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70 Cards in this Set
- Front
- Back
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What carry blood to the heart
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veins
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what carry blood AWAY from heart, bigger walls, more prone to plaque and more elastic
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arteries
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what is a blood clot that forms within a vein. (Thrombosis is a specific medical term for a blood clot that remains in the place where it formed.)
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venous thrombosis
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inflammation of a superficial vein, caused by IV in 65 percent of patients
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superficial venous thrombosis
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what is a thrombus in deep vein (FEMORAL/ILIAC) , 5 percent of surgical patients, can result in an EMBOLIZATION TO LUNGS
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Deep Vein Thrombosis
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Valves/muscles dont function properly, increased in OBESITY, CHF, Immobility, lack of excrcise
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Venous stasis
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encompasses the three broad categories of factors that are thought to contribute to thrombosis.[1]
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Virchow's triad
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caused by trauma, externam pressure, veniluncture, prolonged IV, contaminated IV, one of the three steps causing thrombosis
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damage of inner lining of vein (endothelium)
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a hematologic condition, pregnancy, meds, smoking, oral concenptives...one of 3 steps causing thrombosis
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hypercoagulability of blood
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What is the most common site for Deep Vein THrombosis DVT
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Femoral/Illiac
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SYMPTOM : firm, cordlike vein, tender to touch, red and warm (IV)
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Superficial Thrombosis
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SYMPTOM: unilateral leg edema, PAIN, warm, systemic temperature OVER 100.4 , positive homans sign
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DEEP vein thrombosis DVT
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How do you treat Superficial THrombosis
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REMOVE IV IMMEDIATELY
Elevate extremity warm moist heat oral analgesics |
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How do you treat Deep Vein THrombosis
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Elevation
Bed rest ANTICOAGULATION |
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NCLEX : How do you properly ELEVATE THE LEG
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1 pillow under THIGHT
2 pillows under LOWER LEGS NEVER MASSAGE LEGS |
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To prevent Pulmonary Embolisms, you must
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dorsiflex feet, early mobilization and ankle roation, TEDS, intermettent compression devices, anticoagulations
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WHo are at most risk for DVT and staymotionless
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post-op patients
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prevent embolizations, doesn't dissolve clot, eventual lysis
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anticoagulation
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what helps unclot blood, takes up to 1 week, this is a VITAMIN K Antagonist (vitamin K clots blood)
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Coumadin
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You must STOP coumidin when?
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1 week prior to surgery
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lovenox, and heparin help prevent what?
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DVT
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given through injection, subcute abdomen because FASTEST ABSORPTION, keep in the same spot...helps to prevent DVT
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indirect thrombin inhibitors
(HEPARIN,LOVENOX) |
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if patient is at HIGH risk, the strongest anticoagulant is
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heparin
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if at LOW risk, a low molecular heparin, not as potent is
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lovenox
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a DIRECT thrombin prohibitor, rarely use
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Hirudin
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what helps to dissolve the clot?
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Streptokinase
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a filter in the groin that traps clot, prevents dislodging and PE
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Greenfield Filter
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to prevent emboli, reduce inflammation, teach anticoagulation, review vitamins and minerals, you can not take WHAT with heparin.coumadin???
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Gingko
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a patient on bloodthinners, you must
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NO ASPIRIN
assess HR, vitals Avoid IM injections electronic razor only stool softenors |
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what is the lab value that shows you the hematology for COUMADIN?
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PT/INR
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A patient should be taught to take medications when?
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with dinner, same time daily
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Pt on HEPARIN should be monitored for what lab value
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PTT
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diet for a patient with bleeding./pe
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No vitamin K/E
No Alcohol NO GREENS, do not eat only salad (increaed vitamin K clots blood) |
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dilated , subcutaneous veins most frequently found in saphenous system (small or bulgin)
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varicose veins
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family history, congenital weakness of veins are what
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Primary cause of Varicose Veins
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previous DVT, or obstruction of veins are what
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Seconary cause of varicose veins
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small veins that are flat are called
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reticular veins
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spider veins, less than 1 mm
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telangiectasias veins
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syptoms of discomfort, ache and pain after prolonged sitting or standing, nocturnal leg cramps, worse when standing or sitting too long,
pain relieved WITH MOVEMENT |
Varicose Veins
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The opposite of Intermittant Cautication is
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Varicose Veins
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To treat varicose veins
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rest with limb elevated
compression stockings excercise walking herbal therapy horse chestnut seeds |
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Injection into veins, to dissolve and strengthen them, if varicose veins get serious (eliminates spider veins, retictular veins)
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sclerotherapy
(2 to 3 weeks of compression stockings after surgery) |
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take entire vein out, for cosmetic reasons
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ligation
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more than 1 session, 6 to 12 week intervals, heating hemoglobin in vessels, injuring endothelium, ressulting in vessel sclerosis
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Laser therapy
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what is the BEST excercise for PVT patients
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walking
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to prevent PVD, avoid
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sitting or standing long periods
keep ideal body weight excericse- WALK avoid constrictive clothing compression stockings |
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valves in veins damaged, pooling of blood in legs, swelling, leading to VENOUS LEG ULCERS
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Chronic Venous Insufficency
occurs as a result of previous DVT |
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Chronic venous insuffiency is most found in
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elderly
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leathery brownish skin,pruritis, dermatitis with scaling, are symptoms of
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chronic venous insufficency
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irregular shaped wound margins, above medial malleolus, extend through epidermis and dermis, increased drainage, painful with edema, infection, dependant position
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Venous leg ulcers
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what is eventually developed with Chronic venous insuffiency that helps identify between venous or arterior ulcers?
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Venous leg ulcers
(pain with edema, infection in a dependant position) |
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WITH WHAT DISEASE DO YOU NEVERRRRRRRRR COMPRESS
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ARTERIAL DISEASE NEVER COMPRESS
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WITH WHAT DISEASE DO YOU
ALWAYSSSSSSSSS COMPRESS |
VENOUS DISEASE ALWAYS
COMPRESS (A/V) |
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Always put these on in the AM, before swelling, never wash in machine, hang dry, never roll down
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Compression stockings
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REMOVE COMPRESSION STOCKINGS AT NIGHT?
T/F |
TRUE
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adequate nutrition for a patient with DVT is increased
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protein
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keep leg elevated above?
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the heart
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venous disease only, helps to drain, must be changed every THREE days
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VAC Vacuum assisted closure
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because it is very painful, and can break away plaque causing thrombosis to heart and lungs, you must never
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use compression on an ARTERIAL ulcer
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what is the therapeutic INR for patients on coumidid
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1.5-3.5
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a normal APTT is
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30-40 seconds
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APTT on coumadin normal is
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70-100 seconds
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when assessing a patient the nurse determines cap refill time to be 7 seconds, the nurse determines the patient may be experiencing
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decreased cardiac output
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the nurse explains to patient that the goal of anticoagulant therapy with DVT is
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PREVENT EMBOLIZATION
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what is the most common cause of an aneurysm
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atherosclerotic plaque damage arteries
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the nurse is caring for a pre-op patient who has an order for vitamin K, the nurse should verify which lab data is abormal prior to adminstering
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Vitamin K = ANTAGANOIST TO COUMADIN = PT (COUMADIN) LEVEL
COUMADIN = PT/INR |
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when adminstering lovenox 30mg subcute, it is appropriate to
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leave air bubble in pre-filled syringe
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3 RN diagnoses for vascular disorders
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risk for impaired skin integrity r/t decreased peripheral circulation
ineffective tissue perfousion r/t decreased blood flow knowledge deficit r/t disease process |
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name some disorders of the veins
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VENOUS THROMBOSIS
VARICOSE VEINS VENOUS INSSUFICENCY VENOUS LEG ULCERS |
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found chiefly in leafy green vegetables such as spinach, swiss chard, and Brassica (e.g. cabbage, kale, cauliflower, broccoli, and brussels sprouts); some fruits such as avocado and kiwifruit help to COAGULATE BLOOD
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vitamin k (clots blood)
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