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55 Cards in this Set
- Front
- Back
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what is an oral anticoagulant
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coumadin
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What is some parenteral anticoagulants
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heparin, lovenox,
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what are oral antiplatelet agents
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aspirin, clopidogrel (Plavix), and dipyridamole (Persantine, Aggranox-includes aspirin)
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name a blood viscosity reducing agent
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pentoxifylline (Trental)
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what is an antidoe for heparin
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Protamine Sulfate
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what is an antidote for Warfarin
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Vitamin K
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does heparin dissolve clots
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no. it prevents their formation. It prevents thrombin from converting fibrinogen to fibrin.
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What is a therapeutic value for heparin?
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normal level aPTT is 20-36 seconds. Therapeutic is up to 2.5 times normal
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What is a therapeutic value for coumadin?
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normal level Pt is 11-13, Therapuetic is 1.5 - 2 time. Over 20 needs to be looked at.
INR is 2-3 |
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what is the main adverse side effect of antiplatelet meds
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GI bleeding, bruising, hematuria, tarry stolls.
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What are interventions for antiplatlet meds?
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determine sensitivity before admin. VS, take w/food if GI upset. Monitor bleeding time, monitor for side effects of bleeding.
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What is HIT or HAT
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heparin induced thrombocytopenia. May develop on 8th day of therapy. May reduce platelet cout to 5,000
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what is an antidote for Warfarin
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Vitamin K
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does heparin dissolve clots
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no. it prevents their formation. It prevents thrombin from converting fibrinogen to fibrin.
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What is a therapeutic value for heparin?
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normal level aPTT is 20-36 seconds. Therapeutic is up to 2.5 times normal
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What is a therapeutic value for coumadin?
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normal level Pt is 11-13, Therapuetic is 1.5 - 2 time. Over 20 needs to be looked at.
INR is 2-3 |
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what is the main adverse side effect of antiplatelet meds
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GI bleeding, bruising, hematuria, tarry stolls.
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What are interventions for antiplatlet meds?
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determine sensitivity before admin. VS, take w/food if GI upset. Monitor bleeding time, monitor for side effects of bleeding.
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What is HIT or HAT
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heparin induced thrombocytopenia. May develop on 8th day of therapy. May reduce platelet cout to 5,000
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Name 3 arterial Disorders
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arteriosclerosis - arteries,
Atherosclerosis - intema of large and medium arteries-lipid accumulation, Plaque or atheromas-injuries |
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What are 2 types of atheroscleroitc lesions?
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Fatty streaks, fibrous plaque
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What is collateral circulation
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growing more blood vessels around the structure involved.
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What is the pathophysiology of atherosclerosis?
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Due to damage of vessal walls (vascular endothelial cell injury), caused by sheering stresses and turbulent flow, there is injury to the endothelium.
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What are high risk factors for an arterial disorder?
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smoking
high fat diet HTN lifestyle, exercise, hereditary factors Diabetes Hyperlipidemia |
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What are medical treatments for Arterial disorders
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Angioplasty PTA
Vascular stents - balloon no femoral artery, blown up, backed out. Can go to leg, kidney, lung... Surgery Pharmacological Mgt - Aspirin, coumadin, heparin, Plavix, Trental |
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What are the main nursing diagnosis for arterial disorders?
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Alteration of peripheral tissue perfusion,
pain risk for impaired skin integrity knowledge deficit |
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Nursing interventions for arterial disorders?
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applicaiton of warmth (cautiously)
instruct pt to avoid the cold smoking cessation emotional support avoid constrictive clothing relief of pain avoid trauma to extremities nutrition - lower cholesterol, increase protein |
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What are s/s of intermittent claudication?
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The classic symptoms are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms start during exercise and go away after several minutes of rest
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what is intermittent claudication? Claudication means limp in Latin.
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a narrowing or blockage in the main artery taking blood to the leg due to hardening of the arteries (atherosclerosis).
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What is a bruit, a thrill?
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Bruit is the sound made over a narrowing. The thrill is the feel of the turbulence.
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What are medical/surgical managements for peripheral arterial occlusive diseases?
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exercise - start slow in increaseing levels
wt reduction smoking cessation Vascular grafting -anastomosis (articical of one of their own) endarterectomy - cleaning out femoral/popliteal graft - own autogolous graft beset Amputation. |
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Nursing interventions Post-Op
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pulse and circulation checks q 15/hr, 30/hr, then q hr/24hrs.
Check Distal Circulation! doppler signal checks at least q 2 hrs notify sugeon immediately if there is a loss of pulse, change in color (pale) or temp (cold) bleeding, dressing & incision BP mgmt - not too low or high Pain mgmt |
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What is Thromboangitis Obliterans or Buerger's disease
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recurring inflammation of the intermediate and small arteries
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s/s of buerger's disease
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pain, cold sensitivity, digital rest pain constantly present, rubur (reddish-blue discoloration of the feet)
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what is the treatment for buerger's disease?
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same as atheroscleroitic peripheral disease.
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What are aortitis & aortoliliac diseases?
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Inflammation of the aorta
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What is an aortic Aneurysm
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localized sac or dilation involving an artery formed at a weak point in the vessel wall
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who does the aortic aneuysm most often affect? What part of the Aorta and how many die?
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Men 40-70, the Thoracic segment, and 1/3 die from rupture
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what are the s/s of aortic aneurysm?
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pain - constant and boring to back
dyspnea, hoarseness, loss of voice from presssure of the sac against trachea, main bronchus or lung. Pulsatile mass of the abdomen |
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signs of impending rupture of aortic aneurysm includes...
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severe back or abdominal pain
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Nursing considerations for an aortic aneurysm
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Don't palpatate if your patient has this. You can hear a systolic bruit over the mass. The aneurysm will be reassessed q 6 months if it is 5-7 cm.
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What are the signs of a dissecting Aorta
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Onset of severe, unrelenting pain not relieved w/anything
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s/s of dissecting aorta
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pt will show signs of shock
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diagnostic of dissecting aorta
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angiogram, ct scan, transesophageal echocardiography, duplex ultrasound, MRI
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Medical treatment for Arterial embolism
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embolectomy - stent to pull clot out
Thrombolytic therapy - to dissolve clot. Can't use if pt had surgery in past 6 months. |
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What are the 5 Ps or symptoms of an Arterial Embolism?
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pain, pallor, pulselessness, parethesia, and paralysis
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What are risk factors for getting an arterial embolism?
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artrial fibrillation (should be on an anticoagulant), trauma - DIC, crush injury
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What is a medical management for Arterial embolism or thrombosis?
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heparin therapy w/ inital bolus of 5000 to 10,000 units followed by continuous drip at 1000 units per hr. aPTT. Heparin prevents further clotting
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What is raynaud's disease/
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intermittent arteriolar vasoconstriction due to stress or cold.
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s/s of raynaud's disease
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coldness, pain, pallor of the fingertips, toes, ears
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who does raynaud's disease most commonly occur in?
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women 16-40 years old
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mgmt of Raynauds disease includes?
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avoid cold, smoking.
Calcium Channel blockers. Use hot mits to get ice trays |
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Venous disorders can cause?
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thrombophlebitis, DVT, leg ulcers, varicose veins.
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Treatment for venous disorders?
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exercise, anticoagulant therapy - coumadin
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What lab tests will be ordered to monitor therapy for DVT?
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CBC Coagulation panel, aPTT, D-Dimer
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