Exam 1 chapter 20 Flashcards Preview

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Flashcards in Exam 1 chapter 20 Deck (46)
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1

predisposing factors to DVT

previous DVT
smoking
contraceptive
age
cardiovascular disorder
weight
gender

2

what is are the 3 stages of Virchow's Tried

stasis of blood
vessel wall injury
altered coagulation

3

Nursing assessment for DVT

edema-bilateral baseline limb girth
skin temperature-warm
pain
color
pyrexia
pulse

4

therapeutic intervention for DVT

increase fluids
early mobilization
ROM
bed rest
planter and dorsiflexion
ambulate
meals

5

Elastic compression stockings (TED hose)

increase venous return
risk-low
mod/high with anticoagulants
apply correctly with band, wrinkles, size

Patient teaching: don't roll down, don't cut
off for an 1 per shift

6

what is the antidote for warfarin (coumadin)

Vitamin K

7

hgb

12-18

8

HCT

38-54%

9

RBC

4-6

10

platelet count

150,000-400,000

11

WBC

5-10

12

if neutrophils increase and lymphocytes decrease...

shift to the left
bacterial infection

13

if lymphocytes increase and neutrophils decrease

shift to the right
viral infection

14

dehiscence and evisceration can happen POD

5-6
wound infection
abdominal distention
edges part slowly with extravasation of pink serous fluid

15

Interventions for evisceration

cover with saline
increase IV
monitor for shock-stay with patient
call Dr

16

what is the antidote for heparin

protamine sulfate

17

anticoagulant therapy for DVT

heparin
LMWH - fragmin, lovenox
xarelto (rivaroxaban)

18

what are the site for heparin and LMWH

abdomen
iliac crest

19

subcutaneous injection of LMWH-Fragmin, Lovenox

keep air bubble
sites abdomen or iliac crest
DO NOT aspirate
hold skin fold during injection
DO NOT rub site

20

when giving heparin subcutaneously

abdomen or iliac crest
rotate sites
DO NOT aspirate
hold skin fold during injection
DO NOT rub site

21

what is are the therapeutic effects of LMWH

no lab measurements required
fixed doses per weight (1 mg/kg)

22

therapeutic effects of heparin

PTT normal 24-36 sec, therapeutic 46-70 sec
ACT normal 80-135 sec, therapeutic 3 min

23

what are the therapeutic effects of warfarin (Coumadin)

INR daily
normal .75-1.25, therapeutic 2-3

levels take 48-72 hours (3-5 days)

24

drug interactions with warfarin

barbiturates (phenobarb)
NSAIDS
dilantin
herbal supplements
food-green leafy vegetables

25

defining characteristics of pulmonary emboli

sudden sharp chest pain
extreme apprehension
intense hyperventilation
intense dyspnea
cough
hemoptysis
decrease PO2
increase CO2

26

Packed RBCs (PRBC)

prepared from whole blood
1 unit =250-300 ml
less risk of fluid overload
increase RBC mass

for anemia, platelets not functional

27

Frozen RBCs

prepared from RBCs
Can be stored for 10 years
after thawing use within 24 hrs
used in autotransfusion

28

Platelets

prepared from whole blood
1 unit =30-60 ml
used for bleeding disorders

29

Fresh Frozen plasma

liquid portion of whole blood
1 L = 200-250 ml
rich in clotting factors
no platelets
used for bleeding disorders, low Vit K
use 2 hrs after thawing

30

Albumin

prepared from plasma
cause water shift from extravascular to intravascular space
used to tx hypovolemic shock
used for someone with low BP and edema
increase BP and decrease edema
hypoalbuminemia