Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Cardio 5
OLOL N130 cardio 5
| Question | Answer |
|---|---|
| What is an example of Thrombophlebitis? | Deep vein Thrombosis (DVT) |
| What are examples of Chronic Venous Insufficiency? | Varicose veins and venous ulcers |
| A failure of the valves of the veins to function, which interferes with venous return to the heart, and may produce edema. | Venous Insufficiency |
| Inflammation of a vein in conjunction with the formation of a thrombus. It usually occurs in an extremity, most frequently a leg | thrombophlebitis |
| What are two disorders of the veins? | Thrombophlebitis and Chronic Venous Insufficiency |
| An abnormal accumulation of tissue fluid (potential lymph) in the interstitial spaces. | Lymphedema |
| Inflammation of lymph vessels | lymphangiitis |
| What are two Lymphatic disorders? | Lymphedema and Lymphangitis |
| Describe superficial veins | thick walled and just under the skin |
| Describe deep veins | thin-walled and deeper, they run parallel with arteries |
| What type of veins have valves that permit unidirectional flow back to the heart? | Both Superficial and Deep veins |
| What is inflammation of the vein walls? | Thrombophlebitis |
| What is DVT? | A thrombus(clot) usually in the lower extremites, but can be in arms ( usually in the calf) |
| What is a Thrombus? | A blood clot that adheres to the wall of a blood vessel or organ. |
| What causes DVT and Thrombophlebitis? | Virchows triad.. Stasis of blood, vessel wall injury, and altered blood coagulation |
| What are clinical manifestations of deep veins? | Edema & swelling of the extremity, cynosis, affected extremity feels warm, superficial veins may appeaar more prominent, pain, tenderness, fever, chills, malaise, positive homans sign |
| What are clinical manifestations of superficial veins? | pain or tenderness, redness, warmth, induration, breaking off as emboli, very low, most of them dissolve spontaneously |
| What is more of phlebitis that you see with IV infiltration? | Superfical veins |
| What are the risk factors for DVT? | Pt. with Hx of varicose veins, hypercoagulation, neoplastic disease, cardiovascular disease, recent major surgery/injury. obese,elderly,oral contraceptives, prolonged bedrest, trauma, paralysis, childbirth, long air flights |
| People with cancer are at high risk for what? | Clots |
| What measures should one take to prevent DVT? | Elastic compression stockings (TED ), intermittent pneumatic compression devices, frequesnt position changes, active and passive leg exercises, and in surgical pts, subcutaneous unfractionated or low molecular weight heparin, early ambulation after surger |
| What do you use to prevent DVT in surgical patients? | Subcutaneous unfrationated or low molecular weight heparin |
| What drugs are used to manage DVT? | Anticoagulants and Thrombolytics |
| What Anticoagulants are used to manage DVT? | Unfractionated heparin Subcutaneous, IV---intermittent or continuous ( 5 to 7 days) and Low molecular weight heparin subcutaneous one or two injections a day also Warfarin(coumadin) |
| What do you monitor when a patient is on Anticoagulant thearapy? | PTT, PT, INR, platelet count |
| What do you monitor for a pt on Coumadin? | PT and INR |
| What lab do you monitor for a pt. on continous heparin IV/electric pump? | PTT, PT, INR, platelet count, H&H |
| Thrombolytic therapy is used for pts with DVT to do what? | dissolve the clot |
| When anticoagulant or thrombolytic therapy is contraindicated, danger of pulmonary emoblisms is extreme, venous drainage so compromised permanent damage can occur, what is the option then for DVT?> | Surgical Management |
| What is the intial way to manage DVT? | Bedrest |
| After an acute episode of DVT subsides, pts may begin to walk while wearing what? | Antiembolism stockings and they should be applied before getting out of bed |
| What are some ways to manage DVT? | bedrest,elevation of the affected arm or leg, warm/moist soaks to affected area, analgesics as ordered, antiembolism stockings, in superficial thrombophlebitis may include anti-inflammatory drug |
| For Superficial thrombophlebitis what medical management might be used? | Anti-inflammatory drug |
| What are some s&s of complications the nurse should monitor a pt on anticoagulant thearapy for? | bleeding, early signs brusing, nosebleeds, & bleeding gums/ hematuria, vital sign change, LOC change, |
| What is usually the first sign of anticoagulant complications? | hematuria (blood in the urine) |
| What is the heparin antidote? | protamine sulfate |
| What is the coumadin antidote? | vitamin K, fresh frozen plazma |
| What is Thrombocytopenia? | decreased platelets |
| What should you watch for with heparin therapy? | Thrombocytopenia (decreased platelets) <100,000/ml decreases 25% at one time |
| What are some nursing interventions for anticogulant therapy? | bedrest, elevation of the affected extremity, elastic compression stockings and analgesics, deep breathing exercises, |
| When on anticoagulant therapy what should be used when ambulation is allowed? | elastic compression stockings |
| When a pt. is on anticoagulant thearpy and is on bedrest, these things should be done | elevate the feet and lower the legs periodically above the level of the heart, active and passive exercises |
| Why should a pt. on anticoagulant thearpy do deep breathing exercises? | to produce negative pressure in the thorax which will assist in emptying the large veins |
| When a pt. is on anticoagulant therapy and is ambulating what should the nurse teach the pt.? | teach to avoid sitting greater than two hours at a time, walk 10 minutes q 1 to 2 hrs |
| What should the nurse be alert for in pt.s that have DVT? | Pulmonary embolism, watch for gasping for breath |
| What helps relieve pain and inflammation for a person on anticoagulant therapy other than Meds? | warm compresses as ordered |
| How often should the circumference of the affected arm or leg be measured when a pt has DVT? | daily, mark on skin for consistency |
| What are varicose veins? | abnormally dilated, tortuous, superficial veins caused by incompetent venous valves and most common in the lower legs |
| What are the s&s of varicose veins? | can have no symptoms but the apperance of dilated veins, dull aches, muscle cramps & increased muscle fatigue in the lower legs, may have ankle edema & a feeling of heaviness of the legs nocturnal cramps, may develop chronic venous insufficiency |
| What is a person with varcose veins susceptibile to? | suseceptibility to injury and infection is increased |
| When a person develops chronic venous insufficiency what do you see? | edema, pain, pigmentation, and ulcerations |
| When a pt. has chronic venous insufficiency why may the pulse be hard to find? | edema |
| What are the s & s of chronic venous insufficiency? | Pain(aching and cramping), pulses (present, but hard to find due to edema), skin (pigmentatin in area of medial and lateral malleous (bone side of ankle) skin), skin thick and tough,reddish blue, possible dermatitis |
| What is dermatitis? | Inflammation of the skin |
| When vessels rupture in chronic venous insufficiency what happens? | RBC breakdown and cause brownish discoloration |
| Where is an ulcer usually located in Chronic venous insufficiency? | medial mlleoulus, infrequently lateral malleolus or anterior tibial area. |
| What are ulcers like on a person with chronic venous insufficiency? | minimal pain if superficial or may be very painful, superficial depth, irregular shape, base is granulation tissue BEEFY RED TO YELLOW fibrinous, leg edema may be present ( moderate to severe) |
| What are the two diagnostic test for chronic venous insufficiency? | Duplex ultrasound and Venography (dye) |
| What diagnostic test identifies reduced blood flow to a specific area and any obstruction to venous flow? | Duplex ultrasound, used in chronic venous insufficiency |
| What diagnostic test shows filling defects and diverted blood flow? | Venography (dye) |
| managed? | ligation and stripping |
| What is sclerotherapy? | Treatment, as for varicose veins, involving the injection of a sclerosing solution into vessels or tissues. Hardens vessels so they don't get as engorged. |
| What should the nurse teach the pt after sclerotherapy>? | Bed rest x24 hours, then ambulation q 2 hrs for 5 to 10 minutes, use elastic compression stockings(worn continously for about a week after striping), keep foot of bed elevated, leg exercises, use analgesics, watch dressing for bleeding (esp. at groin) |
| 24 hours after sclerotherapy how often should the pt ambulate? | q 2hr for 5 to 10 minutes |
| after sclerotherapy how long should a pt wear elastic compression stockings? | continuously for about one week after striping. |
| After sclerotherapy where should the nurse monitor for bleeding? | Monitor dressing for bleeding, esp. in the groin |
| After sclerotherapy why should the nurse monitor for pins and needles and hypersensitivity to touch? | because it could indicate possible nerve damage |
| How long after sclerotherapy may a pt shower and what are the instruction the nurse should teach the pt about showering. | may shower after 24 hrs, pat dry, no lotion |
| What procedure may cause the pt to have burning sensation for 1 to 2 days and what should the nurse encourage for this pt.? | after sclerotherapy and the nurse should encourage mild analgesic |
| Evacuation of the skin surface that occurs when inflamed necrotic tissue sloughs off | Leg Ulcers |
| 75% of leg ulcers result form | chronic venous insufficiency |
| 20% of leg ulcers result from | arterial insufficiency |
| 5% of leg ulcers result from | burns, sickle cell anemia, and other factors |
| If arterial you'll see | more around toes, none to minimal edema, thick ridgid toes, redness, pale shinny skin, ulcer- can't get o2 down, better to hang legs off side of bed |
| If venous you'll see | brown pigment, ulcer, pitting edema, can't get o2 back up, elevation of the leg best. |
| How do you clean a leg ulcer? | keep clean of drainage and necrotic tissue by flushing with SALINE or if unsuccessful, debridement may be neccessary |
| What is debridment? | sharp surgical management, wet to dry saline gauze dsg, be sure to manage pain prior to changing drsg, painful. use exzymatic ointment( covered with saline soaked gauze that has benn thoroughly wrung out-then dry gauze. |
| With wound dressings for leg ulcers what should a nurse do? | Make sure to keep ulcer clean and moist. |
| What are nursing diagnosis for leg ulcers? | Impaired skin inegrity r/t vascular insufficiency, Impaired Physical mobility r/t activity, Imbalanced nutrition : less than body requirements r/t increased need for nutrients that promote wound healing |
| What are problems and potiential complications of leg ulcers? | Infection and Gangrene |
| What are nursing interventions for venous insufficiency, leg ulcers? | keep area clean, elevate the affected lower extremity, avoid trauma, avoid heating pads, hotwater bottles, or hot baths, gloat heels, bed cradle, activity restricted at first then gradual increase, diet high in protein, vit. C, A, iron and zinc |
| Why should a pt with chronic venous insufficiency eat a diet high in protein, vitamin C,A, iron and zinc? | To encourage wound healing |
| When tissue swelling occurs in the extremities because of an increased quantity of lymph that results from obstruction of lymphatic vessels occurs what is it called? | Lymphedema |
| Primary Lymphedema is conginital and is usually found in women of what age? | between 15 and 25 years |
| Secondary Lympedema ( aquired obstructions) are found in which extremites after which procedures? | arm after axillary node dissection (breast cancer), leg after chronic lymphagitis, varicose veins, or chronic thrombophlebitis |
| In Lymphedema what is the edema like initally? | soft, pitting, and relieved by treatment |
| s Lymphedema progresses what happens? | edema becomes firm, nonpitting, and unresponsive to treatment |
| What are some side effects of Lymphedema | Can have acute infection, fever, chills, residual edema |
| Lymphedema can progress to chronic fibrosis, thickening of the subcutaneous tissue and what? | Hypertrophy of the skin |
| If Lymphedema is chronic what can happen? | Swelling recedes only slightly with elevation- elephantiasis |
| How do you treat Lympedema? | active and passive exercises, external compression devices, elastic hose when ambulatory, when leg affected(bed rest & evaluation) possible diuretic antibiotic, surgical |
| What happens in surgery for lympedema? | removing affected skin and skin grafting, surgical relocation of superficial lymphatic vessels into the deep lymphatic system by means of a buried dermal flap. |
| After Lymphedema surgery what should the nurse monitor for and do? | monitor and manage skin grafts and flaps, administer antibiotics, constant elevation of the affected extermity, monitor for complications, infection |
Created by:
4LSUFootball
Popular Nursing sets