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Vascular Disease for Progressive Care Certified Nurse (PCCN)

Vascular Disease for Progressive Care Certified Nurse (PCCN)

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Outline

Vascular Disease

 

Definition/Etiology:

  • Definition
    • partial or total occlusion of an artery
  • PCCN Test focus
    • PAD – arms/legs
    • Carotid Artery Stenosis
  • Etiology
    • Atherosclerosis – Causes
      • HTN
      • Smoking
      • DM

 

Pathophysiology:

  • Atherosclerosis
    • Fatty material (i.e., plaque) builds up on the walls of the arteries and makes them narrower
    • Stiff arteries = low FLOW
    • Think of a hose

 

Noticing: Assessment & Recognizing Cues:

  • Subjective Cues
    • PAD
      • Chronic vs Acute
        • Chronic = intermittent claudication – Pain increases with exercise
          and decreases with rest
        • Acute = Sudden
    • Carotid Arterial Stenosis
      • Asymptomatic until Stroke
  • Objective Cues
    • PAD
      • ankle-brachial index
      • Neurovascular 5 P’s
      • Poor skin integrity
    • Carotid Arterial Stenosis
      • Stroke-like symptoms

 

Interpreting: Analyzing & Planning:

  • Labs
    • Cholesterol
    • Lipids
  • Diagnostics
    • Traditional Doppler Ultrasound
    • Duplex Ultrasound – looks closer at bloodflow
    • Ankle-Brachial Index (PAD)

 

Responding: Patient Interventions & Taking Action:

  • Pharmacological Interventions
    • Antihypertensives
    • Statins
    • Calcium Channel Blockers
    • Narcotics
  • Non-Pharmacological
    • Angioplasty/Balloon with possible Stent
    • Endarterectomy
    • Bypass

 

Reflecting: Evaluating Patient Outcomes:

  • ABCs
  • PAD
    • Neurovascular 5 P’s
  • Carotid Artery
    • Cranial Nerves
    • LOC
    • PERRLA
    • Visual Changes
    • Dysphasia
    • Aphasia
    • Headache
  • All procedures
    • Post-Op: Infection or Bleeding
    • Smoking cessation

 

Linchpins (Key Points):

  • Notice
    • Peripheral or Cerebral symptoms
  • Interpret
    • Labs & Vascular studies
  • Respond
    • Pharmacology & Procedure
  • Reflect
    • Perfusion + Post – Surgical

 

 

 

 

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Transcript

References

  • AACN, and Tonja Hartjes. AACN Core Curriculum for Progressive and Critical Care Nursing. Available from:
    Pageburstls, (8th Edition). Elsevier Health Sciences (US), [Insert Year of Publication].
  • Dennison, R. D., & Farrell, K. (2015]). Pass PCCN!. Elsevier Health Sciences (US).
  • Knippa, S., Rauen, C. A., & Flynn Makic, M. B. (2018). Is It Better to Give or to Receive?. Critical Care Nurse, 38(6), 67-71.
  • Kupchik, N. (2020). Ace The Pccn! you can do it!: Study guide. Nicole Kupchik Consulting, Inc.
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