Chapter 19 Blood Part 2 Flashcards
xs clot formation=
thromoboembolic disorders
thromboembolic disorders may occur due to
atherosclerosis or inflammation
atherosclerosis or inflammation affect what lining and what else
endothelium lining and hemostasis
what is a persistent blood clot in unbroken BV
thrombus
when may a thrombus form
when platelets and damages BV walls/ heart in same area
large clots can occluded BV’s and cause what downstream
ischemia
ischemia can cause
cellular death
term for when a thrombus breaks off and is free floating in the blood
embolus
when struck in BV too small to transverse what happens
embolism
embolus has the risk of blocking aterial BV’s to heart, brain, or lungs which cause
MI, CVA, PE
prevention of normal clot formation is
bleeding disorders
when do bleeding disorders occur
due to platelet deficiency, clotting factor deficit, liver dysfunction or hemophilia
blood clot forms in a deep vein, usually leg or pelis area
deep vein thrombosis
where is DVT rare
in the arm
symptoms of DVT
red, hot, pain, swelling, loss of function, enlarged veins in affected limbs, increased size
risk factors of DVT
restricted mobility, paralyzed, injury, sedentary, OCP/ smoking, post op, elderly, pregnant, vein obstruction, active cancer, long drive, flight, genetic, PH/FH of DVT
complications of DVT
recurrent VTE, post-thrombotic syndrome, risk of PE, death
diagnosis for DVT
ultrasound
prevention of DVT
exercise/ ambulate, healthy weight, anticoagulants, compression stockings, venodynes, ASA
treatment for DVT
anticoagulants, thrombolysis
what is a blood clot in the lung
pulmonary embolism
Is PE life threatening
yes
symptoms of PE
SOB, chest pain, cough
how does the body react to PE
body dissolves clot on own (weeks to months)
what can help prevent PE
meds
ASA (acetylsalicylic acid)= antiprostaglandin drug- inhibits thromboxane A2 formation is what anticoagulant drug
aspirin
aspirin prevents what aggregation and what formation
prevents platelet aggregation and platelet plug formation
risks for taking aspirin
GI/ intracranial bleeding
what anticoagulant is injectable and IV form
heparin
the injectable and IV form of heparin is slow of rapid acting
rapid acting
what is used to prevent and treat venous thrombosis
heparin
when taking heparin you have a risk of HIT which does what
the antibodies destroy platelets
what does warfarin do
blocks action of vitamin k in produing certain clotting factors
is warfarin easy or difficult to regulate
difficult
what are the dietary restrictions for warfarin
green leafy veggies
examples of direct oral anticoagulants
rivaroxaban (xarelto) and apixaban (eliquis)
tPA is
tissue plasminogen activator
tissue plasminogen activator =
thrombolytics
what do thrombolytics do
dissolve blood clots
tPA have a risk of
brain bleeds
counts under 150,000/ul
if <10,000= risk of spontaneous bleeding
thrombocytopenia
what disorder is due to bone marrow malignancy, certain drugs, ionizing radiation
thrombocytopenia
what are small pinpoints of hemorrhage seen on skin
petechiae
how do you treat thrombocytopenia
platelet transfusion
what disorder causes you to be unable to synthesize clotting factors and cause bleeding
impaired liver function
what is impaired liver function due to
vitamin k deficiency, hepatitis, or cirrhosis
A= factor VIII, B= factor IX, C= Factor XI
A&B= males
bleed into tissues and joints is what disorder
hemophilia
how do you treat hemophilia
transfuse fresh plasma or inject deficient clotting factor
rare blood clotting disorder with widespread clotting and severe bleeding
DIC - disseminated intravascular coagulation
2 ways DIC occurs
- small blood clots occlude BVs which shuts down blood supply to major organs
- platelets and clotting factors used up and there is uncontrolled bleeding
labs for DIC
prolonged coag times, thrombocytopenia, high FDP’s and D-dimer levels and schistocytes on smear
causes of dic
preg complications
septicemia
incompatible blood transfusion
burns
liver disease
pancreatitis
cancer
symptoms of dic
uncontrollable bleeding
bruising
confusion
fever >103
complications of dic
CVA, shock, xs bleeding
treatment for dic
supportive care with IV fluids and transfusions of plasma/RBC/ platelets , anticoagulants
need to compensate for blood loss to maintain blood’s what?
bloods 02 carrying capacity
how do you maintain blood 02 carrying capacity
replace rbcs by increasing production of rbcs
when you have a loss of 15-30% of blood volume what happens
pale and weak
loss of >30% of blood volume what happens
severe shock-death
what is an infusion
replace of lost blood volume by replacing with normal saline or ringer’s solution
what is a transfusion
replace of blood or blood components
whole blood transfusion is
rare
what are highly specific molecular markers on external surfaces
rbc antigen
exposure to antibody, form complex is what
agglutination
type a is what ag
a
type b is what ag
b
tybe ab is what ag
both a and b
ab is the universal
recipient
type o is what ag
no ag
type 0 is the universal
donor
rhesus blood group is
d antigen
mix blood with antiserum with ag and check agglutination is
test blood typing
if there is agglutination it means
ag presence
is rh - mom and rh + dad-
risk
exposure of rh- to rh+ blood via
placental exposure or transfusion
abs act against d antigen on rbc->
agglutination and hemolysis of rbcs
how do you treat hemolytic disease of the newborn
exchange transfusion (remove rh+ blood, give rh- blood within 6 weeks
how do you prevent HDN
rhogam- contains abs against rh antigens
bind to rh ags and ianctivates fetal rh ag’s prevents sensitization of mom
injection given during pregnancy, prior to delivery, post delievery/miscarriage/ abortion
