less than 15 minutesFew, if any, associated symptomsUnstable AnginaKey Features of AnginaChest pain or discomfort that occurs at rest or with exertion and causes severe activity limitationPressure may last longer than 15 minutesPoorly relieved by rest or nitroglycerinMay present with ST changes but do not have changes in troponin or creatine kinase (CK) levelsMay include:oNew-onset angina – describes the patient who has his or her first angina symptoms, usually after exertion or other increased demands on the heartoVariant (Prinzmetal’s) angina – chest pain or discomfort resulting from coronary artery spasm and typically occurs after restoPre-infarction angina

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