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N1115 - Trans. to Associates > Exam 2 - VTE > Flashcards

Exam 2 - VTE Flashcards

1
Q

2 primary venous disorders

A

occlusive

ineffective venous blood flow

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2
Q

s/sx of SVT

A 
firm
palpable
chord like vein
itchy
tender, painful
reddened, warm vein area
mild temperature
mild edema
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3
Q

SVT treatment for large clots, lower leg

A

lovenox

arixtra

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4
Q

SVT treatment for small clots

A

NSAIDS
elastic compression hose
mild walking

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5
Q

s/sx of DVT

A 
silent (no s/sx)
edema
redness
heat/warmth
tenderness
paresthesia
feeling of fullness
fever
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6
Q

what occurs with varicose veins?

A

veins stretch, then valves won’t close completely

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7
Q

varicose vein risk factors

A 
family hx
BC or HRT
previous thrombophlebitis
pressure causing blockage
female
weak veins
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8
Q

DVT and varicose veins can lead to __ __ __

A

chronic venous insufficiency (CVI)

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9
Q

what is CVI?

A

leg valves are not competent and blood pools in the lower legs causing increased venous pressure

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10
Q

s/sx of CVI

A 
edema
thick fibrous skin (brown)
stasis dermatitis
pain
ulcers
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11
Q

venous ulcers are located on the ___ whereas arterial ulcers are located on the ___.

A

V: legs

A: feet

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12
Q

s/sx of venous ulcers

A

irregular shape
real wet

*warm, moist dressing needed

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13
Q

What is included in Virchow’s Triad?

A

stasis
vessel wall injury
hyercoagulability

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14
Q

DVT complications

A

CVI (post thrombotic syndrome)

PE

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15
Q

DVT dx testing

A 
D-dimer
duplex US (visualize vein; measure blood flow)
CT
MRI
contrast venography (most accurate)
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16
Q

D-dimer should be less than what?

A

250

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17
Q

PT

*lab value

A

11-16

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18
Q

PT therapeutic

*lab value

A

46-70

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19
Q

INR therapeutic

*lab value

A

2-3

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20
Q

ACT therapeutic

*lab value

A

> 300

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21
Q

bleeding time

A

2-7 minutes

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22
Q

Platelet count

*lab value

A

150,000-400,000

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23
Q

heparin lab

A

PTT

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24
Q

warfarin lab

A

PT / INR

25
Q

most common DVT meds

A 
UH
LMWH
fondaparinux
rivaroxaban
warfarin x3 months
26
Q

preferred terminology over DVT

A

VTE

venous thromboembolism

27
Q

VTE/DVT prophylaxis

A 
initial protocol
reposition q2h
flex, extend feel q2h
up to chair, ambulate at least 6 times daily
elastic compression hose
SCD
28
Q

how long does it take for warfarin to become therapeutic?

A

3 days

29
Q

heparin antidote

A

vitamin k

30
Q

herapin allergic rxn

A

heparin induced thrombocytopenia

occurs 4-10 days after heparin exposures

31
Q

heparin antidote

A

protamine sulfate

32
Q

heparin is aka

A

unfractionated heparin (UH)

33
Q

s/sx of heparin induced thrombocytopenia

A 
skin lesions at site
chills
fever
dyspnea
chest pain after injection
decreased Plt count
thrombosis
34
Q

heparin induced thrombocytopenia treatment

A

DC heparin, start another anticoag

35
Q

LMWH drugs

A

enoxaprin (lovenox)

dalteparin (fragmin)

36
Q

LWMH antidote

A

protamine sulfate

37
Q

labs required for LMWH

A

none

38
Q

direct thrombin inhibitor drugs

A

argatroban (acova) - IV

dabigatran (pradaxa) - PO

39
Q

direct thrombin inhibitor drugs lab requirement

A

PTT

40
Q

direct thrombin inhibitor drugs antidote

A

none

41
Q

factor Xa inhibitors

A

fondaparinux (Arixtra) - SQ
rivaroxaban (Xarelto) - PO
apixaban (eliquis) - PO

42
Q

labs to monitor with factor Xa inhibitors

A

CBC

Crt

43
Q

caution using factor Xa inhibitors in __ and those with impaired __ function

A

elderly; renal

44
Q

factor Xa inhibitors may cause

A

thrombocytopenia

45
Q

factor Xa inhibitors antidote

A

none

46
Q

nursing management if VTE /DVT is present

A

calf circumference
tissue perfusion
pain
knowledge

47
Q

primary cause of varicose veins

A

congenital vein weakness

48
Q

secondary cause of varicose veins

A

result from previous VTE

49
Q

small varicose veins are considered

A

cosmetic

50
Q

telangiectasis is aka

A

spider veins

51
Q

etiology of varicose veins

A

weakened walls > incompetent valves > backward blood flow

52
Q

varicose veins prevention

A 
support hose
frequent postion changes
elastic compression hose
exercise
weight management
53
Q

varicose vein treatment

A

surgical, meds only indicated with risk factors for CVI

endovenous ablation

54
Q

nonsurgical/cosmetic treatment for varicose veins

A

sclerotherapy - inject caustic substance

light therapy
laser therapy

55
Q

pt education after varicose vein treatment

A

risk factors reduction
elevate legs frequently the first few days
elastic compression hose

56
Q

s/sx of CVI

A 
brownish discoloration
dermatitis, eczema
skin is thick, fibrous
venous ulcers
heavy drainage
57
Q

what occurs with CVI

A

serous fluid, RBC leak into tissue

58
Q

CVI treatment

A 
prevention
compression (in absence of PAD)
moist dressings
good nutrition for wound healing
debridement with abx
skin grafting
amputation (sometimes necessary)
59
Q

CVI pt teaching and monitoring

A 
compression hose use
avoid trauma to limb
daily moisturizing
proper position of limb
activity guidelines
dressing changes
monitor for s/sx of infection, complications
when to call for help

N1115 - Trans. to Associates (21 decks)

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