FA Davis Company The Six Clinical Signs of The Six Clinical Signs of Arterial

Fa davis company the six clinical signs of the six

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Copyright © 2015. F.A. Davis Company The Six Clinical Signs of The Six Clinical Signs of Arterial Thrombosis/Embolism Arterial Thrombosis/Embolism “The Six P’s” 1. Pain 2. Pulselessness 3. Paralysis 4. Pallor 5. Paresthesia -numbness 6. Poikilothermia - temperature
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Copyright © 2015. F.A. Davis Company Arterial Thrombosis Arterial Thrombosis / / Embolism Embolism Treatment Treatment Initial bolus of Heparin IV- 5000 international units DAILY Xa or PTT monitored After3-7 days Warfarin (Coumadin) will be added Takes 3-5 days to be therapeutic Heparin will discontinue once Coumadin level is therapuetic Anticoagulants- Heparin IV/ Coumadin PO Monitor INR/PTT levels to maintain therapeutic level Adjust dose as needed per level and protocol Thrombolytics –”ASE” drugs- Dissolve thrombus or embolus Surgical Intervention: Thrombectomy & Embolectomy – artery cut, emboli removed
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Copyright © 2015. F.A. Davis Company Peripheral Arterial Disease- Peripheral Arterial Disease- PAD PAD Pathophysiology Chronic, Progressive Arterial Narrowing Reduced Blood Supply Ischemia Develops
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Copyright © 2015. F.A. Davis Company Peripheral Vascular Disease - Peripheral Vascular Disease - PAD PAD Arterial – chronic, progressive narrowing of arterial vessels; lower extremites Organic – structural change from plaque or inflammation Functional - short term localized spasm in blood vessel ( Raynaud’s Syndrome - Red white blue fingers) SIGNS & SYMPTOMS: Intermittent claudication- Pain in calves with exercise or activity Ischemia increases- pain even at rest Cool to touch; pale when elevated; reddish purple or cyanotic when in dependent position. Hair loss in lower calf, diminished or absent pulses Due to loss of perfusion tissue death, gangrene, and amputation are eminent
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Copyright © 2015. F.A. Davis Company Raynaud’s Disease Raynaud’s Disease Vasoconstriction with Cold/Stress Causing Ischemia Mainly Affects Hands Phases: Blanching, Pain, Reddening Therapeutic Intervention: Keep Warm, Avoid Vasoconstriction, Take Vasodilators Nursing Care: Education
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Copyright © 2015. F.A. Davis Company Buerger’s Disease Buerger’s Disease Recurring Inflammation of Small and Medium Arteries and Veins of Hands/Feet Vasospasms, Ischemia, Gangrene Cause is Unknown Heavy Cigarette Smoking Contributes
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Copyright © 2015. F.A. Davis Company Buerger’s Disease (cont’d) Buerger’s Disease (cont’d) Signs and Symptoms Intermittent Claudication Six Ps Lower Extremities Red or Cyanotic in Dependent Position Therapeutic Interventions Smoking Cessation Calcium Channel Blockers Skin Assessment
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Copyright © 2015. F.A. Davis Company Peripheral Arterial Disease Peripheral Arterial Disease Diagnostic Tests Ankle-Brachial Index Doppler Ultrasound MRI Arteriography
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Copyright © 2015. F.A. Davis Company Peripheral Arterial Disease Peripheral Arterial Disease Interventions Low-fat, Low-cholesterol, Low-calorie Diet Medications Lipid-lowering Agents Pentoxifylline (Trental) Thrombolytics Invasive Therapies Percutaneous Transluminal Angioplasty (PTA) Atherectomy Stents Aortic-femoral Bypass
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Copyright © 2015. F.A. Davis Company
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