CARDIOVASCULAR SYSTEM Fibrinolytics Flashcards
What is the goal of a fibrinolytic?
to dissolve the clot that is blocking the blood flow to the heart muscle. To ultimately decrease the size of the infarction.
Streptokinase, TPA ,TNKase, Retavase are all____.
which one are people mostly allergic to?
clot busters
streptokinase
How soon after the onset of pain should these drugs be administered for an MI?
How soon should it be administered for a stroke?
the sooner the better; within 6 - 8 hours
3 hours
The major complication of a fibrinolytic is___.
what do you wanna ask them?
Bleeding
- if they’ve had surgery lately, stroke lately, bleeding ulcer… anything related to bleeding.
ABSOLUTE CONTRAINDICATIONS:
intracranial___
intracranial___
suspected aortic___
internal____
- neoplasm (brain tumor)
- bleeding
- aortic dissection (A tear in the inner layer of the large blood vessel branching off the heart (aorta).
- bleeding
During and after administration, we take____ precautions.
Bleeding
BLEEDING PRECAUTIONS:
Watch for bleeding____
______ urine
_______ stools
use an _____ razor
______ toothbrush
no______ shots
- gums
- blood in urine
- black stools
- electric
- soft
- IM shots
What other drugs will also need bleeding precautions?
heparin, coumadin, lovanox
Would you take bleeding precautions in an alcoholic? why?
yes; liver is messed up (liver produces clotting factors)
Why would we also want to watch bleeding precautions for a patient with tylenol overdose?
it kills your liver, so no clotting factors (ANYTHING THAT KILLS YOUR LIVER)
When we are giving them these clot busting drugs, why must we watch their EKG rythm?
reperfusion arythmia it may affect your cardiac output.
draw__ when starting IVs, and decrease punctures. why?
blood; we don’t want them to bleed.
would it be smart to draw ABGs on someone who is started on fibrinolytic?
no. because they’ll bleed a lot… ABGs are taken from an artery. (they’re high pressured).
Aspirin ,Plavix ,Reopro ,IV Integrilin are all____
anti-platelets
You have a patient who has no IV access and needs to get started on a fibrinolytic. Do you prefer they get a central line or a normal IV at the antecubital region? why?
antecubital; because we must give fibrinolytics in a compressible site. if we get caught putting pressure in a central line (one located in the carotid artery) we get fired because we are not suppose to do that.
