Clotting

Question 1

A physiologic process in which blood is converted from a liquid to a semisolid gel

Answer 1

Clotting

Question 2

When the problem extends to entire body; is usually the result of a significant hematologist event

Answer 2

Systemic Clotting

Question 3

When the problem is localized; is usually a problem in a vein or an artery, either injury to a vessel or a clot within a vessel.

Answer 3

Localized Clotting

Question 4

Clotting Process:

First Response is ___

Answer 4

Vasoconstriction

Question 5

Clotting Process:

Second Response is ___

Answer 5

Platelet plug formation

Question 6

Clotting Process

Third Response is ___

Answer 6

Thrombin—>Fibrinogen to form insoluble fibrin=stabilized clot

Question 7

Clotting Process

Fourth response is ___

Answer 7

Breakdown of the clot

Question 8

Factors that are activated by contact with collagen that has been exposed from damaged vessel wall

Answer 8

Intrinsic Factors

Question 9

Damaged Tissue

Exposure of the tissue factor to extra vascular injuries

Answer 9

Extrinsic Factors

Question 10

Process of breaking up a clot

Starts with plasminogen

Plasmin

Fibrin splits products

Answer 10

Fibrinolysis

Breaking up a clot

Question 11

Prevention of a DVT

Answer 11

Early ambulation: easiest & most cost effective method to decrease VTE risk

Question 12

PA of a DVT

Answer 12

Pain-calf or groin area

Swelling of the calf/leg or extremity

Compare the ext. with the other(measure)

Warmth and/or redness to compare

Question 13

A test to see how blood moves through your arteries and veins

Answer 13

Venous Duplex Ultrasonography

Question 14

measure changes in volume in different parts of the body to check for blood clots in the arms and legs

Answer 14

Plethysmograph

Question 15

Inhibits clotting factors

Stops fibrin production

Prevents further clots

Prevents current clot from getting bigger

Existing clot slowly dissolves overtime

Answer 15

Heparin

Question 16

Before administering Heparin____

Answer 16

Get a baseline serum aPTT, CBC and platelet count

Verify no bleeding disorders; active bleeding, or recent spinal surgery

2 RNs to verify dose administration

aPPT should be normal

Question 17

Prevention & treatment of DVT/PE

Prohibits thrombin formation

Can be taken at home

Adjusted according to renal function

*Advise patient don’t rub the injection site, this could cause bruising. Don’t push air bubbles out of syringe, call HCP of any signs of bleeding

Answer 17

Enoxaparin (Lovenox)

Question 18

May take 3 to 4 days to become therapeutic

Verify PT/INR prior to start

Typical 1st dose is 5mg

3 to 6 months following DVT

Verify PT/INR–teach patient the importance of having these checked on a regular basis*

Answer 18

Coumadin (Warfarin)

Question 19

While taking Coumadin, the patient should maintain a diet of ____

Answer 19

Vitamin K

Question 20

Placement of a filter in the inferior vena cava to “catch the clot” but allow blood flow back to the heart

Answer 20

Inferior Vena Cave Filter

Question 21

When the venous thrombus dislodges and travels up the IVC to pulmonary arteries and capillaries

Answer 21

Pulmonary Embolism (PE)

Question 22

5 P’s for Assessment of an Arterial Clot

Answer 22

• pain
• pallor (color)
• pulse or lack thereof
• poikilothermia (skin temperature)
• paresthesia (tingling or prickling)