Exam 24: Vascular Surgery

Patients with acute arterial insufficiency with occlusion usually present with the onset of the six P's: sudden severe pain,pulselessness,paresthesia,paralysis,pallor,and poikilothermia (coolness)of an extremity.This occlusion can be the result of which condition?

Which drug is used to reverse,or neutralize,the effects of heparin?

Surgically created arteriovenous fistulas are also referred to as a(n)_________ and are indicated for enabling __________.

While arteriosclerosis is a natural part of the aging process and occurs when the walls of the arterial vasculature undergo changes such as increased thickness and hardening,reducing the elasticity of the arteries,certain risk factors for arteriosclerosis are modifiable by the individual.Select the modifiable risk factors that could minimize the potential for acute or chronic vascular insufficiency.

A vena cava filter maintains a patent vena cava but prevents pulmonary emboli (PE)by trapping the emboli at the apex of the device.This procedure may be performed in the OR,radiology suite,or intensive care unit (ICU)for critical patients.Select the statement that best describes the appropriate preferred insertion approaches.

A perioperative nurse circulator is preparing the OR for a vascular procedure where heparin will be used.She has obtained the heparin from the medication dispensing system and is preparing to mix the heparin in IV saline according to the dosage on the surgeon's preference/pick-list.The scrub person,also a perioperative nurse,is preparing the sterile back table.Which expected and appropriate risk reduction strategies related to the use of heparin would the scrub person perform?

Patients with arterial disease are treated surgically more often than patients with chronic venous insufficiency (CVI)because:

Why is the change in sound made by a passing train's whistle similar to the reason the pitch rises quickly in systole and drops quickly in early diastole when measuring arterial sounds?

Which statement regarding risk factors for developing vascular disease is true?

Assessing blood flow through diseased vessels by palpation is often difficult.Assessment of the patient's hemodynamic status during surgery can be further complicated by spasm of the vessel walls,the cool environment of the OR,and alterations in blood pressure.Vascular monitoring during carotid endarterectomy (CEA)is critical to determine the quality of cerebral perfusion.What vascular monitoring device is employed during CEA and which important surgical need is determined by its results?

Arterial procedures,especially those that involve the aorta,may place the patient at risk for significant blood loss.A nursing diagnosis related to the care of patients undergoing vascular surgery is risk for deficient fluid volume related to loss of body fluids,with a nursing outcome stated as,"Fluid balance will be maintained as evidenced by postoperative pulses equivalent to preoperative level,hourly urine output of at least 30 mL,and good skin turgor." Select all the nursing interventions that are appropriate to this outcome.

Select the statement that best describes the comparative difference between open aortic aneurysm repair and endovascular aneurysm repair (EVAR).

Substituting a cryopreserved cadaveric vein or an in situ or reversed vein graft from the patient for an arterial bypass graft is an option for patients who do not have healthy,easily accessible saphenous veins.How does an in situ vein graft differ from a reversed vein graft?

What properties enable arteries to compensate for changes in blood pressure and blood volume?

Vascular surgery patients are at risk for impaired skin integrity and ineffective peripheral tissue perfusion related to surgical positioning,presence of vascular disease,and vascular clamping.Positioning of the patient undergoing vascular surgery is of importance because of restricted circulation distal to the area of arterial obstruction and a generalized state of poor circulation.An appropriate protective intervention is reflected in which true statement about patient positioning for vascular surgery?

The perioperative nurse,with an understanding of the special surgical considerations for vascular procedures,will plan for the possibility of angiography studies being performed during the intraoperative or interventional procedure.An appropriate consideration when preparing the OR or interventional procedure room would be to:

Heparin sodium is an anticoagulant.The basic mechanism of heparin's action is best described as:

During an open exploration of above-knee popliteal artery,an incision is made into the femoral artery with a #11 knife blade and extended with Potts angulated scissors.What is the proper name of this surgical approach?

Varicose veins are enlarged and distended veins that are visible and palpable beneath the skin.Secondary varicose veins are believed to be a result of insufficiency of the deep venous system.The primary objective of varicose vein surgery,for the patient with secondary disease,is to prevent extremity:

Identify the venous structure that prevents blood backflow.