PAD vs PVD
1. What is PAD Chronic Occlusion: Peripheral arteriosclerosis Occurs over time
Atherosclerosis
Lesions develop in abdominal aorta and iliac, femoral and popliteal arteries More distal ones
2. What is PAD?a: Initially asymptomatic
Claudication: muscle pain, cramping, burning with exercise
Pain while resting/awakens
Numbness, burning, toothace type pain pain relieved by
dependent position Aggravated by limb elevation
Necrosis/gangrene: ulcers blackened tissue occurs: toes, forefoot, and heel
3. Dependent Rubor or Reactive Hyperemia (Dr Ep): Thi,
shiny taut skin
Loss of hair on lower legs
Diminished or absent pedal, popliteal or femoral pulses Foot pallor with leg elevation
4. What are PAD Chronic Occlusion Complications?: Gangrene Extremity amputation
Rupture of AAA
Infection Sepsis
5. Critical Limb Ischemia (CLI): Characterized by: Chronic ischemic rest
pain lasting more than 2 weeks Arterial leg ulcers or gangrene
Atrophy of skin and underlying muscles Delayed healing
Wound infection
Tissue necrosis
Arterial ulcers
6. What are PAD Diagnostic Tests?: Doppler Ankle/ Brachial
Indexing: 1-1.4 is a good score Arteriography
Magnetic resonance imaging Exercise tolerance
test Plethysmography
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7
, PAD vs PVD
7. Arterial Thrombosis and Embolus Clinical Manifestations 6 Ps!!: Pain
Paresthesia, numbness Pallor
Perishing cool skin Pulselessness distal to
blockage Paralysis
8. Nursing actions for tissue perfusion- PAD: assess circulation no smoking
limit cafeine socks,
slippers change
position
avoid crossing legs
no pillows under knees avoid
restrictive clothing
9. Nursing actions relief of pain PAD: assess pain relaxation skills
keep feet warm and in dependent position to inc blood flow inc pain is a warning sign
NO HEATING PADS OR HOT WATER BOTTLES
10.Chronic occlusion diet: lose wight and eat low fat, low cholesterol, low refined sugar diet
11.Peripheral Angioplasty Nursing Actions: Do neurovascular checks to affect- ed extremity every 15 mins X 4,
every 30 mins X 4, then q 1-4 hrs
Notify MD of changes: thready pulse, 6 Ps! Monitor site for
bleeding, hematomas
Maintain immobilization of affected extremity at least 6 hours Maintain pressure dressing at site
12.Bypass Grafting Post Op: IS every 1-2hr control n/v
b/p at baseline!! could blow sterile tech
hydrated with iv fluids assess 6 ps of
ischemia strict bedrest first 24hr after
24 hr ROM
discuss ambulation w surgeon
13.ACE inhibitor drug therapy: prils dec
cardiovascular morbidity
2/
7
1. What is PAD Chronic Occlusion: Peripheral arteriosclerosis Occurs over time
Atherosclerosis
Lesions develop in abdominal aorta and iliac, femoral and popliteal arteries More distal ones
2. What is PAD?a: Initially asymptomatic
Claudication: muscle pain, cramping, burning with exercise
Pain while resting/awakens
Numbness, burning, toothace type pain pain relieved by
dependent position Aggravated by limb elevation
Necrosis/gangrene: ulcers blackened tissue occurs: toes, forefoot, and heel
3. Dependent Rubor or Reactive Hyperemia (Dr Ep): Thi,
shiny taut skin
Loss of hair on lower legs
Diminished or absent pedal, popliteal or femoral pulses Foot pallor with leg elevation
4. What are PAD Chronic Occlusion Complications?: Gangrene Extremity amputation
Rupture of AAA
Infection Sepsis
5. Critical Limb Ischemia (CLI): Characterized by: Chronic ischemic rest
pain lasting more than 2 weeks Arterial leg ulcers or gangrene
Atrophy of skin and underlying muscles Delayed healing
Wound infection
Tissue necrosis
Arterial ulcers
6. What are PAD Diagnostic Tests?: Doppler Ankle/ Brachial
Indexing: 1-1.4 is a good score Arteriography
Magnetic resonance imaging Exercise tolerance
test Plethysmography
1/
7
, PAD vs PVD
7. Arterial Thrombosis and Embolus Clinical Manifestations 6 Ps!!: Pain
Paresthesia, numbness Pallor
Perishing cool skin Pulselessness distal to
blockage Paralysis
8. Nursing actions for tissue perfusion- PAD: assess circulation no smoking
limit cafeine socks,
slippers change
position
avoid crossing legs
no pillows under knees avoid
restrictive clothing
9. Nursing actions relief of pain PAD: assess pain relaxation skills
keep feet warm and in dependent position to inc blood flow inc pain is a warning sign
NO HEATING PADS OR HOT WATER BOTTLES
10.Chronic occlusion diet: lose wight and eat low fat, low cholesterol, low refined sugar diet
11.Peripheral Angioplasty Nursing Actions: Do neurovascular checks to affect- ed extremity every 15 mins X 4,
every 30 mins X 4, then q 1-4 hrs
Notify MD of changes: thready pulse, 6 Ps! Monitor site for
bleeding, hematomas
Maintain immobilization of affected extremity at least 6 hours Maintain pressure dressing at site
12.Bypass Grafting Post Op: IS every 1-2hr control n/v
b/p at baseline!! could blow sterile tech
hydrated with iv fluids assess 6 ps of
ischemia strict bedrest first 24hr after
24 hr ROM
discuss ambulation w surgeon
13.ACE inhibitor drug therapy: prils dec
cardiovascular morbidity
2/
7
