NURS 642 Exam Latest Update 200 Questions and
Answers
Define PAD
decreased blood flow to extremities due to atherosclerotic narrowing or obstruction of vessels
When is PAD a medical emergency or vascular surgeon referral needed
if suspect arterial occlusion or dissecting aneurysm
PAD Type 1, 2, 3
TYPE 1: Arteriosclerosis obliterans (ASO)
TYPE 2: Sudden/acute arterial obstruction: occluding arterial supply, from thrombus or embolus
TYPE 3: Varicose veins-abnormally distended and tortuous superficial veins, primarily in distal
extremities
Occlusive arterial disease most affects? This can lead to ?
the abdominal aorta and the small- and medium-sized arteries of the lower extremities
leads to absent dorsalis pedis, posterior tibial, and/or popliteal artery pulses.
Risk factors for PAD
Age>50
Male sex
Tobacco abuse
Diabetes mellitus
,HTN
Hyperlipidemia
Hyperhomocysteinemia
Associated CVD in most
Associated cerebrovascular disease (stroke)
Causes of PAD
Degenerative or collagen abnormalities ( Marfan's Syndrome)
Dysplastic disorders (fibromuscular)
Vascular inflammatory processes (arteritis)
Autoimmune conditions
Arteriosclerosis
Obstruction/ Thrombosis
Symptoms of PAD
Can be asymptomatic
Intermittent CLAUDICATION: pain/cramping in calf with exercise (due to lactic acid build up)
that is relieved with rest
,Purple coloring of BLE
Calf vs Hip claudication occlusion sites
Calf claudication: occlusion at or proximal to popliteal artery
Hip claudication: occlusion is aortoiliac
Diabetics and onset of PAD. Where are their occlusions?
they have earlier onset of PAD. Occlusions in tibial and popliteal arteries
Claudication severity is assessed by
how far a patient can walk before pain ensues
What can decrease distance when someone has claudication
Weather, meals, and incline may reduce distance
Does claudication occur at rest
no!
What is first muscle that can affected in claudication
Thigh/butt (Leriches Syndrome)
Pain at rest results in?
severe obstruction in circulation of feet ( recliner sleeping, hanging feet over edge of bed to
help improve circulation to relieve pain)
History of PAD
Exertional leg symptoms ( fatigue, aching, numbness, or pain; record location of symptom:
buttock, thigh, calf, or foot)
, Poor wound healing in legs or feet
Pain at rest in lower leg or feet; note whether occurs when patient is recumbent or upright
Abdominal pain that occurs after eating and is associated with weight loss
Family history thats important for PAD
a first degree relative with AAA or with a brain aneurysm
Physical exam of PAD - auscultation
Auscultate carotid arteries bilaterally for bruits
Auscultate femoral arteries for bruit
Physical exam of PAD - palpation
Palpate carotid pulses ( upstroke/pulse amplitude)
Palpate abdomen ( measure width of aortic pulsation)
Palpate pulses/intensity( 0=absent, 1= diminished, 2= normal, 3=bounding)
Physical exam of PAD - inspection
Assess lower extremities for PAD distal hair loss, trophic skin changes, hypertrophic nails
Assess feet color, temperature, skin integrity, ulcerations/lesions
How to measure BP in PAD
in both arms!
PAD is graded based on ?
Answers
Define PAD
decreased blood flow to extremities due to atherosclerotic narrowing or obstruction of vessels
When is PAD a medical emergency or vascular surgeon referral needed
if suspect arterial occlusion or dissecting aneurysm
PAD Type 1, 2, 3
TYPE 1: Arteriosclerosis obliterans (ASO)
TYPE 2: Sudden/acute arterial obstruction: occluding arterial supply, from thrombus or embolus
TYPE 3: Varicose veins-abnormally distended and tortuous superficial veins, primarily in distal
extremities
Occlusive arterial disease most affects? This can lead to ?
the abdominal aorta and the small- and medium-sized arteries of the lower extremities
leads to absent dorsalis pedis, posterior tibial, and/or popliteal artery pulses.
Risk factors for PAD
Age>50
Male sex
Tobacco abuse
Diabetes mellitus
,HTN
Hyperlipidemia
Hyperhomocysteinemia
Associated CVD in most
Associated cerebrovascular disease (stroke)
Causes of PAD
Degenerative or collagen abnormalities ( Marfan's Syndrome)
Dysplastic disorders (fibromuscular)
Vascular inflammatory processes (arteritis)
Autoimmune conditions
Arteriosclerosis
Obstruction/ Thrombosis
Symptoms of PAD
Can be asymptomatic
Intermittent CLAUDICATION: pain/cramping in calf with exercise (due to lactic acid build up)
that is relieved with rest
,Purple coloring of BLE
Calf vs Hip claudication occlusion sites
Calf claudication: occlusion at or proximal to popliteal artery
Hip claudication: occlusion is aortoiliac
Diabetics and onset of PAD. Where are their occlusions?
they have earlier onset of PAD. Occlusions in tibial and popliteal arteries
Claudication severity is assessed by
how far a patient can walk before pain ensues
What can decrease distance when someone has claudication
Weather, meals, and incline may reduce distance
Does claudication occur at rest
no!
What is first muscle that can affected in claudication
Thigh/butt (Leriches Syndrome)
Pain at rest results in?
severe obstruction in circulation of feet ( recliner sleeping, hanging feet over edge of bed to
help improve circulation to relieve pain)
History of PAD
Exertional leg symptoms ( fatigue, aching, numbness, or pain; record location of symptom:
buttock, thigh, calf, or foot)
, Poor wound healing in legs or feet
Pain at rest in lower leg or feet; note whether occurs when patient is recumbent or upright
Abdominal pain that occurs after eating and is associated with weight loss
Family history thats important for PAD
a first degree relative with AAA or with a brain aneurysm
Physical exam of PAD - auscultation
Auscultate carotid arteries bilaterally for bruits
Auscultate femoral arteries for bruit
Physical exam of PAD - palpation
Palpate carotid pulses ( upstroke/pulse amplitude)
Palpate abdomen ( measure width of aortic pulsation)
Palpate pulses/intensity( 0=absent, 1= diminished, 2= normal, 3=bounding)
Physical exam of PAD - inspection
Assess lower extremities for PAD distal hair loss, trophic skin changes, hypertrophic nails
Assess feet color, temperature, skin integrity, ulcerations/lesions
How to measure BP in PAD
in both arms!
PAD is graded based on ?
