DVT, PE, FES Flashcards

1
Q

DVT, what is it

A

Deep vein thrombosis
+ blood clot formation – thrombus – in deep veins
+ usually in the legs
+ calves, thighs, pelvis

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2
Q

Pathophysiology of DVT

A

+ Clot formation: aggregates of platelets/fibrin/other cells + attached to the wall, including vein
+ blood flow stops

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3
Q

What is a PE

A

Pulmonary embolism
+ obstruction in pulmonary artery or smaller branch

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4
Q

What is the pathophysiology of a PE

A

+ Fragment of DVT that is pushed into a pulmonary vein or branch
+ air emboli
+ fat emboli
+ amniotic fluid
+ septic emboli – bacterial invasion of thrombus

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5
Q

What is FES

A

Fat embolism syndrome
+ fat particles that travel through circulation and large and a blood vessel
+ fat embolism causing multi system dysfunction – lungs, then brain, heart, kidneys, skin

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6
Q

What is the pathophysiology of FES

A

And 90% of cases: fracture or injury in long bone (femur)
+ widespread trauma, disease altering lipid metabolism
+ lipid transfusion

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7
Q

Risk factors of DVT

A

VIRCHOW’S TRIAD:
1. Venous status
2. Vessel wall injury
3. Altered hemoglobin coagulation (see all below, they all fit into triad)

+ age - over 60
+ genetics
+ inactive lifestyle
+ smoking
+ Pregnancy
+ heart disease
+ Obesity
+ hormonal changes
+ cancer
+ being sedentary

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8
Q

Diagnostic steps for DVT

A

+ Duplex ultrasound!
+ MRI
+ D dimer blood test
+ contrast venography
+ physical exam of limbs
+ labs: PT, PTT, INR

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9
Q

Treatments for DVT

A

+ Anticoagulant therapy – if not contra indicated
+ vitamin K antagonists

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10
Q

Common site of pulmonary embolism – PE

A

Outflow tract of main pulmonary artery

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11
Q

Complications of PE

A

Massive PE equals death within one hour!!
+ Increased pulmonary vascular resistance
+ increased pulmonary arterial pressure
+ decreased cardiac output
+ right ventricle failure
+ shock

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12
Q

Signs and symptoms of PE

A

+ Shortness of breath!
+ Rapid pulse/tachycardia
+ excessive sweating, anxiety
+ sharp chest pain - worse with deep breaths
+ coughing blood
+ hypotension
+ dizziness, syncope, fainting

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13
Q

Medical diagnostics for PE and treatments

A

DIAGNOSTICS:
+ Duplex ultrasound
+ MRI
+ D dimer blood test
THERAPIES:
+ anticoagulant therapy
+ aspirin
+ thrombotic agents
+ surgical procedures

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14
Q

Nursing interventions for DVT and PE to prevent

A

+ Early ambulation
+ leg exercises
+ repositioning body
+ graduated compression stockings
+ intermittent pneumatic compression devices
+ assess risks
+ lifestyle changes

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15
Q

Prevalence of PE with people who have DVT

A

30%!!!!

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16
Q

Pertinent lab/labs for Enoxaparin

A

PLT – platelet count Essential

17
Q

Pertinent lab/labs for warfarin

A

PT/INR – prothrombin time/international normalized ratio - Time for clot to form

18
Q

Lab/labs for heparin

A

PTT – partial time – function of coagulation