Peripheral Vascular Disease: Arterial vs. Venous Insufficiency Study Guide

Clinical Judgment and Nursing Assessment

An introduction to the clinical judgment process, the nursing process, and fundamental physical assessment techniques and data collection methods.

• Clinical judgment definition and process
• Nursing process phases
• Physical assessment techniques IPPA
• Head-to-toe assessment
• Vital signs significance
• Subjective and objective data
• Health history and review of systems
• Evidence based practice
• Standards based approaches
• Clinical judgment measurement model
• Pathophysiology and etiology
• Data validation and verification

Nursing Process and Physical Health Assessment

This material covers the principles of collecting and organizing physical health assessment data using specific techniques and focused system assessments.

• Nursing process and patient assessment
• Inspection, palpation, percussion, and auscultation
• Focused assessments and head-to-toe assessment
• Cardiovascular system assessment
• Anatomical landmarks of the precordium
• Common diagnostic tests and imaging
• Collecting and organizing clinical data
• Assessing apical impulse and heart sounds

Cardiovascular and Peripheral Vascular Assessment

This material covers cardiac auscultation, heart sound identification, diagnostic testing, and physical examination techniques for the peripheral vascular system.

• Cardiac auscultation and heart sounds
• Abnormal heart sounds including S3, S4, murmurs, rubs, and thrills
• Cardiac diagnostic tests
• Arterial and venous anatomy
• Peripheral pulse assessment sites
• CWMS assessment criteria
• Ankle Brachial Index

Principles of Safe Pharmacotherapy

An overview of pharmacology principles including drug classifications, pharmacokinetics, pharmacodynamics, and the characteristics of safe and effective drugs.

• Safe pharmacotherapy principles
• Nursing Process in pharmacotherapy
• Pharmacokinetics and pharmacodynamics
• Drug therapy in children, pregnancy, and older adults
• Drug classifications
• Chemical, generic, and brand names
• Characteristics of an ideal drug
• Medication administration records

Principles of Medication Administration and Nursing Care

A guide to the ten rights of medication administration, pre-administration assessments, and managing pharmacological and non-pharmacological therapies.

• Ten rights of medication administration
• Pre-administration assessment
• Pharmacological vs. non-pharmacological therapies
• Adverse drug reactions
• Toxicity
• Anaphylaxis
• Contraindications
• PRN medications
• Baseline data collection
• High-risk patients

Nursing Process in Pharmacotherapy

This material covers nursing roles, responsibilities, and assessments related to medication administration, safety protocols, and managing drug effects.

• 10 rights of drug administration
• Pre-administration assessment
• Minimizing adverse effects and interactions
• Making PRN decisions
• Evaluating responses to medication
• Managing drug toxicity
• Drug names and mechanisms of action
• Adverse drug reactions
• Patient education
• Nursing process application

Principles of Nursing Medication Administration

An overview of the nursing process, the ten rights of medication administration, and considerations for drug therapy.

• Ten rights of medication administration
• Nursing process in drug therapy
• Pre-administration assessment
• Pharmacological vs. non-pharmacological therapies
• Adverse drug reactions
• Contraindications
• High-risk patient identification
• Baseline data collection
• Drug metabolism organs
• Patient education

Principles of Nursing Drug Therapy

An overview of the nursing process, the ten rights of medication administration, and considerations for safe drug therapy.

• Ten rights of medication administration
• Pre-administration assessment
• Pharmacological vs. non-pharmacological therapies
• Adverse drug reactions
• Drug indications and contraindications
• Pharmacokinetics (ADME)
• Pharmacodynamics
• High-risk patient identification

Cognition and Intracranial Regulation Concepts

This topic explores the general concept of cognition, its relationship to intracranial regulation, and the physiological mechanisms of altered level of consciousness.

• Cognition
• Intracranial Regulation
• Level of Consciousness
• Perception
• Memory
• Cognitive Domains
• Cognitive Impairment

Nursing Assessment of Cognition and Consciousness

• General Survey
• Level of Consciousness (LOC)
• Glasgow Coma Scale (GCS)
• Decorticate Posture
• Decerebrate Posture
• Alert and Oriented (A&O x 3)
• Obtunded
• Stupor
• Comatose

Cognition, Delirium, Dementia, and Depression

A study of delirium, dementia, and depression involving cognitive, perceptual, emotional, and behavioral alterations.

• Delirium
• Confusion Assessment Method (CAM)
• Dementia
• Depression
• Cognitive Impairment
• Altered Consciousness

Mini Mental State Examination Assessment

The Mini Mental State Examination (MMSE) is a tool used for assessing cognition in adults.

• Mini Mental State Examination (MMSE)
• Cognition assessment
• Dementia assessment
• Glasgow Coma Scale (GCS)
• Confusion Assessment Method (CAM)

Interventions for Cognitive Impairment and Care

A guide for healthcare teams to manage cognitive impairment through multidisciplinary approaches, patient safety, and family support.

• Cognitive impairment management
• Multidisciplinary care approach
• Patient safety and reorientation
• Collaborative healthcare interventions
• Patient and family support

Physiological Mechanisms and Impact of Pain

An exploration of pain as a multidimensional subjective experience involving nociception, physiological transmission, and the psychological impact of acute and chronic pain.

• nociception
• transduction
• transmission
• perception
• modulation
• nociceptors
• chemical mediators
• afferent nerve fibers
• delta fibers
• c fibers
• somatosensory system
• acute pain
• chronic pain
• nociceptive pain
• neuropathic pain
• nosoplasmic pain

Classifications and Assessment of Pain

This content explores nociceptive, neuropathic, and nociplastic pain, along with pain assessment methods.

• nociceptive pain
• somatic pain
• visceral pain
• referred pain
• neuropathic pain
• centrally generated pain
• peripherally generated pain
• diabetic neuropathy
• nociplastic pain
• mixed pain
• dermatomes
• pain assessment
• fifth vital sign

Physiology and Classification of Pain

This content explores the four phases of the pain pathway including transduction, transmission, perception, and modulation, alongside classifications of nociceptive, neuropathic, and nociplastic pain.

• transduction
• transmission
• perception
• modulation
• nociceptors
• action potential
• acute pain
• chronic pain
• nociceptive pain
• neuropathic pain
• nociplastic pain
• mixed pain
• subjective report of pain

Inflammation and Tissue Integrity Pathophysiology

An immunologic defense against tissue injury, infection, or allergy characterized by local or systemic responses and stages of vascular, cellular, and repair processes.

• Inflammation
• Tissue integrity
• Local and systemic inflammation
• Vascular response
• Cellular response
• Tissue repair and replacement
• Arachidonic acid cascade
• Proinflammatory hormones
• Chemotaxis
• Granulocytes
• Agranulocytes
• Regeneration
• Repair
• Angiogenesis

Inflammation, Tissue Integrity, and Pharmacology

This lecture covers acute and chronic inflammation, clinical manifestations, tissue integrity, and the management of inflammatory processes through nonpharmacological and pharmacological interventions.

• Acute inflammation
• Chronic inflammation
• Tissue repair and replacement
• Local and systemic responses
• Leukocytosis
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• RICE protocol
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
• Glucocorticoids
• Adrenal crisis
• Tissue integrity
• Epidermis
• Dermis
• Subcutaneous layer

Cell Injury and Adaptive Processes

This lecture covers sublethal and lethal cell injury, types of necrosis, and adaptive or maladaptive cellular processes.

• Sublethal injury
• Lethal injury
• Apoptosis
• Necrosis
• Coagulative necrosis
• Liquefactive necrosis
• Caseous necrosis
• Dry gangrene
• Wet gangrene
• Hypertrophy
• Hyperplasia
• Atrophy
• Metaplasia
• Dysplasia
• Anaplasia

Impaired Tissue Integrity and Wound Healing

This lecture covers categories of impaired tissue integrity and the stages of wound healing through primary, secondary, and tertiary intention.

• Categories of impaired tissue integrity
• Trauma/injury
• Loss of perfusion
• Immunologic reaction
• Infections and infestations
• Thermal or radiation injury
• Lesions
• Primary intention
• Secondary intention
• Tertiary intention
• Blood clot formation
• Acute inflammation
• Granulation tissue
• Angiogenesis
• Scar tissue and remodeling
• Fibroblasts
• Collagen
• Factors delaying wound healing

Concepts and Mechanisms of Perfusion

The flow of blood through arteries and capillaries delivering nutrients and oxygen to cells involves central perfusion, tissue perfusion, and blood pressure regulation.

• Perfusion
• Central perfusion
• Tissue perfusion
• Preload
• Afterload
• Cardiac output
• Stroke volume
• Heart rate
• Contractility
• Systemic vascular resistance
• Vasodilation
• Vasoconstriction
• Tissue hypoxia
• Blood pressure regulation
• Sympathetic nervous system
• Antidiuretic hormone

Hypertension Etiology, Risk Factors, and Management

Hypertension is a sustained elevation of arterial blood pressure and a significant modifiable risk factor for cardiovascular disease, kidney disease, and death.

• Hypertension etiology
• Primary and secondary hypertension
• Hypertension risk factors
• Clinical manifestations of hypertension
• Hypertensive crisis
• Hypertensive retinopathy
• Peripheral artery disease
• Hypertension diagnosis
• Nonpharmacological interventions
• Pharmacological interventions
• ACEIs
• Diuretics
• Calcium channel blockers

Patient Health Assessment and Data Collection

A guide to collecting subjective health history and performing objective physical examinations using various assessment techniques.

• Subjective vs Objective data
• Assessment technique
• Health History components
• Review of Systems
• Physical Examination techniques
• Inspection, Palpation, Percussion, and Auscultation
• General Survey observations
• Head-to-Toe Assessment
• Vital Signs
• Functional assessment

Respiratory Anatomy and Lung Fissures

An anatomical review of lung fissures and their locations relative to and clinical surface landmarks.

• horizontal fissure location
• right oblique fissure
• landmarks
• respiratory anatomy

Principles of Pharmacokinetics and Pharmacodynamics

An overview of how drugs move through the body via pharmacokinetic processes and their physiological effects through pharmacodynamics.

• Pharmacokinetic processes ADME
• Absorption and routes of administration
• Drug distribution and protein binding
• Hepatic metabolism and P450 system
• First pass effect
• Renal drug excretion
• Pharmacodynamics and dose-response relationships
• Agonist versus antagonist
• Therapeutic index
• Drug bioavailability
• Liver function tests and serum creatinine

Pharmacokinetics: Absorption, Distribution, Metabolism, and Excretion

This lecture covers the pharmacokinetic processes of absorption, distribution, metabolism, and excretion, focusing on drug movement across cell membranes.

• Absorption
• Distribution
• Metabolism
• Excretion
• Cell membrane penetration
• Lipid solubility
• Ionization
• Routes of administration
• First pass effect
• Blood-brain barrier
• Protein binding

Pharmacokinetics: Absorption, Distribution, Metabolism, and Excretion

Understanding the processes of absorption, distribution, metabolism, and excretion helps in creating appropriate drug dosage and scheduling.

• Pharmacokinetics
• Absorption
• Distribution
• Metabolism
• Excretion
• Cell membrane penetration
• Lipid solubility
• Ionization
• Routes of administration
• First pass effect
• Blood brain barrier
• Protein binding
• Albumin

Pharmacology of Protein Binding and Distribution

Drug distribution is influenced by protein binding to albumin, the blood brain barrier, and the ability of unbound drugs to cross the placenta.

• Albumin protein binding
• Bound vs. unbound drug
• Drug distribution
• Drug toxicity
• Blood brain barrier
• Placental transfer

Pharmacology of Drug Metabolism and Excretion

This lecture covers how drugs are metabolized in the liver and excreted through various bodily systems, including the impact of age, enzyme activity, and renal function.

• Drug metabolism
• Liver enzymes
• First pass effect
• Enzyme inducers and inhibitors
• Drug inactivation
• Pro drugs
• Hepatotoxicity
• Glomerular filtration
• Passive tubular reabsorption
• Active tubular secretion
• Renal excretion

Cognition and Sleep Physiological Processes

Sleep is a restorative cyclical pattern of sleep and wakefulness involving changes of consciousness and loss of awareness of surrounding environment.

• Sleep stages
• NREM sleep
• REM sleep
• Melatonin regulation
• Insomnia
• Sleep disruptors
• Physiological restoration

Nursing Pain Assessment and Management

The goal of the pain assessment is to describe the patient's sensory affective behavioral and sociocultural response to pain using various assessment tools and addressing barriers to adequate pain management.

• Pain assessment tools
• Numeric pain scale
• Visual analog scale
• Brief Pain Inventory
• Pain assessment in advanced dementia scale
• Barriers to pain management
• Acute pain indicators
• Chronic pain management
• Neuropathic pain
• Pain misconceptions in older adults
• Analgesics
• NSAIDs
• Opioids

Inflammation and Tissue Integrity Inspection

Clinical inspection of skin color changes including pallor, cyanosis, erythema, jaundice, and brown pigmentation.

• Pallor
• Cyanosis
• Hyperemia
• Polycythemia
• Venous stasis
• Brown pigmentation
• Unoxygenated hemoglobin
• Serum bilirubin
• Melanin production

Pharmacology of Diuretics and Antihypertensives

This content covers mechanisms of action, indications, and nursing considerations for diuretics and various antihypertensive medication classes.

• Loop diuretics
• Potassium-sparing diuretics
• Aldosterone antagonists
• Calcium channel blockers
• Beta adrenergic blockers
• Angiotensin converting enzyme inhibitors
• Angiotensin II receptor blockers
• Sodium reabsorption
• Blood pressure regulation
• Electrolyte imbalances
• Renal physiology

• Pharmacology of Diuretics and Antihypertensives

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Physical Assessment of Vital Signs

An overview of assessing vital signs including temperature, blood pressure, pulse, respiration, and oxygen saturation.

• Thermoregulation and hypothalamus function
• Factors impacting vital signs
• Blood pressure physiology and cardiac output
• Hypertension and hypotension parameters
• Pulse assessment characteristics
• Respiration rate and oxygen saturation
• Nursing process in vital sign assessment
• National Early Warning Score (NEWS2)

Respiratory Assessment and Clinical Findings

A guide to performing respiratory physical examinations, identifying breathing patterns, and auscultating breath sounds.

• Respiratory anatomy and acinus structure
• Common respiratory complaints and symptoms
• Nursing assessment and data collection
• Inspection of chest shape and configuration
• Normal and abnormal respiration patterns
• Tachypnea and bradypnea
• Tactile fremitus and chest expansion
• Anatomical landmarks for lung auscultation
• Adventitious breath sounds
• Crackles, wheeze, stridor, and pleural friction rub
• Auscultation techniques and patient positioning
• Pulmonary function tests

Integumentary System and Head-to-Toe Assessment

This material covers the biological functions of the integumentary system and clinical inspection and palpation techniques used during a head-to-toe physical assessment.

• Integumentary system biological functions
• Clinical inspection of skin color
• Assessment of hydration and turgor
• Inspection of hair, nails, and oral cavity
• Head-to-toe assessment components
• Neurovascular examination of extremities
• Respiratory and gastrointestinal assessment
• Genitourinary assessment and urine characteristics
• Impact of drugs and blood work on body systems

Time Course of Drug Responses

An examination of pharmacokinetic values and drug administration patterns including half-life, steady state, and therapeutic range.

• onset of action
• duration of action
• termination of action
• peak plasma concentration
• drug half-life
• therapeutic range
• steady state
• loading dose
• maintenance dose
• single-dose drug administration
• multiple-dose drug administration

Fundamentals of Pharmacodynamics and Drug Therapy

An overview of the biochemical effects of drugs, receptor mechanisms, safety measures, and considerations for drug therapy across the lifespan.

• biochemical and physiological effects of drugs
• drug efficacy and potency
• drug receptor mechanisms
• four primary receptor families
• therapeutic index and drug safety
• drug to drug interactions
• drug to food and supplement interactions
• drug therapy across the lifespan
• acetaminophen mechanism and administration

Pharmacology of Drug Metabolism and Excretion

An overview of how the liver metabolizes drugs and how the kidneys facilitate drug excretion.

• Metabolism
• Liver enzymes
• Drug inactivation
• Pro drugs
• Hepatotoxic metabolite
• Enzyme inducers
• Enzyme inhibitors
• First pass effect
• Glomerular filtration
• Passive tubular reabsorption
• Active tubular secretion

Pharmacokinetics and Pharmacodynamics Principles

An exploration of drug response time courses, therapeutic ranges, half-life, and the relationship between dose and clinical response.

• Pharmacokinetics
• Pharmacodynamics
• Onset of action
• Duration of action
• Therapeutic range
• Toxic range
• Half-life (t 1/2)
• Steady state
• Loading dose
• Maintenance dose
• Dose-response relationship
• Efficiency
• Potency

Pharmacokinetics and Pharmacodynamics Fundamentals

An overview of drug response time courses, therapeutic ranges, half-life, and the molecular mechanisms of drug-receptor interactions.

• Pharmacokinetics
• Pharmacodynamics
• Onset of action
• Duration of action
• Therapeutic range
• Toxic range
• Half-life (t 1/2)
• Steady state
• Loading dose
• Maintenance dose
• Efficiency
• Potency
• Agonist
• Antagonist
• Therapeutic index
• Drug-to-drug interactions

Pharmacology of Sedatives and Benzodiazepines

Pharmacological action on GABA receptors involves using sedatives-hypnotics to depress CNS activity and control behavioural alterations.

• GABA neurotransmitter
• Benzodiazepines
• Sedative-hypnotics
• CNS depressants
• Mechanism of action
• Drug interactions
• Flumazenil antidote
• Melatonin

Pharmacological and Non-Pharmacological Pain Interventions

This content discusses pharmacological interventions including non-opioids, opioids, adjuvant therapy, and atypical analgesics, alongside non-pharmacological therapies for pain management.

• pain pathway
• transduction
• transmission
• perception
• modulation
• WHO step ladder
• non-opioid analgesics
• NSAIDs
• cyclooxygenase inhibition
• COX-1 and COX-2 enzymes
• opioid receptors
• mu, kappa, and delta receptors
• opioid tolerance
• physical dependence
• addiction
• strong opioid analgesics
• adjuvant therapy
• cannabinoids
• multimodal therapy
• gate control theory

Inflammation and Tissue Integrity Assessment

Clinical characteristics of skin lesions, pressure injuries, and wound management strategies.

• Primary and secondary skin lesions
• Pressure injury staging
• Deep tissue pressure injury
• Unstageable pressure injury
• Wound exudate types
• Braden Scale for predicting pressure sore risk
• Malignant mole ABCDE criteria
• Wound complications including dehiscence and evisceration
• Skin assessment and management

Peripheral Vascular Disease Overview

Peripheral arterial disease and peripheral venous disease involve thickening of artery walls or failure of leg veins and valves.

• Peripheral Arterial Disease
• Peripheral Venous Disease
• Chronic Venous Insufficiency
• Atherosclerosis
• Intermittent claudication
• Ankle-brachial index
• Venous leg ulcers
• Stasis dermatitis
• Hemodinamic manifestations

• Peripheral Vascular Disease: Arterial vs. Venous Insufficiency

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Pharmacology Principles of Potency and Receptors

This lecture covers drug potency, receptor families, agonist and antagonist mechanisms, and the therapeutic index.

• Potency
• Efficiency
• Receptor families
• Agonist
• Antagonist
• Competitive vs Non-competitive inhibition
• Therapeutic index
• Drug-to-drug interactions

Pharmacology Across the Lifespan

This lecture covers drug interactions, food influences on absorption, and the physiological considerations for drug therapy in pregnant women, breastfeeding mothers, children, and older adults.

• Drug-drug interactions
• Drug-food interactions
• Placental drug transfer
• Teratogenesis
• Pediatric pharmacology
• Geriatric pharmacology
• Pharmacokinetics