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168 Cards in this Set

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What is HYPERTENSION and what are the risk factors?
prolonged elevation of systolic and diastolic blood pressure. Risk factors- race (African-American), aging, obesity, stress, elevated cholesterol levels, sodium intake, tobacco, oral contraceptives.
What are the signs & symptoms of HYPERTENSION?
usually none, asymptomatic. Hypertension strains the heart and lungs and may result in left ventricular hypertrophy, failure, CHF or pulmonary edema
What are dx for HYPERTENSION?
is made by serial blood pressure readings with a systolic greater than 140 and a diastolic greater than 90. Take two or more blood pressure readings rather than relying on one single abnormal reading
What drugs are used to treat HYPERTENSION
diuretics, antihypertensives , Vasodilators, Calcium blockers Beta-adrengergic blockers and ACE inhibitors
Provide two examples of diuretics meds
Lasix, diazide
Provide two examples of antihypertensive meds
Aldomet, Minipress
Provide one example of a Vasodilator
Nipride
Provide two examples of Calcium blockers
Procardia, Cardizem
What is PERIPHERAL VASCULAR DISEASE?
chronic inadequate blood flow in the lower extremities
What are signs and symptoms of PERIPHERAL VASCULAR DISEASE
moderate edema, burning, itching, prominent superficial veins, ulcers and skin changes
Explain the treament of PERIPHERAL VASCULAR DISEASE
aimed at vasodilation, pain relief, and maintaining skin integrity. Do NOT use a heating pad to keep extremities warm
What are complications of PERIPHERAL VASCULAR DISEASE
Complications include gangrene, and pressure sores
What should be encouraged and avoided as it relates to PERIPHERAL VASCULAR DISEASE? What instructions should be given?
Encourage walking and other leg exercise, watch for signs of decreased peripheral circulation. Avoid temperature extremes, prolonged standing, constrictive clothing or crossing the legs at the knee when seated. Provide instruction about foot care and exercise programs
What type of drugs are used to treat PERIPHERAL VASCULAR DISEASE
antiplatelet vasodilators anticoagulants Lipid reducers
Questran is an example of what type of medication
Lipid reducer
Trenta is what type of medication
vasodilators
Mevacor is an example of what type of medication
Lipid reducer
Buerger’s Disease
vascular disease linked to cigarette smoking and jewish ancestry between the ages of 20-40
What is the most common symptom of buerger's disease
Intermittent claudication of the instep
What is Raynaud’s disease?
episodic vasospasms precipitated by stress and exposure to cold. Common in women between puberty and age 40. Affects both hands and sometimes both feet
What are signs and symptoms of Raynaud’s disease
tingling and numbness, blanching that is relieved with warming
What is GANGRENE
lack of oxygen supply that leads to thrombosis and tissue necrosis and localized edema.
What are signs and symptoms of GANGRENE
severe localized pain, discoloration and swelling that usually occurs within 72 hours of surgery or trauma. Tachycardia, tachypnea and hypotension related to toxemia and hypovolemia.
What is another name for ARTERIOSCLEROTIC HEART DISEASE
CORONARY ARTERY DISEASE
What is CORONARY ARTERY DISEASE?
common disorder caused by a buildup of fatty, fibrous plaques that narrow the coronary artery lumen.
What are non-modifiable risk factors for CORONARY ARTERY DISEASE
Non-modifiable risk factors include age (over 50), gender (male) with increased incidence of disease in postmenopausal women (loss of the protective effects of estrogen) and family history
CORONARY ARTERY DISEASE
Other risk factors include stress, sedentary life-style, hypertension, obesity, cigarette smoking, diabetes mellitus, increased cholesterol, alcohol intake
What are treatments for CORONARY ARTERY DISEASE
- reduce lipid levels , reduce hypertension, modify diet to limit meat, dairy and high-fat foods, and quit smoking. Limit alcohol intake to 2 ounces
clofibrate is an example of type of medication
Lipid lowering agents
cholestyramine is an example of type of medication
Lipid lowering agents
Questranis an example of type of medication
Lipid lowering agents
What are complications of CORONARY ARTERY DISEASE
angina, MI, CHF, and
What is ANGINA?
dull squeezing or crushing pressure resulting from decreased blood flow to the heart. May radiate to the arms, usually lasts 3-5 minutes
What are signs and symptoms of ANGINA
sweating, pallor, nausea, vomiting, cool extremities and fainting. Associated with physical exertion, emotional excitement and exposure to cold.
What are dx for ANGINA
EKG: ST depression, T wave inversion during acute pain
What are tx for ANGINA
include beta-adrenergic blockers ( propranolol, Lopressor), and calcium channel blocers (Verapamil, Cardizem, Procardia). The aim is to decrease oxygen demand or increase myocardial oxygen supply.
What should be noted about the storage of nitroglycerine?
store in dark, glass, securely capped vial, kept fresh enough that it tingles when you place it under your tongue
When nitroglycerine is given in paste form what should be noted?
When using paste do not rub it in and rotate sites
What patient teachings should be given as it relates to nitrolycerine?
include keeping nitro available at all times, use at the first sign of pain and stop and rest until pain subsides. Seek medical attention if pain lasts more than 20 minutes. Instruct the patient about risk factors for MI
Which activities commonly lead to aginal pain?
are exposure to cold, emotional upset or excitement, exertion, smoking, heavy meals, and rushing about as well as decongestants, diet pills, caffeine and nicotine.
Explain prevention as it relates to anginal pain?
Prevention is the best treatment and includes reducing risk factors, reducing calories, fats, salt and getting regular exercise.
What are complications of angina?
Complications include arrhythmias, CHF, and MI.
What is ABDOMINAL AORTIC ANEURYSM
widening of the aorta. There are three types type
What are the three types of abdominal aortic aneurysm? Which one is the most common and deadly?
Ascending (most common and deadly), Descending or Transverse
What are signs and symptoms of ABDOMINAL AORTIC ANEURYSM
severe ripping, boring pain of the shoulder, neck, lower back or abdomen. Bradycardia, pericardial friction rub, pulse intensity disparit
What is the dx test for ABDOMINAL AORTIC ANEURYSM
Dx confirmed by x-ray
Explain Life-threatening emergency as it relates to ABDOMINAL AORTIC ANEURYSM
includes decreasing hypertension, myocardial contractility, pain control and relief of respiratory distress while preparing for surgical intervention. Abdominal aneurysm resection- surgical removal of a portion of weakened arterial wall with an end-to-end anastomosis to a prosthetic graft.
What is CARDIAC FAILURE ? Which side usually fails
heart can’t pump enough blood to meet the body’s metabolic needs. Left-sided heart failure caused mostly pulmonary
What are general signs of cardiac failure?
SOB, dyspnea, and a moist cough. Also crackles, and gallop rhythm: S3 and S4
Explain signs and symptoms of right-side of the heart failure
edema, swelling, dependent edema, jugular vein distention, hepatomegaly and weight gain
What causes cardiac failure
atherosclerosis, conduction defects, COPD, fluid overload, hypertension, MI, pulmonary hypertension, valvular insufficiency or stenosis
How is heart failure dx as it relates to the left side of the heart
by chest x-ray that shows increased pulmonary congestion and L ventricular hypertrophy
How is heartfailure dx for the right side of the heart?
R sided failure shows pulmonary congestion, cardiomegaly and pleural effusions on chest x-ray
What are the interventions for cardiac heart failure?
low-sodium diet, fluid restriction, IABP, O2 therapy, ACE inhibitors
What are the nursing interventions for cardiac failure?
keeping the patient in semi-fowler’s position to increase chest expansion and improve ventilation. Administer O2 to enhance arterial oxygenation. Monitor patient for fluid gain. Plan periods of relaxation for patients with cardiac failure. Restrict fluid intake after two consecutive days of weight gain.
What is DYSRHYTHMIA ? What are the the 4 most common types?
- abnormal electrical conduction or automaticity changes the heart rate and rhythm. The most common arrhythmias include atrial fibrillation, asystole, ventricular fibrillation, and ventricular tachycardia
What are the signs and symptoms for atrial fibrillation
Asymptomatic, Irregular pulse
What are the signs and symptoms of Asystole arrhythmias
Apnea
Cyanosis
No palpable blood pressure Pulselessness
What are the signs and symptoms of ventricular fib arrhythmias
Apnea
Pulselessness
No Palpable blood pressure
What are the signs and symptoms of ventricular tachycardia arrhythmia
Chest Pain
Diaphoresis
Hypotension
Weak pulse
Dizziness
LOC Possible
What 5 EKG changes are noted with Atrial fibrillation arrhythmias
Irregular atrial rhythm
Rate> 400/minute
Uniform QRS complex
Indiscernible PR interval
No P waves
What 4 EKG changes are with Asystole arrhythmias
No rate or rhythm
No P waves
No QRS complex
No T waves
What 3 EKG changes are noted with Ventricular fib arrhythmias
Rapid/chaotic ventricular rhythm

No discernible P’s

Wide/irregular QRS complex
What EKG changes are noted with Ventricular tachy arrhythmias
Ventricular rate 140-220

No discernible P’s

Wide/bizarre QRS complex

Starts/stops suddenly
What are the treaments for Atrial fibrillation arrhythmias
Cardioversion

Pacemaker
What are the treaments for Asystole arrhythmias
Atropine, epi

Resuscitation

Defibrillation
What are the treaments for Ventricular tachy arrhythmias
Antiarrhythmics
What are the treaments for Ventricular fib arrhythmias
Antiarrhythmics

Resuscitation

Defibrillation
What are Ventricular tachy arrhythmias treatments?
Antiarrhythmics

Resuscitation

Cardioversion

Defib implant
What are arrhythmias treatments?
identifying and treating life-threatening arrhythmias (duh!)
What is MI (MYOCARDIAL INFARCTION)?
death to myocardial muscle related to lack of oxygen from inadequate perfusion
What are the signs and symptoms of MI (MYOCARDIAL INFARCTION)?
crushing substernal pain that may radiate to the jaw, back, and arms. It last longer than anginal pain and is unrelieved by rest or nitroglycerin. May also be asymptomatic. diaphoresis, pallor, arrhythmias
What are are the ekg readinging to confirm an MI (Myocardial infration)
EKG: enlarged Q wave, elevated ST segment, T wave inversion.
What dx are used to confirm MI (Myocardial Infraction)
CK, LDH, AST, and positive CK-MB fraction
What may be used used to treat MI (Myocardial Infraction)
beta-adrenergic blockers (propranolol-Inderal, Lopressor) . Thrombolytic therapy includes the use of Streptase, and Eminase
When would beta-adrengeric blocker be contraindicatedfor MI (Myocardial infraction) treatment
contraindicated if patient also has CHF, hypotension or bronchospasm
When would Thrombolytic therapy be contraindicated for MI (Myocardial infraction) treatment
the patient has had recent surgery, or experienced a fall or head wound concurrent with the MI
What would the plan of care for MI (Myocardial Infraction) include?
discussion of the resumption of patient’s sexual activities (based on endurance- ability to climb 2 flights of stairs without pain, sob).
What is VALVULAR HEART DISEASE
mechanical disruption of blood flow through the heart.
What are the three types of VALVULAR HEART DISEASE
Three main types: stenosis-narrowing, incomplete closure of the valve, and prolapse of the valve.
What does Aortic insufficiency result from?
blood flowing back into the left ventricle during diastole (rest), creating fluid overload in the left atrium and pulmonary system
What causes Aortic insufficiency
enocarditis, hypertension, rheumatic fever, and syphilis.
What test are commonly used to dx aortic insufficency and what would they reveal?
Echocardiography shows L ventricular enlargement,

x-ray shows L ventricular enlargement and pulmonary vein congestion
What does Mitral insufficiency result from?
in blood flowing back into the L atrium during systole (squeeze), the atrium enlarges and the ventricle dilates to accommodate the increased volume of blood
What may cause Mitral insufficiency result from?
include L ventricular failure, mitral valve prolapse, and rheumatic fever
What test are used to confirm Mitral insufficiency and what do they show?
Cardiac catheterization shows mitral regurgitation and elevated atrial and pulmonary artery wedge pressures.

X-ray shows L atrial and ventricular enlargement.
What does Mitral stenosis do?
obstructs blood flow from the L atrium to the L ventricle
What may cause Mitral stenosis
rheumatic fever
What test are performed to confirm Mitral stenosis and what would the test show?
cardiac catheterization shows diastolic pressure gradient across the valve and elevated L atrial and pulmonary artery wedge pressures.

Echocardiography shows thickened mitral valve leaflets.

ECG shows L atrial hypertrophy and x-ray shows L atrial and ventricular enlargement.
What is Mitral valve prolapse etiology & the etiology
one or both valve leaflets protruding into the L atriumIt has an unknown etiology
What is a test that confirms Mitral valve prolapse
ECG shows prolapse of the mitral valve into the L atrium
What does Tricuspid insufficiency result in
results in blood flowing back into the R atrium during systole (squeeze). Blood flow to the lungs and L side of the heart is decreased. Fluid overloads in the R side of the heart
What causes Tricuspid insufficiency
Causes include endocarditis, rheumatic fever and trauma
Which test are used to confirm Tricuspid insufficiency and what would they show?
Echocardiography shows systolic prolapse of the tricuspid valve.

ECG shows R atrial or ventricular hypertrophy.

X-ray shows R atrial dilation and R ventricular enlargement.
What test are performed to confirm Tricuspid insufficiency and what would the test show?
Echocardiography shows systolic prolapse of the tricuspid valve.

ECG shows R atrial or ventricular hypertrophy. X-ray shows R atrial dilation and R ventricular enlargement.
Aortic Insufficiency
Angina, Cough, Dysnpea,Fatigue, Palpitations
What are the signs and sympotoms of Tricuspid insufficiency Mitral Insufficiency
Angina, Dysnpea, Fatigue, Orthopnea, peripheral edema
What are the signs and sympotoms of Tricuspid insufficiency Mitral stenosis
dyspnea on exert
fatigue
orthopnea
palpitations
peripheral edema
weakness
What are the signs and sympotoms of Tricuspid insufficiency Mitral valve prolapse
Asymptomatic
Palpitations
Chest Pain
Fatigue
Headache
What are the signs and sympotoms of Tricuspid insufficiency
Dysnpea, Fatigue, Peripheral edema,
What are the Tx for all valvular diseases
surgical replacement of the valves

sodium restriction in cases of heart failure

anticoagulant therapy (Coumadin) to prevent thrombus formation around diseased

replace valves
what are the nursing interventions for patients with valvular diseases?
placing the patient in an upright position to relieve dyspnea, maintain bed rest ect. to decrease oxygen demands on the heart
What is Endocarditis?
infection of the endocardium, heart valves or cardiac prosthesis caused by bacterial or fungal invasion. Vegetative growths form on the heart valves, endocardial lining of the heart chamber, or endothelium of a blood vessel
What are risk factors for Endocarditis?
include coarctation of the aorta, marfan’s syndrome, pulmonary stnosis, tetralogy of fallot and ventricular septal defect
What are the signs and symptoms of Endocarditis
chills, fatigue, loud, regurgitant murmur, malaise, night sweats, weakness, weight loss.
What are test are run to confirm Endocarditis?
EKG may show atrial fibrillation.

Three or more blood cultures identify the causative organism
What are the treaments for Endocarditis
Antibiotics, aspirin and maintaining sufficient fluid intake
What are the nursing interventions for Endocarditis
prevent anaphlaxis ( history of drug allergies before implementing antibiotic), watch for signs of embolization

(hematuria, pleuritic chest pain, LUQ pain and paresis,

monitor renal status (BUN, creatinine clearance and output),

educate patient in need for prophylactic antibiotics before, during and after any invasive procedures (dental work etc.).
What is Myocarditis
focal or diffuse inflammation of the cardiac muscle (middle muscular layer). Can be acute or chronic and occur at any age. Recovery is usually spontaneous, without residual defects
What are the signs and symptoms of Myocarditis
arrhythmias (S3 and S4 gallops, faint S1), dyspnea, fatigue, fever.
What test are done to confirm Myocarditis
EKG shows diffuse ST-segment and T-wave abnormalities, Prolonged PR interval and supraventricular arrhythmias.

Biopsy confirms the diagnosis
What are six treaments for Myocarditis
includes bed rest,

restricted sodium diet,

antiarrhythmics (Pronestyl),

antibiotics,

anticoagulants (Coumadin),

Lanoxin to increase myocardial contractility and diuretics (lasix).
What are the nursing interventions for Myocarditis
watching for signs of Lanoxin toxicity( anorexia, n/v, blurred, vision) and stress the importance of bed rest to decrease oxygen demands on the heart.
Pericarditis
inflammation of the fibroserous sac that envelops, supports and protects the heart
What causes Pericarditis name at least 5
Many varied causes include, bacteria, fungus, virus, radiation, hypersensitivity or autoimmune disease (lupus, rheumatic arthritis), neoplasms, injury, trauma and uremia or none of these at all
What are the signs and symptoms of Pericarditis
Friction rub (grating sound heard as the heart moves)

Sharp sudden pain in the sternum that radiates to the neck, shoulders, back and arms (increasing with deep inspiration and decreasing when the patient sits up and leans forward).
what test confirm and what do they show Pericarditis
echo confirms free space between the ventricular wall and pericardium. EKG- elevated ST segments without significant changes in the QRS.
what is the tx for Pericarditis?
bed rest and possibly surgery depending on symptoms. Drug therapy includes antibiotics, corticosteroids, and NSAIDs
what are the nsg interventions for Pericarditis?
bed rest to decrease oxygen demands on the heart, relieve dyspnea and chest pain by placing the patient in an upright position, reassurance to promote patient comfort and allay anxiety.
What is CARDIOMYOPATHY
increased muscle mass to compensate for flabby L. ventricle, altering cardiac function and resulting in decreased cardiac output
what are the causes of CARDIOMYOPATHY
alcoholism, infection, metabolic and immunologic disorders, pregnancy and postpartum disorders, hypertension, amyloidosis and cancer or other infiltrative disease
what are the signs & symptoms CARDIOMYOPATHY
-murmur (S3, S4), dyspnea, cough, crackles, jugular vein distention, dependent pitting edema, fatigue.
what may indicate CARDIOMYOPATHY
echo indicates L ventricular hypertrophy and nonspecific changes
what are the tx for CARDIOMYOPATHY
beta-adrenergic blockers, calcium channel blockers, diuretics, inotropic drugs (dopamine), anticoagulants
what are nursing interventions for CARDIOMYOPATHY
monitoring for arrhythmias and ischemia, monitor for hypokalemia (s/e of diuretics), monitor respiratory and cardiovascular status for signs of heart failure, administer O2 and meds to improve oxygenation and cardiac output.
what is CARDIOGENIC SHOCK?
heart fails to adequately pump reducing cardiac output and compromising tissue perfusion.

Decreased stroke volume increases back volume in the L ventricle.

Blood from the L ventricle backs up into the lungs creating pulmonary edema.

Compensation for decreased CO is increased heart rate and contractility, increasing the need for O2.

An imbalance between supply of O2 and demand for O2 increase myocardial ischemia further impairing the heart’s pumping action. Causes include MI, heart failure, myocarditis, cardiomyopathy and advanced heart block
What are signs and symptoms of CARDIOGENIC SHOCK
cold, clammy skin, hypotension with a narrow pulse pressure, oliguria (less than 30 ml/hr), S3 and S4 heart sounds, tachycardia, tachypnea, and weak, thready pulse
what would an ekg show for a CARDIOGENIC SHOCK patient?
shows enlarged Q wave, elevated ST segment (MI
Drug treatment for CARDIOGENIC SHOCK includes
adrenergics (epinephrine_, digoxin, dopamine, diuretics, vasodilators (Nitro-press) and vasopressors (norepinephrine
CARDIOGENIC SHOCK
NPO status to reduce risk of aspiration, admminister meds, fluids, oxygen to maximize cardiac, pulmonary and renal fx. Use of IABP
Explain IABP (intra-aortic balloon pump) as it relates to CARDIOGENIC SHOCK
an inflatable balloon is inserted through the femoral artery into the descending aorta. Coronary artery perfusion increases when the aortic valve closes and the balloon inflates during diastole (rest). It deflates during systole (squeeze) to reduce cardiac workload by reducing resistance to ejection.
HYPOVOLEMIC SHOCK is ?
reduced blood volume causes circulatory dysfunction and inadequate tissue perfusion. Without reversal, it can lead to cerebral and renal damage, cardiac arrest and death
What causes HYPOVOLEMIC SHOCK
include blood loss (didn’t we already go over this?), acute pancreatitis, dehydration from excessive perspiration, intestinal obstruction, severe diarrhea, protracted vomiting, inadequate fluid intake and diuresis
HYPOVOLEMIC SHOCK s/s are
- cold, pale, clammy skin, decreased sensorium, hypotension with narrowing pulse pressure, reduce urine output, tachycardia, rapid, shallow respirations
what are used to confirm HYPOVOLEMIC SHOCK
Blood tests (elevated K, serum lactate, BUN , urine specific gravity (greater than 1.020), ABG reveals metabolic acidosis (decreased pH) decreased PO2 and increased PCO2
HYPOVOLEMIC SHOCK tx are
blood and fluid replacement, control of bleeding
what are nsg interventions and special considerations HYPOVOLEMIC SHOCK
spiritual/religious beliefs of Jehovah’s witness to refuse blood transfusions. Interventions include correcting fluid volume deficit, monitoring for adequate urine output, provide emotional support to the patient and his family to help them cope and relieve anxiety.
IRON DEFICIENCY ANEMIA tx is
diet high in iron, fiber, and protein with increased fluids. Avoid teas and coffee which reduce absorption of iron
IRON DEFICIENCY ANEMIA s/s are
pallor, sensitivity to cold, weakness and fatigue. Dx- decreased Hb, HCT, iron
IRON DEFICIENCY ANEMIA nsg interventions are
Increase the intake of vitamin C.

iron injection deep into the muscle using Z-track technique to avoid subQ irritation and discoloration from leaking drug.
PERNICIOUS ANEMIA is
chronic, progressive, macrocytic anemia caused by a deficiency of intrinsic factor which prevents the absorption of dietary vitamin B12. Without intrinsic factor RBCs are defective as they mature
PERNICIOUS ANEMIA s/s are
tingling and paresthesia of hands and feet, weight loss, anorexia, dyspepsia
PERNICIOUS ANEMIA is confirmed by , what do these test reveal
bone marrow aspiration shows increased megaloblasts, few maturing erythrocytes and defective leukocyte matureation. Peripheral blood smear reveals oval, macrocytic, hyperchromic erythroctyes
PERNICIOUS ANEMIA tx is
diet high in iron and protein and restricting highly seasoned or extremely hot foods. Vitamins especially B12 and B6, Vitamin C and folic acid
Provide sn overview of SICLE CELL ANEMIA excluding the dx, tx, s/s and nsg interventions
congenital hematologic disease that causes impaired circulation, chronic ill health and premature death. Exists in African populations and people from Puerto Rico, Turkey, India, the Middle East and the Mediterranean. The RBc are rigid and rough, forming an elongated sickle shape and impairing circulation by “clumping” together. This happens during periods of hypoxia which can be provoked by strenuous exercise, high altitude, unpressurized aircraft, cold and vasoconstrictive drugs
SICLE CELL ANEMIA s/s are
aching bones, jaundice, pallor, tachycardia, family history, frequent infections, joint swelling and leg ulcers, especially on the ankles. Sickle cell crisis is very painful
SICLE CELL ANEMIA may be confirmed vy
decreased RBC, elevated WBC and platelet counts, decreased ESR. Hb electrophoresis shows HbS.
SICLE CELL ANEMIA tx is
iron and folic acid supplements, prevent dehydration and analgesics for pain
SICLE CELL ANEMIA nsg interventions are
during crisis include warm compresses to painful areas, (cold aggravates the condition) maintain bed rest to reduce workload on the heart and to reduce pain, encourages fluid intake to prevent dehydration, which can precipitate a crisis.
DISSEMINATED INTRAVASCULAR COAGULATION (DIC) is
)- complication of diseases and conditions that accelerate clotting. Accelerated clotting process caused depletion of circulating clotting factors and platelets which can provoke severe hemorrhage
DISSEMINATED INTRAVASCULAR COAGULATION (DIC) s/s are
abnormal bleeding without history of serious hemorrhagic disorder, oliguria, shock, sever muscle, back and abdominal pain
DISSEMINATED INTRAVASCULAR COAGULATION (DIC) is confirmed by
prolonged PT greater than 15 seconds, prolonged PTT greater than 60-80 seconds, fibrinogen levels less than 150 mg/dl, platelets less than 100,000/ul, and a positive D-dimer test specific for DIC
DISSEMINATED INTRAVASCULAR COAGULATION nsg interventions and tx are
bedrest and transfusion with fresh frozen plasma, platelets, and packed RBCs. Interventions- complete bed rest protects the patient from injury. Apply pressure to injection sites for at least 10 minutes to prevent hemorrhage. Weight the patient daily to monitor for fluid volume excess. Measure abdominal girth every 4 hours to detect intra-abdominal bleeding.
HEMOPHILIA is
hereditary bleeding disorder affecting only males. Inherited as x-linked recessive traits
HEMOPHILIA s/s are
spontaneous or severe bleeding after minor trauma (excessive bleeding at circumcision), subcutaneous and intramuscular hematomas, prolonged bleeding after major trauma/surgery (up to 8 days), hematuria, joint tenderness, pain and swelling in a weight-bearing joint (hip, knee or ankle), tarry stools
HEMOPHILIA is confirmed by
Factor VIII assay reveals 0-25% of normal factor VIII
HEMOPHILIA tx is
administer cryoprecipitate antihemophilic fact to encourage normal hemostasis. Analgesics to control joint pain.
ALTERNATIVE/COMPLEMENTARY TX for ALTERATION IN COAGULATION
THROMBOCYTOPENIC PURPURA are
interventions could include vitamin E, soy products, oat bran, relaxation therapy, guided imagery, music therapy, garlic and parsley for hypertension.
Briefly explain POLYCYTHEMIA
chronic myeloproliferative disorder characterized by increased RBC mass, leukocytosis, thrombocytosis and increased Hb concentration. Occurs between the ages of 40-60 to male of Jewish ancestry. Mortality is high if untreated
POLYCYTHEMIA s/s are
clubbing of the digits (cystic fibrosis), dizziness, headache, hypertension, ruddy cyanosis of the nose, thrombosis of smaller vessels, visual disturbances (blurring, diplopia, engorged veins of fundus and retina.)
POLYCYTHEMIA tx is
phlebotomy (350-500ml removed every other day until the patient’s HCT is reduced to low-normal), plasmapheresis. Drug tx includes chemotherapy and myelosuppressive drugs and anitgout agents (allopurinol).
POLYCYTHEMIA nsg interventions are
Interventions include administering juice or water to replace fluid volume lost during procedure.
Briefly explain Positive Homan’s sign
The sign is positive (indicative of a problem) if, when the examiner flexes your foot, you feel pain in the calf. A positive Homan's sign helps diagnose deep vein thrombosis.
Buerger-allen exercises
Exercises used to empty engorged vessels, stimulate circulation, and at least partially relieve swelling (oedema) in patients with arterial insufficiency of the lower limbs and feet
What is buerger's Disease
A chronic inflammatory disease of the peripheral vessels forming blood clots that results in reduced blood flow, possible ulceration, and gangrene.
Explain Buerger's Disease as it relates to exercise
Exercise or walking will bring on rapid fatigue, pain, and leg cramps. The feet or hands may turn pale or feel cold. The pain may be increased by exposure to cold, and painful ulcers or gangrene may develop
When Anticoagulant therapy is given what activties should be avoided
Shave With An Electric Razor instead of a disposable.

Use a Toothbrush With Soft Bristles

Any activities that could cause injuries
What foods are high in vitamin K?
green leafy vegetables (spinach, kale), liver