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Med Surg > Clotting > Flashcards

Clotting Flashcards

1
Q

Heparin is __ acting

A

Rapid acting

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2
Q

What labs should the nurse monitor while her pt. is on a heparin drip?

A

PTT

K+ (can cause hyperkalemia)

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3
Q

Antidote for Heparin

A

Protamine Sulfate

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4
Q

Enoxaparin antidote

A

Protamine Sulfate

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5
Q

Warfarin is ___ acting

A

Delayed acting

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6
Q

Warfarin indication

A

Prevention of DVT, PE

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7
Q

What labs should the nurse monitor if her pt. is on Warfarin?

A

PT and INR

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8
Q

Antidote for Warfarin

A

Vitamin K

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9
Q

Side effect of Warfarin

A

Terotegenesis

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10
Q

Alteplase drug classification

A

Thrombolytic - breakdown clots

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11
Q

Major adverse effect of Alteplase

A

Bleeding

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12
Q

Blood transfusions are only administrated with that type of IV fluid?

A

Isotonic - NS

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13
Q

What is common gauge size for blood admin?

A

18-20

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14
Q

Universal blood donor

A

O-

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15
Q

Universal blood receiver

A

AB+

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16
Q

When starting a blood transfusion the blood must be verified by __ ____

A

2 nurses

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17
Q

The nurse must stay in the room for ___ min after starting the blood transfusion

A

15 min

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18
Q

Pt. receiving blood after 2 hours. the pt. is having a reaction. What is the nurse’s first action?

A

Stop the infusion

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19
Q

Pt. receiving blood after 2 hours. the pt. is having a reaction. Nurse stops the infusion. can the nurse save the rest of the blood for later?

A

No, after 4 hours of the blood being out of the blood bank to blood has to be sent back

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20
Q

Stages of Hemostasis

A 
Vasospasm
Formation of platelet plug
Clot formation
Clot retraction
Fibrinolysis
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21
Q

Von Willebrand’s Factor

A

Necessary for platelets to be able to stick together

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22
Q

Clot retraction function:

A

Platelets contract and pull injury together and release growth factor to stimulate tissue repair

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23
Q

Intrinsic Pathway

A

Injury occur inside the blood vessel
Slower (more steps)
Measured by PTT

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24
Q

Hageman Factor

A

Factor XII

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25
Q

Extrinsic Pathway

A

Injury due to elements outside the blood vessel
Faster
Measured by PT

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26
Q

Final Clotting Pathway

A

Prothrombin to thrombin to fibrinogen to fibrin

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27
Q

Intrinsic pathway lab

A

PTT

28
Q

Extrinsic pathway lab

A

PT

29
Q

How do antibiotics affect clotting?

A

They decrease Vitamin K levels

Decrease ability to clot

30
Q

How does aspirin, salicylates, clopidogrel, NSAIDs, thiazide diuretics, antibiotics, heparin affect clotting?

A

Interfere with platelet production or function (Decrease clotting)

31
Q

How does amiodarone, steroids, warfarin, and low weight heparin affect clotting?

A

Interfere with coagulation factors

32
Q

Class of drug that breaks down clots

A

Fibrolytics/Thromobolytics (TPA)

33
Q

True/False: Anticoagulants break down clots that have already formed

A

False, anticoagulants only prevent more clots from forming

34
Q

What time frame must fibrinolytics be given if a pt. is currently presented to ER with MI/Stroke

A

Must be given within 3-4 hours of the ischemic symptoms

35
Q

Normal PTT level

A

60-70 secs

36
Q

Normal PT level

A

10-13 secs

37
Q

Normal INR level

A

0.8-1.2 secs

38
Q

Normal RBC Male

A

4.71-5.1

39
Q

Normal RBC Female

A

4.2-4.8

40
Q

Normal WBC

A

4,500-11,000

41
Q

Normal Hemoglobin Male

A

13.5-16.5

42
Q

Normal Hemoglobin Female

A

12-15

43
Q

Normal Hematocrit Male

A

43-49%

44
Q

Normal Hematocrit Female

A

38-44%

45
Q

What disease can result from bone marrow suppression?

A

Anemia

Thrombocytopenia

46
Q

Symptoms of Anemia

A 
Pale skin, lips, nails
Fatigue
Dizziness
Weakness
HA
SOB
Tachypnea
Tachycardia
47
Q

Neutropenia symptoms

A

No symptoms unless have infection

48
Q

Most common site for bone marrow biopsy?

A

Posterior superior iliac crest

49
Q

Thrombocytopenia

A

Low platelets

50
Q

Neutropenia

A

Low WBCs

51
Q

Causes of thrombocytopenia

A 
Malignancy
Sulfa meds
Infection
Autoimmune conditions
DIC
52
Q

Most common autoimmune platelet disorder

A

Immune thrombocytopenia purpura

53
Q

Immune thrombocytopenia purpura

A

Usually follows viral infection

Immune mediated platelet destruction faster than normal

54
Q

Disseminated Intravascular Coagulation

A

Follows severe trauma

Pt. clots too much and exhausts clotting factors then not able to clot which leads to lots of bleeding

55
Q

Symptoms of Thrombocytopenia

A 
Bruising
Pink urine
Nosebleed
Small red/purple spots
Bleeding that does not stop w/ pressure
56
Q

Precautions for thrombocytopenia

A

Stop NSAIDS or aspirin if can
Use soft toothbrush
Use electric razor
Encourage shoes when out of bed
Maintain clutter free environment
Use stool softener - avoid straining
Avoid rectal thermometers, suppositories, enemas
Do not blow nose
Apply pressure for no less than 5 min after cut
Arterial procedures should be kept to a minimum

57
Q

Heparin given ___ (route) can cause ___

A

Heparin given IM can cause severe hematomas

58
Q

___ nurse always check dose of heparin before it is given

A

2 nurses always check dose of heparin before it is given

59
Q

Pt. with immune thrombocytopenia purpura is at risk for:

A

Bleeding

60
Q

“-ase” drugs

A

Fibrinolytics

61
Q

Platelet inhibitor

A

Clopidogrel

62
Q

Clotting factors for Intrisic

A

XII, XI, IX

All “X” factors but not X

63
Q

Clotting factor of extrinsic

A

III, VII

3+7= 10

64
Q

Anticoagulants effect what clotting factors

A

II
VII
IX
X

65
Q 
The nurse is assigned to a patient with
thrombocytopenia. What is the priority goal
of nursing care?
A. Prevention of infection
B. Prevention of injury
C. Prevention of dehydration
D. Prevention of nutritional deficit
A

B - b/c low platelets high risk for injury and bleeding

Med Surg (22 decks)

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