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
T1 exam 5
PVD Disorders
| Question | Answer |
|---|---|
| What is a disorder involving a thrombus in a deep vein causing inflammation and obstruction? | Deep Vein Thrombosis (DVT) |
| Where is a DVT most commonly found? | Most common in iliac, femoral, popliteal and veins of the calf |
| What are some causes/risk factors of DVT? | Surgical complication, trauma and some medical conditions |
| Why are DVT's more common then Arterial clots? | Because of the lower pressure in our veins |
| What are the three parts of Virchow's triad? | Venous stasis, Endothelial damage and hypercoagulability |
| What is VTE protocol ? (venous thrombosis embolus protocol)? | Prophylaxis to keep clots from forming. Or used to decrease the risk of embolism. |
| What is venous stasis? | Decreased blood flow |
| What is hypercoagulability? | It is increased clotting |
| What factors can cause hypercoagulability. | Dehydration, cancer, OCP, pregnancy/post-partum/Can also be congenital |
| What is endothelial damage? | Damage to blood vessles/the endothelium prevents platelet adhesion until it's damaged |
| What are some factors that can cause endothelial damage? | SMOKING, Diabetes, hypertension, catheters, IV's |
| What causes venous stasis? | Immobility/obesity/Surgery/Pregnancy/anything that interferes with mobility |
| Can a patient with a DVT be asymptomatic? | Yes |
| What are some clinical manifestations of DVT's? | Dull, aching pain in affected extremity/ Tenderness/Edema (unilateral)/Warmth/Erythema (redness) |
| What diagnostic labs can we do for patients who are at risk or that have a dvt already? | D-Dimer/Coagulation studies/Platelet count/HGB and HCT |
| If the D-dimer is negative, what might that indicate? | Indicates that they do not have any clot formation anywhere. |
| What test do they monitor if a patient is on coumadin? What is their therapeutic level? | Monitor PT/INR tells if dose is therapeutic/ INR levels between 2-3/The higher the number-the longer it takes to clot |
| What is the normal platelet count? *** | Greater than 150,000-450,000 platelets per microliter of blood |
| What does a higher HGB and HCT? *** | Blood may be more viscous and thicker. The patient is at higher risk for developing a blood clot |
| What does a venous compression ultrasound? | Puts pressure on the vein to collapse it to stop the flow of blood |
| What diagnostic study for DVT is very painful and not really used anymore? | Ascending contrast venography |
| What study for DVT tells us the exact location of a clot? | color flow duplex venous ultrasonography # 1 test |
| CT and MRI venography do what......... | MAP the VEINS |
| What are some mechanical prevention measures? | Early mobilizations/Leg exercises (as allowed based on their surgery)/Ted hose/SCD (moon boots) |
| What is the problem you may have with TED hose? | If they roll at the top they may act as a tourniquet. |
| Can you place SCD's over an area with a known DVT? | No this can cause the dvt to break off and turn into a pulmonary embolism |
| If someone has arterial disease, should they have SCD's used? | No, they already have decreased blood flow to that area, and you don't want to put any more pressure making it worse. |
| What are some pharmacological preventions? | Prophylactic anticoagulation/ anticoagulation for dvt |
| Pharmacological management of DVT's with Unfractionated Heparin | typically, Bolus dose 5,000 units IV or sub-q for prophylactic/Continuous IV fusion for treatment/ Dose for IV infusion based on weight/Aptt or antifactor XA tells us how the therapy is working/ Has a risk of bleeding and we need to watch their platelets. |
| Pharmacological management of DVT with low molecular weight heparin. | Lovenox or Dalteparin/Less risk of bleeding/ Do not have to monitor labs like with heparin/Leave the air bubble in the pre-filled syringe to prevent bleeding. |
| Pharmacological management of DVT with Warfarin. | Long term anticoagulation/1-10mg per day/used for 3-6 months/started at the same time as heparin because it takes 3-5 days to become therapeutic/therapeutic levels based on INR/Risk of bleeding/No high-risk sport or activity/ avoid vitamin K rich foods |
| Pharmacological management of DVT with Factor XA inhibitors | Less monitoring/NON-REVERSABLE/Increased risk of bleeding/Rivaroxaban or apixaban/ |
| Why should someone on coumadin monitor, but not necessarily change the amount of green leafy vegetables they eat? | Watch green leafy vegetables, don't change them by increasing or stopping quickly this may change their therapeutic levels |
| What is an example of a direct thrombin inhibitor? | Dabigatran/Increased risk of bleeding |
| What are thrombolytics? | Meds that dissolve the clot/ Streptokinase, urokinase, TPA/Strict criteria for use/HIGH risk of bleeding/hemorrhage (IV) |
| What are some criteria for the use of TPA? | No head trauma/No prior stroke < 3 months/ symptoms <3 hours before beginning treatment/No blood thinners/Systolic pressure <180/No surgery past 3 months/No brain mass/Vitals q 15min nurse bedside whole time they are infused. |
| What is a Percutaneous mechanical thrombectomy? | Go in and retrieve the clot and remove it/Prevents it from becoming embolus |
| Why do you use a manual BP on someone who is on blood thinners? | Better control of pressure/Automated may cause bleeding |
| What is an Inferior Vena Cava Interruption device? | IVC filter/Placed via the femoral vein/Acts as a catchers mitt for blood clots/good for 6months to 1 year |
| How does a balloon angioplasty work? | widens the vein after clot is dissolved/ widens the vein because of endothelial damage to prevents clots form forming in that same area. |
| Nursing assessment for DVT (History) | Presence of risk factors/Presence of symptoms |
| Nursing assessment for DVT (physical examination) | Monitor VS/Assess and compare extremities/Measure edema/Assess for bleeding if on anticoagulants |
| Nursing interventions for DVT | Assess /monitor peripheral effusion/Pain management (may show that clot has moved /Activity/Warm heat increases blood flow/Complications (Pulmonary embolism) *** |
| What is chronic venous insufficiency? | Inadequate venous return over a prolonged period of time. |
| What is the number one cause of CVI? | Deep vein thrombosis/Other causes are varicose veins or leg trauma/May occur without an identified cause |
| What is the pathophysiology of CVI? | Distended, Valves damaged, unable to close correctly/Venous stasis and increased venous pressure occur/This pushes fluid into the tissues causing EDEMA. |
| What can edema impair? | Edema can impair arterial circulation, and prevent nutrients and 02 from reaching tissues |
| What can venous stasis and increased venous pressure cause? | It can push the fluids into the tissues causing EDEMA. |
| Wastes that are unable to be cleared away causing dermatitis can lead to ? | Venus ulcer formation. |
| Manifestations of CVI? | Lower leg edema/Itching fragile skin/Discomfort W/ effected extremity with prolonged standing/Cyanosis or brown pigmentation of lower leg or foot/Weeping dermatitis/Thick, hard fibrous sub q tissue/Recurrent stasis ulcers |
| Manifestations of recurrent stasis ulcers consist of? | Superficial/usually over medial or anterior ankle/Minimally painful/Pink (because they still get blood supply/Uneven edges |
| Is there a specific test to use when testing for CVI? | No tests /History and physical are important since DVT is a major risk factor |
| What is the collaborative care for cvi based on? | Relieving symptoms/Promoting adequate circulation/Healing/preventing tissue damage |
| How can you promote adequate circulation with CVI? | Graduated compression hose/Elevate legs and feet at night and several times a day. |
| What do compression stockings do for a patient with CVI? | It helps get blood out of tissue, back into circulation and back up to the heart. |
| What are varicose veins? | Irregular, tortuous veins with incompetent valves. AKA as "varicosities" |
| What causes varicose veins? | Increased venous pressure due to standing. |
| Where in the body do varicose veins usually affect? | Usually affect veins of the lower extremities. Saphenous vein |
| What does a Color duplex doppler ultrasound look for. | Identify if there is any valve reflux in the vessel. |
| What can the Trendelenburg test tell a doctor about a patient? | It can Identify if there is venous stasis and if so, how much. |
| What are complications of varicose veins? | Venous insufficiency/Stasis ulcers/Chronis stasis dermatitis/Superficial venous thrombosis. |
| What is chronic stasis dermatitis? | Thickened, Hard, firm skin of lower extremities. (this develops into venous stasis ulcers) |
| What are some conservative measures to treat varicose veins? | Compression stockings/Daily walking/ Avoiding prolonged sitting/elevating legs frequently during the day |
| What is Compression sclerotherapy? | This is a treatment for varicose veins, it's done for small varicosities/compress the vein and make them less visible. |
| What happens in a Vein ablation? | it collapses and destroy the vein |
| What surgery is done for varicose veins? | Ligation and stripping of the veins and use other vessels to replace the veins removed. |
| In Post op care for venous surgery, what do you look for when assessing the patients' extremities? | Color, movement, sensation, pulses, temperature and edema All of the six P's! |
| Is bruising and discoloration normal after a venous surgery? | Yes |
| For any type of venous insufficiency, prevention is the best option. True or false | True |
| What are some things to avoid that cause venous insufficiency? | Sitting for long periods/Crossing legs when sitting/Change positions infrequently/Avoid constrictive clothing/Weight reduction/Elevating legs when tired/Compression socks/walking daily |
Created by:
Akrombach
Popular Nursing sets