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Which parts of the body are typically impacted in a venous disorder?
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The lower extremities
What is responsible for the majority of cases of peripheral artery disease (PAD)?
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Atherosclerosis
Peripheral artery disease involves progressive narrowing and degeneration of the arteries of the...
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Neck, Abdomen and extremities
A person who is diagnosed with PAD is thought to have systemic atherosclerotic disease. This means they have increased risk for what type of diseases?
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Coronary Artery Disease (CAD) or Carotid artery disease
What are the four most significant risk factors for PAD?
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hypertension, smoking, hyperlipidemia, and diabetes mellitus
There are several risk factors for PAD that blood serum can reveal. What are they? (5)
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CRP, fibrinogen, ferritin, homocysteine, and lipoprotein (a)
Which parts of the arterial tree are most likely to be affected by PAD?
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Coronary arteries, Carotid arteries, the aortic bifurcation, iliac and common femoral arteries, profunda femoris artery, superficial femoral artery and distal popliteal arteries
Which arteries are commonly impacted by PAD in diabetics?
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The popliteal arteries
At what point (how much occlusion) does the symptoms of PAD begin to manifest?
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When the lumen is occluded 60-75%
Which gender is more likely to develop an abdominal aortic aneurysm (AAA)?
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Men
What is the location of most aortic aneurysms?
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The abdominal aorta, below the level of the renal arteries
What are the two strongest risk factors for developing an abdominal aortic aneurysm?
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Male and smoking
There are two classifications of a true aneurysm. They are fusiform and sacculated. What is the difference between the two?
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Fusiform: circumferential and uniform in shape, think blowing up a balloon Sacculated: pouched out, shaped like an ear lobe
What is the difference between a true aneurysm and a false one?
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True: one layer of the vessel wall is still intact False: all layers are disrupted, bleeding is contained by surrounding structures
Which type of aortic aneurysm: No pain or a deep, diffuse chest pain that extends to the extrascapular area
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Thoracic aortic aneurysm
Which type of aortic aneurysm? Angina, hoarseness, dysphagia, distended neck veins, edema of the head and arms
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Ascending aorta and/or aortic arch
Which type of aortic aneurysm: Usually asymptomatic. A bruit may be auscultated or a pulsatile mass in the periumbilical area slight left of midline
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AAA (Abdominal aortic aneurysm)
What is blue toe syndrome and what causes it?
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It is the result of an embolized plaque traveling to distal locations and occluding blood flow, usually caused by an abdominal aortic aneurysm
The development of severe back pain with or without bruising on the flanks (ecchymosis) is called _________, and means that an AAA has ruptured
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Gray Turner's sign
How do you know if an abdominal aortic aneurysm has ruptured in the posterior peritoneal cavity or anteriorly in the abdominal cavity?
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Posteriorly: back pain with or without bruising (Gray Turner's sign) Anteriorly: they die from hemorrhage
________ is the process of anatomically mapping the aortic system by contrast imaging. It can be useful for determining the amount of vessel involvement in an aneurysm and can detect thoracoabdominal or suprarenal aneurysms.
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Angiography
What is the most accurate tool for determining the extent of an aneurysm, including length, diameter and presence of a thrombus?
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CT Scan
What is considered the threshold of repair for an aneurysm?
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5.5 centimeters
When would repair of an aneurysm be considered even if it is too small according to standard guidelines?
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If a woman has an abdominal aortic aneurysm, if the patient is young and low risk, if the aneurysm is growing rapidly or if the patient is symptomatic
What types of grafts are typically utilized to repair aneurysms?
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Dacron or Polytetrafluoroethylene (PTFE)
Which patients are most likely to have an endovascular graft procedure?
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Elderly, higher risk patients (it is less invasive than the standard surgery)
Who are not an ideal candidate for an endovascular graft procedure? (3)
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-Anyone with a aortoiliac occlusive disease -anyone with an aneurysm with renal artery involvement -Women with a small femoral artery
What is the most common post-endovascular graft surgical complication?
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Perigraft leak: seeping of blood from the graft site into the aneurysm
What are the possible indications of an aortic aneurysm rupture?
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Diaphoresis, paleness, weakness, tachycardia, hypotension, abdominal-back-groin or periumbilical pain, changes in LOC, or development of a pulsatile mass
What are some preoperative nursing considerations/responsibilities prior to surgery for aneurysm repair?
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-the patient usually has bowel prep (laxatives, enemas, etc) -NPO after midnight prior to surgery -preoperative shower with antimicrobial soap -IV antibiotics prior -ICU orientation for the family


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