Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/45

Click to flip

45 Cards in this Set

  • Front
  • Back
DOPPLER FLOW STUDIES WITH DUPLEX IMAGING
NONINVASIVE TEST
USES ULTRASOUND TO LISTEN FOR BLD VELOCITY IN THE VEINS
ASSESSES BLD FLOW DISTURBANCES
IMPEDANCE PLYTHYSMOGRAPHY
NONINVASIVE
DETECTS DVT
MEASURES ELECTRICAL RESISITANCE OF BLD TO DETECT CHANGES IN VENOUS VOLUME
DOPPLER FLOW STUDIES WITH DUPLEX IMAGING
NONINVASIVE TEST
USES ULTRASOUND TO LISTEN FOR BLD VELOCITY IN THE VEINS
ASSESSES BLD FLOW DISTURBANCES
CONTRAST VENOGRAPHY
ALSO CALLED: (PHLEBOGRAPHY-VENOGRAM-PHLEBOGRAM)
INVASIVE TEST
*GOLD STANDARD OF DETECTING DVT*
INJECTION OF RADIO-CONTRAST DYE INTO THE VENOUS SYS THROUGH A VEIN IN THE FOOT
-EXAMINES VEINS FOR EVIDENCE OF BLOCKAGE
WHICH TESTS DETECT DVT?
1.DOPPLER FLOW STUDIES W/DUPLEX IMAGING
2.IMPEDANCE PLETHYSMOGRAPHY
3.CONTRAST VENOGRAPHY
WHICH TESTS DETECT PULMONARY EMBOLI?
VENTILATION-PERFUSION SCAN
PULMONARY ANGIOGRAPHY
WHICH TESTS DETECT ARTERIAL THROMBOSIS?
ANGIOGRAPHY
CXR
ABG
ECG
VENTILATION-PERFUSION SCAN
LUNG SCAN
2 PART TEST USED TO DETECT VENTILATION ABNORMALITIES (EMPHYSEMA,TUMORS) AND PERFUSION (VASCULAR ABNORMALITIES)EXP:PULMONARY EMBOLUS)
VENTILATION SCAN (PART 1 OF VENTILATION -PERFUSION SCAN)
CLT BREATHES INHALATION OF AIR MIXED W/ RADIOACTIVE GAS
DELINEATES AREAS OF GAS DISTRIBUTION
PERFUSION SCAN
RADIOACTIVE DYE INJECTED INTRAVENOUSLY
X-RAY PICTURES TAKEN AT INTERVALS TO SEE HOW WELL THE DYE PERFUSED THE PULMONARY VASCULATURE;PERFUSION OF THE LUNGS
VENTILATION-PERFUSION MISMATCH
THE LUNG SCAN IS POSITIVE FOR PULMONARY EMBOLI...WHEN THE VENTILATION SCAN IS NORMAL IN AN AREA WHERE THERE IS DIMINISHED OR ABSENT BLD FLOW DEMONSTRATED ON THE PERFUSION SCAN
PULMONARY ANGIOGRAPHY
**GOLD STANDARD TEST FOR PULMONARY EMBOLI**
INVASIVE TEST
CONTRAST AGENT INJECTED INTO PULMONARY ARTERIAL SYS ALLOW VISUALZATION OF OBSTRUCTION TO BLD FLOW
USED WHEN LUNG SCAN IS NOT DIAGNOSTIC
ANGIOGRAPHY
DYE IS INJECTED INTO VESSELS TO DIAGNOSE ARTERIAL EMBOLI
WHICH TEST IS USED TO MEASURE IMPAIRED GAS EXCHANGE?
ABG
TESTS HYPOXEMIA WITH PULMONARY EMBOLUS
PARTIAL THROMBOPLASTIN TIME (PTT)& ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)
STAGE 1 CLOTTING TEST
USED TO MONITOR HEPARIN DRUG THERAPY
(APTT) IS MORE SPECIFIC
NORMAL PTT:
NORMAL APTT:
PTT IS 30-40 SEC
APTT IS 16-25 SEC
NORMAL PTT:
NORMAL APTT:
PTT IS 30-40 SEC
APTT IS 16-25 SEC
PROTHROMBIN TIME (PROTIME,PT)
MEASURES DEFECTS IN STAGE 2 OF CLOTTING MECHANISM
MONITORS COUMADIN (WARFARIN) DRUG THERAPY
NORMAL PROTHOMBIN TIME (PROTIME,PT)
11-16 SEC
INTERNATIONAL NORMALIZED RATIO (INR)
MEASURE USED TO MONITOR COUMADIN
IF ON COUMADIN TO ANTICOAGULATION DESIRE,THE INR TO BE BETWEEN 2.0 & 3.0
THOMBIN TIME (TT)
MEASURES DEFECTS OF DEFECTS IN STAGE 3 OF THE CLOTTING MECHANISM
**BEST FOR MONITORING THROMBOLYTIC DRUG THERAPY**
NORMAL THROMBIN TIME (TT)
7-12 SEC
WHAT IS THE GOAL OF ANTICOAGULANTS?
TO DELAY CLOTTING TIME
**ANTICOAGULANTS DO NOT DISSOLVE THE CLOT!!!***
AIM IN TXT IS TO REMOVE THROMBUS/EMBOLI
HEPARIN
CLASSIFICATION:ANTICOAGULANT
MECH OF ACTION:INHIBITS PROTHOMBIN TO THROMBIN IN STAGE 1 OF CLOTTING
USE:PREVENTION & TXT OF THROMBOEMBOLIC D/O
SAFE DOSE RANGE:MAINTAIN APTT 2-3 X'S THE PTS BASELINE APTT
ROUTE:PARENTAL,FIRST BOLUS 5,000 UNITS,
THEN CONTINUOUS DRIP TO MAINTAIN BLD LEVELS**GIVEN SUB Q**
(1000 UNITS/HR IV THEN TITRATED TO APTT
ADVSERSE EFFECTS:BLEEDING(ALL PARTS)
ANTAGONIST-PROTAMINE SULFATE IV**
NURSING RESPONSIBILITES FOR HEPARIN
1.OBTAIN APTT AS ORDERED-1ST DRAW IT EVERY 2-4 HRS,LATER EVERY 6 HRS
AND TITRATED IV INFUSION AS ORDERED
IV CONTINUED 5-7 DAYS
2.ASSESS FOR BLEEDING FROM ANY SITE ON BODY**HAVE PROTAMINE SULFATE READY**
COUMADIN (WARFARIN)
ANTICOAGULANT
MECH OF ACTION:ACTS ON LIVER TO INHIBIT SYNTHESIS OF VIT K
USE:LONG TERM TXT OF THROMBOEMBOLIC D/O
SAFE DOSE:MAINTAIN PT 1.5-2 X PTS BASELINE PT....INR 2.0-3.0
ROUTE:ORAL,GIVEN ONCE A DAY
ADV EFFECT:BLEEDING
ANTAGONIST: VIT K
NURSING RESPONSIBILITIES FOR COUMADIN:
1.OBTAIN PT AS ORDERED
EXPECT CLT TO BE ON BOTH HEPARIN & COUMADIN FOR 2-3 DAYS BEFORE STOPPING HEPARIN
2.ASSESS FOR BLEEDING
3.REMIND PT TO GET WEEKLY OR BIWEEKLY PT'S-PT MAY BE ON COUMADIN FOR REST OF LIFE
PT EDUCATION FOR ANTICOAGULANTS:
1.AVOID INJURY
2.USE ELECTRIC RAZOR
3.SOFT TOOTH BRUSH
4.WEAR MEDIC ALERT BRACELET
5.AVOID DRUGS THAT CAUSE BLEEDING(ASPIRIN)**
THROMBOLYTIC THERAPY
DRUGS THAN CAN LYSE AND DISSOLVE CLOT
MUST BE GIVEN W/IN CERTAIN TIME OF THE OCCLUSION
1.DOSAGE BASED OIN THROMBIN TIME
2.SIDE EFFECTS:BLEEDING
3.EXP:STREPTOKINASE,UROKINASE,rtPA
4.ANTAGONIST:AMINOCAPRIC ACID (AMICAR)
RISK FACTORS FOR EMBOLI
1.ARTERIAL:CARIAC DISEASE-ATRIAL FIBRILLATION
VASCULAR
ALTERED BLD COAGULABILITY
2.VENOUS:PULMONARY EMBOLI "VIRCHOWS TRIAD"
STASIS OF BLD "IMMOBILITY"
INJURY TO VESSEL WALL "IV INSERTION"
WHO ARE THE PPL AT RISK FOR AN EMBOLI?
SMOKERS,OBESE
OVER AGE OF 40
MALIGNANCY
PREGNANT,BIRTH CONTROL,PREV HISTORY OF EMBOLI
MAJOR SURGERY
ASSESSMENT FOR ARTERIAL:
S/S
1ST- CHECK PULSE AND COLOR
S/S:ACUTE SEVER PAIN-LACK OF O2,NUMBNESS
LOSS OF DISTAL PULSES
PALE,MOTTLED
LINE OF DEMARCATION
S/S OF SUPERFICIAL THROMBOPHLEBITIS
RED,WARM,TENDER
S/S OF DVT:
1/3 ASYMPTOMATIC
**UNEXPLAINED FEVER**
**CHANGE IN CIRCUMFERENCE OF CALF***
EDEMA,SWELLING,WARMTH,TACHYCARDIA
AS NURSE:SQEEZE CALF TO TEST
LOOK FOR TENDERNESS ON PALPATION
PULMONARY S/S IF MAJOR:
SHARP, STABBING CHEST PAIN
BREATHLESS
CARDIO-RESP ARREST
S/S OF PULMONARY EMBOLUS IF SMALL:
MILD DYSPNEA
MILD PAIN
HEMOPTYSIS
FEVER
TACHYCARDIA
IF PT HAVING CHEST PAIN FROM PULMONARY EMBOLISM...WHAT IS TO BE DONE AS NURSE:
1ST CHECK VS
YOU WILL NOTICE DECREASE IN BP & WHEEZES AND CRACKLES (RALES) IN ASSOCIATED AREA
NURSING DIAGNOSIS FOR PULMONARY EMBOLSIM
1.ALTERED TISSUE PERFUSION:
(PERIPHERAL/CARDIOPULMONARY)
2.INEFFECTIVE BREATHING PATTERN
3.IMPAIRED GAS EXCHANGE (ONLY IF ABG'S CHECKED 1ST !)*
DIAGNOSTIC TEST FOR PULMONARY EMBOLISM
DOPPLER FLOW STUDIES WITH DUPLEX IMAGING
INTERVENTIONS FOR ALL EMBOLI:
1.ANTICOAGULANT THERAPY
2.THROMBOLYTICS
2.BED REST (ARTERIAL-KEEP LEGS DOWN)
EMBOLECTOMY OR BYPASS SURG
(VENOUS-ELEVATE LEGS)
INTERVENTIONS FOR THROMBOPHLEBITIS
1.GIVE WARM PACKS
2.MILD ANALGESICS-TYLENOL
3.ELEVATE LEGS
4.MEASURE CALFS
GIVE:LOVENOX
INTERVENTIONS FOR PE
1.CARDIO RESP SUPPORT
2.VENA CAVA UMBRELLA (MECHANICAL FILTER)
3.GREENFIELD FILTER
PREVENTION OF EMBOLI
1.INCREASE FLUIDS-3,000 CC/DAY
2.LEG EXERCISES
3.ELASTIC STOCKINGS-PUT ON BEFORE GETTING OUT OF BED
PROPHYLACTIC HEPARIN
ADM SQ TO PTS AT RISK
5,000 UNITS SQ EVERY 2 HRS PRE OP
5,000 UNITS SQ EVERY 12 HRS
GIVEN IN ABDOMEN OR THIGH
DO NOT MASSAGE**
WHAT ARE OTHER MEDS GIVEN FOR EMBOLI
1.LOVENOX (ENOXAPRIN)-LOW MOLECULAR WT HEPARIN
SUPPRESSES PLATELET AGGREGATION
2.ASA-1 EVERY DAY
DECREAES PLATELET AGGREGATION
3.DIPYRIDAMOLE-PERSANTINE
4.COUGH & DEEP BREATH 10X Q HR