Download Vascular Disorders: Aneurysms, Embolism, Venous Disorders, and Insufficiency and more Slides Pediatrics in PDF only on Docsity!
Aortic Aneurysm
It’s a localized sac or dilation involving an artery
formed at a weak point in vessel wall
THORASIC AORTIC ANEURYSM
Caused by atherosclerosis in men aged ( 40-70 yrs ) Most common is dissecting aneurysm, 1/3 of cases die of rupture
AORTIC ANEURYSM
- Clinical manifestation
- Pain in supine position, dyspnea, hoarseness or aphonia ( complete loss of voice ), dysphagia
- Medical management
- Surgical repair, control BP, correcting risk factors
ABDOMINAL AORTIC ANEURYSM
- Medical management
- Surgery is the treatment of choice
- Bypass graft, endovascular graft ( suturless )
- Nursing management
- Assessment before surgery, post op. systematic monitoring, neurological assessment, signs of impeding rupture ( abdominal & back pain )
ARTERIAL EMBOLISM
Its acute vascular occlusion due to an embolus or acute thrombosis
Causes
Iatrogenic injury ( insertion of catheters ), trauma from fractures, crush injury, penetrating wound, thrombi development in heart champers as a result of (AF, MI, CHF)
Clinical manifestations
Cessation of distal bld flow, gradual loss of sensory & motor function, pain, pallor, cold, paresthesia, pulse lessens & paralysis
VENOUS DISORDERS
DVT, THROMBOPHLEBITIS and
PHLEBOTHROMBITIS
Clinical manifestations
Massive swelling, tenderness,
warmer affected extremity,
homans sign,
heaviness & functional loss
VENOUS DISORDERS
- Medical management
- Anti coagulants (heparin 5-7 days), low molecular- weight heparin, thrombolytic therapy
- Surgical management: thromboectomy when anti coagulant is contraindicated or danger of pulmonary embolism is extreme
- Nursing management
- Monitor PT, PTT, Hb, platlets, report bleeding, assess anti coagulant therapy, monitor & manage complications, provide comfort & apply elastic pressure stockings.
CHRONIC VENOUS INSUFFICIENCY
- Medical & nursing management
- Reducing venous stasis & prevent ulceration
- Elevating legs to reduce edema & promote venous return
- Encourage walking
- Compression with elastic stockings to reduce blood pooling
- Protect from trauma
- Keep skin dry & soft
- Immediate report for signs of ulceration
LEG ULCERS
Its an excavation of the skin surface that occurs
when inflamed necrotic tissue sloughs off
Clinical manifestations
Open inflamed sore, pain & edema, discharge may be present, heaviness, itching, area may covered with eschar, gangrene
Medical management
Pharmacologic therapy (antibiotics based on culture) depridement, topical therapy, stimulated healing by Epigram
VARICOSE VEINS
- Medical management
- Surgery ( ligation ) & sclerotherapy
- Nursing management
- Bed rest 1st^ 24 hours & start walking at 2 nd^ day 5- 10 min /2 hours, elastic pressure stockings, elevate foot, discourage standing & sitting, promote comfort (analgesia), home & community based care
NURSING PROCESS
Assessment
Sub. (interview) & obj. (physical assessment)
Diagnosis
Alteration in peripheral tissue perfusion Pain, risk for impaired skin integrity, knowledge deficit regarding self care activities
HYPERTENTION
Definition: it’s a raise of blood pressure above
normal range” systolic above 140 mmhg & diastolic above 90 mmhg” over sustained period
A multifactorial condition
A sign ,a risk factor , and a disease.
HYPERTENTION
- Types & causes
- 1- Primary (idiopathic essential ) hypertention
- 80-90% of cases are of unknown cause but predisposed by: old age over 60 yrs, obesity, black race, atherosclerosis
- Benign or chronic hypertention
- Rise is usually slight to moderate & continue to rise slowly often asymptomatic ( silent killer )
- Malignant (accelerated) hypertention
- BP very high & continue to raise rapidly, diastolic pressure in excess of 120 mmhg & the effects are quickly apparent
HYPERTENTION
- Clinical manifestations
- High blood pressure reading
- Headache, epistaxis, angina,
- dizziness, dyspnea, ringing in ears
- Retinal changes “may be papilledema”
- “ a common consequence M.I. & CAD
HYPERTENTION
- Medical management
- Treatment of underlying cause
- Life stile modification :-
- Management of predisposing factors (
low salt diet, decease weight, stop smoking,
decrease stress level)
- Pharmacologic therapy (diuretics,
vasoconstrictive agents & agents to
decrease cardiac output )
