Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
168 Cards in this Set
- Front
- Back
|
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
|
