Cad,DVT,PVD,PAD S.G Test 3- DONE Flashcards
- Kill, hurt, know antiplatelets. Purpose? (ATI PG.172)
Aspirin, Clopidogrel)
Uses: Clot preventions
bleeding precautions
-GI bleeding ect
-risk for hemorrhage
-black tarry stools
ANTIDOTE : activated charcoal
Caution:
-clients w/GI ulcers
-vitamin k deficiency
-renal/hepatic impairment
-pancytopenic clients
-discontinue use 1 week prior to surgery
Monitor for salicylate poisoning: Main symptom = tinnitus
-take w/meals to reduce GI upset
-Do not take aspirin w/anticoagulants or 2 anticoagulants
LABS (not weekly)
-platelet
-HGB (Less than 7 “go to heaven”), HCT
- Coronary artery disease client education (pp slide 9, flashcard)
check cholesterol levels
-manage HTN
-control diabetes
-stop smoking
-increase physical activity (weight loss if needed)
-Reduce red meat, egg yolks & whole milk
-low fat, high fiber diet (increase foods w/omega 3 fatty acids like tuna/salmon)
- Coronary artery disease nursing actions (pp slide 9)
-Assess characteristics & level of chest pain
-Administer oxygen
-encourage rest
(Oxygen, then nitroglycerin)
- Coronary artery disease risk factors(pp slide 5)
Modifiable:
-High LDL’s
-hypertension
-tobacco & alcohol use
-physical inactivity
-obesity
-diabetes (2-4 times greater risk)
- Manifestations of an MI (PP Slide 16)
-sudden chest pain
-shortness of breath
-indigestion
-Nausea
-Anxiety
-cool, pale, moist skin
- increased HR & RR
- Priorities & key labs for MI (pp slide 21)
Priorities (pp slide 21)
-oxygen -nitroglycerin
- IV morphine sulfateKey labs: (pp slide 18)
-Troponin is the gold standard to diagnose an MI
- Myocardial infarction client education (pg.334)
-set up cardiac rehab
-gradual exercise that increases w/pts tolerance
-stop smoking
-minimize stressors
-monitor pulse & BP
-report symptoms to PCP ASAP
-diet modifications (avoid foods high in sugar, fat, sodium, red meats)
-establish physical limitations such as maximum amount client can lift
-important to continue medical supervision
-recognize & manage depression
-can resume sexual activity when pt can walk 1 block or climb 2 flights of stairs w/out symptoms
- Manifestations of angina (pp slide 7, flashcard)
*Angina will subside w/nitroglycerin & rest. If it doesn’t subside then it’s a myocardial infarction.
-unusual fatigue
-weakness/numbness
-shortness of breath
-pallor
-diaphoresis
-chest pain radiating from chest to shoulders, arms, especially on left side. Or jaw neck, or teeth.
9.DVT manifestations (flashcard)
-pain in the leg
-redness
-warm to touch
-leg swelling (one leg swells, other appears normal)
-low grade fever
- DVT nursing interventions(poster)
-apply warm, moist heat
-increase fluids
-monitor platelets
-reinforce need to perform leg exercises q hr while awake
-encourage ambulation for a few mins each hr while awake
-help client avoid prolonged sitting & poorly fitting, constrictive anti embolic hose
-no crossing legs,no propping extremities w/pillows under the knee
-don’t massage calves/thighs
-apply compression & anti embolic stockings as ordered
-monitor for thrombophlebitis (calf pain, tenderness, warmth, redness swelling, low grade fever) If so notify provider & have client maintain bedrest until further evaluation
10.DVT risk factors (poster, flashcard)
-Venous stasis (bed rest, obesity, surgery, immobilization)
-Endothelial damage (trauma, surgery, IV drug usage, indwelling devices)
-Hypercoagulability (pregnancy, cancer, oral contraceptives, dehydration)
11.PVD client education (poster, flashcard)
-elevate the legs
-avoid crossing legs & restrictive pants
-change positions often
-DO NOT dangle legs, sit/stand for long periods of time
12.Antihyperlipidemic meds (pp slide 12)
(Statins, bile acids, colestipol granules)
-take @ night
-no grapefruit juice
-use sunscreen
-watch for muscle pain (rhabdomyolysis)
-check LFT’s (liver function tests)
-Colestipol mix w/apple sauces or juice to not irritate the esophagus
13.Nursing interventions for cerebral aneurysm
-dark quiet room
-no bright lights
-avoid stress & overstimulation
-avoid people (except fam)
14.PAD client education (poster, flashcard)
-DON’T elevate legs
-avoid tight clothing
-no heating pads
-check bath water w/thermometer
-low fat diet
-stop smoking
-perform daily skin care w/moisturizer
15.Raynaud’s phenomenon client education (poster,flashcard)
-avoid exposure to cold (wear hats, mittens, heavy socks, warm car before going into it)
-avoid tobacco & nicotine products
-avoid trauma
-avoid excessive stress
16.Heparin meds (ATI PG.172)
(Heparin, enoxaparin)
To prevent blood clots from becoming larger or forming
Antidote = protamine sulfate
-Major risk for bleeding/hemorrhage
-Monitor for thrombocytopenia, anemia, bruising
Contraindicated: active bleeding, ulcers, history of stroke or recent trauma
- Check LABS (weekly) :
APTT (activated partial thromboplastin time) RANGE: 30-40PTT
Platelet count (can cause low platelet count), PT, INR, CBC
*Heparin and warfarin can be given together at the same time once we reach therapeutic INR lab values, once therapeutic level is reached stop heparin.
17.Thrombolytic meds (pp slide 12)
(Alteplase (TPA), streptokinase)
most powerful, breaks up clots
-massive bleed risk/ assess for bleeding
Really low BP, tachycardia, pale, short of breath are signs of bleeding
Adverse reactions: internal bleeding GI, brain
-don’t give to people w/ulcers or bleeding tendencies
-do not give injections
-use EXISTING PERIPHERAL IV to administer
-question provider if client has had a recent trauma, hemorrhage stroke
- Nitroglycerin meds (pp slide 12)
-No sildenafil
-keep in dark original packaging
-causes hypotension
-remove for 10-12 hrs
-expected headaches
19.Abdominal Aneurysm nursing interventions (ATI PG.208)
-monitor vital signs & circulation q 15 mins
-monitor & maintain BP w/in normal limits
-maintain warm environment
-monitor I &O’s, weight gain, elevated BUN or creatinine
-monitor bowel sounds & observe for abdominal distention
-monitor PQRST of pain
-Client should avoid straining during BM, coughing & holding breath while changing positions.
20.Nursing manifestations for venous stasis
-Pain & heaviness
-varicose veins
-itchy skin
-dark, hard or leathery skin
-swelling
-weak or poor pulse
- Interventions for venous stasis
-assess pt’s lower extremities
-check body temp
-check pulses
-assess for pain
-assess for wounds
- Client education for venous stasis
-walking 3x/week 30-45 mins/day
-avoid smoking
-avoid constricting clothing
-Don’t cross legs at knees
-check bath water w/thermometer
-warm environments
21.Early and late indications of increased intracranial pressure
Early: headache
Late: no oxygen, leads to decreased LOC
- Manifestations of varicose veins
(Distended rope like veins)
Manifestations:
-muscle cramps (commonly @ night)
-dull, achy feeling
-increased muscle fatigue
-ankle edema
-heavy feeling in the legs
- Preventions & client education for varicose veins
-compression stocking
-change positions frequently
-daily walking up to 30 mins
-weight reduction plan
-elevate legs above heart level
-avoid sitting/standing for long periods of time, wearing tight socks, crossing legs
