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anticoagulation
| Term | Definition |
|---|---|
| hemostasis | A physiologic process by which bleeding is stopped Formation of a platelet plug Followed by; reinforcement of the platelet plug through the formation with fibrin |
| thrombus | a blood clot formed within a blood vessel or within the heart clot becomes mobile |
| arterial thrombus | Damage to the vessel wall or rupture of an atherosclerotic plaque Localized damage related to occlusion at the site of injury Clot forms in the left atrium from atrial fibrillation |
| venous thrombus | Develop where blood flow is slow Long tail develops that can break off and produce an embolus Frequently becomes lodged in the pulmonary arteries |
| risk for thrombus | virchow's triad: Hypercoagulation states (blood components) Vascular Wall Injury (the vessel wall) Circulatory Stasis (decreased blood flow) |
| hypercoagulable state | malignancy pregnancy and peri partum period estrogen therapy trauma or surgery of lower extremity, hip, abdomen or pelvis IBD nephrotic syndrome sepsis thrombophilia |
| vascular wall injury | trauma or surgery venipuncture chemical irritation heart valve disease or replacement atherosclerosis indwelling catheters |
| circulatory stasis | a fib, LVD immobility venous insufficiency or varicose veins venous obstruction from tumor, obesity or pregnancy |
| peripheral artery disease | decreased or absent pulses cap refill >3 secs edema: absent unless leg in dependent position loss of hai Ron legs, feet, toes pain with walking nails thickened skin color is dependent rubber, pallor is thin, shiny, taut, cool, temp |
| venous disease | pulses present but may be difficult w/ edema cap refill <3 sec lower leg edema hair present or absent dull ache or heaviness pain nails normal or thickened bronze-brown pigmentation skin thick and hardened, warm , no temp gradient |
| anticoagulation uses | Treat VTE Prevent VTE Pulmonary embolus CVA MI A-fib Prevention of clots after orthopedic surgery Valve prophylaxis Open heart surgery Dialysis Disseminated Intravascular Coagulation (DIC) |
| s/s of venous clot | swelling in affected limb, usually unilateral, venous clot (pain, tenderness, may be no skin color change) |
| Greenfield filter | Sometimes it's temporary Sits in inferior vena cava and it catches blood clots that would go from the legs and try to get to the lungs Watch for chest pain, SOB (PE), if this happens rule out its not a Mi so get a 12 lead |
| clot in coronary artery | the plaque develops and then the plaque ruptures; will be on antiplatelets if they had a stent |
| clot in appendage from fib | Appendage in left atrium and that’s where blood clots form in afib; in and out of afib; clot can go to brain and cause stroke |
| clot in peripheral artery | 100% blockage = emergency and need surgery; doppler if no pedal pulse |
| diagnosis | venous doppers for DVT Angiography of affected extremity or organ (Arterial Thrombus) Ultrasound MRI of arm or leg CT w/ contrast (gold standard to detect pulmonary embolism) VQ scan for PE (if CT not available) |
| anti platelet drugs | Inhibit platelet aggregation Inhibits thrombus formation |
Created by:
garcia2104
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