Transcript for:
Understanding Venous Disorders and Care

Hi guys, it's me, Professor D, and welcome back to my YouTube channel. On this video, I'm going to be doing another Kahoot, and I'm going to be covering venous disorders. Now, before we get started, as always, I'm going to ask you to please support me and support this channel by liking this video.

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Without any further ado, let's get started. Venus disorders. First question. This is a select all that applies. What are the risk factors for varicose veins?

Select all that applies. Here's your choices. Use of oral contraceptives, being a male, being a female, obesity, active lifestyle, inactive lifestyle. What are the risk factors for varicose veins? Got 25 more seconds.

Select all that applies. All right, let's talk about it. Risk factors for varicose veins.

First of all. Varicose veins are the bulging veins that you see. And usually you see it in the lower extremities. And I'm not going to talk. I'll talk to you about this later.

But let's talk about the risk factors. Oral contraceptives. So women who are on birth control, oral birth control, that makes you a risk factor. Absolutely for varicose vein. Being a female, that is a risk factor.

Obesity and inactivity. active lifestyle, being a couch potato, those are all risk factors automatically for varicose veins. Which teaching would be most helpful to relieve symptoms caused by varicose veins? Here are your choices. Is it to elevate the legs frequently?

Would it be to avoid wearing open toe shoes? Would it be to massage the calves when the patient's experiencing pain? Or would it be to focus on sedentary activities?

So what teaching would be helpful to relieve the symptoms of varicose veins? All right, good. Elevate the legs frequently. I want you guys to think about it.

These varicose veins, guys, these veins are weak. And so you have blood that's pooling, that's causing that bulging. You want to increase circulation.

You want that person moving around. You want them to do isometric exercises such as what? Squats, right? You don't want that blood just to pull at the lower extremity.

You want that blood to go back to the heart. So you're going to have them elevate their legs frequently. So the blood's not just pulling and you want them to do isometric exercises.

You want them moving about. Third question, which fact... is most closely related to the development of varicose veins. Would it be the patient's sister has varicose veins? Would it be the patient avoids high fiber foods?

Would it be a patient that's a runner? Or would it be a patient that is an adolescent? What type of patient would be at higher risk for varicose veins? The correct answer, guys, is the patient that has a family member, that has a sister that has varicose veins.

Besides being female, that's a risk factor. Genetics is also a risk factor. So if you have family members that have varicose veins, that increases your risk of it as well.

True or false? A patient with varicose veins should avoid crossing the legs at the knees. Is this true or is this false? What do you guys think? Very good.

Most of you guys chose the correct answer. It's true. Think about it.

If you're crossing your legs at the knees, right? That crossing at the knees, don't you think that's going to decrease circulation? And I already told you, one of the problems with varicose veins is decreased circulation. We need blood going back up to the heart instead of pooling in the lower extremities.

So when you're crossing your legs, you're going to be preventing that blood from going back up to the heart. So we don't want patients doing things, anything that can... obstruct or make that circulation slower. So that's true. We don't want them crossing their legs at the knees.

Fifth question. This is a select all that applies. Which finding is most characteristic of a venous stasis ulcer? Here are your choices. Purely drainage, redness and warmth, dark brown and dry skin, blisters, edema and rash.

Which is most characteristic of a venous stasis ulcer. All right. So let's talk about this guys.

Venous stasis ulcer. Venous blood, that's blood that's supposed to be going what? Back to the heart to pick up oxygen, right?

So if the patient has a venous stasis ulcer, that blood that's supposed to be going to the heart to pick up oxygen, what stasis? That means not moving. So that blood's not moving.

It's not going back to the heart to pick up oxygen. It's staying where it's at. And I want you to think about what's happening. Because it's not going back to the heart to pick up oxygen and it's pooling in that lower extremity, that causes swelling, right? So the patient's going to have swelling.

They're going to have edema and they're going to have decreased arterial flow. Remember the blood arterial? That's the blood that's supposed to be going to the tissues. That's the blood coming back from the heart. It's already picked up oxygen in the lungs and now it's going to the tissues.

But that patient's got all the swelling down there from that venous blood and it decreases the arterial blood. Right? So the patient got swelling, number one, from the venous congestion.

Now they have decreased arterial circulation, which means that the tissues down there are not getting oxygenated blood. So what can happen? Take a look, guys.

And the correct answer is dark, brown, dry skin. Think about it. Why do you think that skin is, you see that color of that darkness of the skin?

All of that blood's pooling down there. Unoxygenated blood, by the way. And the skin down there is not getting all of the oxygen, vitamins, minerals, nutrients that it's supposed to get.

Because remember, what type of blood actually feeds the tissue? Arterial blood. Arterial blood is decreased in this situation because of all the venous congestion.

So that's why you see the dark brown and dry skin. Let's talk about edema. Why I explained to you edema, all of the venous blood is just sitting there. It's causing congestion. and it's causing edema.

That's why you see the swelling. So those are the two correct answers. Let's talk about the wrong answer choices.

Purulent drainage. When do you see purulent drainage? You see purulent drainage in an infectious process.

This question is asking about a venous stasis ulcer, not an infectious ulcer, a venous stasis ulcer. So purulent drainage, you see that in infection. Redness and warmth, you see that in infection. Blisters, blisters, you see that on top of the skin.

This is much deeper. So we're not talking about venous stasis ulcer and also a rash. We don't see that venous stasis ulcer.

So the correct answer is a deep brown and dry skin and edema. Which intervention is important in promoting venous circulation? What's important to promote venous circulation? Would it be to provide analgesics as ordered?

Would it be to apply compression stockings? Would it be providing IV fluid as ordered? Or would it be applying a heating pad to the affected extremity?

What do you guys think? All right, very good. Apply compression stockings. If you think about it, it makes sense. It makes sense.

If the patient has problem with venous circulation, that means they have problem with unoxygenated blood going back up to the heart. Aren't we gonna wanna do something to help promote that blood flow back up to the heart? Compression stockings. Analgesics is ordered.

Analgesics you get for pain. IV fluids as ordered, you give that for somebody who has something like dehydration and then applying a heating pad. Come on now. If your patient has venous circulation issues, right?

Chances are they're going to have some type of neuropathy going on, problems with sensation. Do you really want to put a heating pad on that affected extremity? No, you can burn the patient.

So that's a big no, that's number one. And number two, what do we know about heat? Heat causes vasodilation. Patient already has all of this blood sitting there pulling, not moving back up to the heart like we want it to.

Is it a good idea to go ahead and put heat on that area? No. The correct answer is applying compression stockings.

Why would you apply an air occlusive dressing on the leg of an ulcer? So a patient has an ulcer. Why would you apply an air occlusive dressing? Here are your choices.

It minimizes scar tissue. It alleviates the pain. It's cheaper than gauze or it will speed the healing process.

Why would you apply an air occlusive dressing on a leg ulcer? Very good. Most of you guys correct.

It will speed up the healing process. Absolutely. By keeping that wound moist. The healing process speeds up and this happens by second intention.

So you need to know that. Okay. Which patient is at highest risk for developing gangrene of the foot?

Look at that foot. Who's at highest risk for developing this? Is it a diabetic patient, an elderly patient, a patient that takes Coumadin or a patient that takes aspirin? What do you guys think? Very good.

The diabetic patient. As you know, that diabetic patient tends to have decreased circulation, especially in the lower extremities. Well, think about it. If you have decreased circulation in the lower extremities long enough, that is decreased oxygen supply to those tissues. What's going to happen?

Ischemia and eventually what? Necrosis, right? So they're at highest risk for developing gangrene. True or false? If a thrombus is suspected, The extremity should be massaged immediately.

Is that true or is that false? If you suspect your patient has a DVT, you should massage that leg immediately. Is it true or is it false?

False. Wonderful. Absolutely false. You do not want to dislodge.

That clot, and God forbid, that embolism goes to the lungs, and now you're dealing with a pulmonary embolism. Very good. Select all that applies. What are risk factors for developing thrombophlebitis?

Select all that applies. Here are your choices. Obesity, smoking, sedentary lifestyle, use of oral contraceptives, history of leg cramps, joint pain. Okay. This is interesting.

Let's talk about this guys. So thrombophlebitis guys, thrombo, what? Clot phlebitis. So this is inflammation and pain in what?

A vein. And it's caused by a clot. The patient's having inflammation in that vein. They're having that pain due to a clot in that vein.

Okay. So that's what the thrombophlebitis is. So let's talk about the risk factors. Obesity. Absolutely.

Smoking. Absolutely. Being a couch potato, not moving around. Absolutely.

Use of oral contraceptives. Absolutely. Absolutely.

But not history of leg cramps or joint pain. History of leg cramps. What can cause leg cramps?

Deficiency of vitamin B, hypocalcemia, right? Deficiency of magnesium. Those can cause leg cramps, but not thrombophlebitis. And that's not a risk factor. And for joint pain.

you know, what can cause joint pain. It could be something like arthritis, but when we're talking about thrombophlebitis, those risk factors, again, obesity, smoking, sedentary lifestyle, and, you know, birth control, use of oral contraceptives. Which finding would increase the risk for development of a thrombus, a clot?

Which finding would increase the risk for development of a thrombus? Is it refusing to ambulate? Is it refusing to breathe deeply?

Is it refusing analgesics or refusing calcium supplements? You guys are on a roll. Refusing to ambulate. Absolutely.

So when... Blood, when you're not moving around, blood slows down. Blood doesn't, you know, blood slows down long enough.

What does it start to do? It starts to clot. That's why patients who's had surgery, I don't care what type of surgery they had, if they had invasive procedure, they're at risk for clots. Why? They've been lying down on that surgical table, not moving, right?

They're at risk for clots. So one of the best ways to prevent that from happening is ambulation, moving around. You want to increase circulation.

What is the action of heparin? What does heparin do? Does it shrink blood clots? Does it dissolve blood clots?

Does it prevent the formation of more blood clots? Or does it prevent current blood clots from dislodging? What does heparin do? Okay, very good. It prevents the formation of more blood clots.

It does not dissolve blood clots, okay? Heparin is an anticoagulant. If you want something that's going to dissolve a current blood clot, that is a thrombolytic. Lytic as in lysis to break down. That's a thrombolytic agent.

It'd be something like streptokinase, right? But for preventing the formation of blood clots, it's going to be heparin. Something important that you need to know. For heparin, you need to know the antidote, which is protamine sulfate, and you need to know the test for heparin, and that's PTT. Very important.

Don't say I didn't warn you. Which lab values should be assessed before you administer heparin? Would it be, oh, I gave you the answer.

I'm so sorry. PTT, CBC, hemoglobin, or potassium? I'm sorry guys, I wrote these questions days ago.

I forgot. This was a question. Probably one person still get this wrong and choose potassium.

All right. Very good, guys. PTT. And the way you remember this, if you look at those two T's, it kind of looks like an H, right?

So you remember those two T's? PTT goes with the H for heparin. All right.

That's the correct answer. I'm so sorry I gave you guys that one. True or false? Vitamin K is a heparin antagonist.

Is this true or is this false? Is vitamin K a heparin antagonist? Very good.

That is false. When it comes to vitamin K, vitamin K is antagonist for what? Coumadin.

All right. The antidote for heparin is protamine sulfate and the antidote for coumadin is vitamin K. Make sure you guys remember that. All right.

Last question. Select all that applies. Which foods are high in vitamin K?

Select all that applies. Here's the choices. Spinach, lettuce, turnip greens, brussel sprouts, peas, corn.

Which foods are high in vitamin K? Okay, the correct answer, spinach, lettuce, turnip greens, Brussels sprouts. Here's the thing.

When you're thinking of vitamin K, you need to think of green leafy veggies, right? Green leafy veggies are high in vitamin K, not peas or corn. You guys did a wonderful job. All right, guys, thank you so much for watching this video. Please let me know what you thought about this video.

Let me know what you'd like me to cover next or more extensively and how you'd like me to cover the video. Would you like it in a kahoot? such as the one we just did? Or would you like it in a lecture such as me teaching out of the book or question and answer format such as the videos that are released every Sunday, 1 p.m. Eastern Standard Time?

Again, guys, thank you for watching this video. You guys will catch me on the next video.