Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Critical Care > Hematologic & Vascular Function > Flashcards

Hematologic & Vascular Function Flashcards

1
Q

What does bone marrow make?

A

RBC
WBC
Platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Normal Platelet Count

A

150-400 x 10^9/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of Decreased Platelets

A

decreased production

increased destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thrombocytopenia: S/Sx

A
  • petechiae
  • jaundice
  • nose bleed
  • bleeding from gums
  • blood in urine/stool
  • unusual heavy menstrual flows
  • fatigue
  • enlarged spleen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Thrombocytopenia: Dx

A

CBC:

  • platelet count
  • RBC
  • H&H
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thrombocytopenia: Interventions

A
  • bleeding precautions
  • basic nursing skills
  • specific preventions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

HIT

A

occurs w/in days of starting heparin

platelet counts drop below 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HIT: Tx

A

-stop heparin
-give alternate thrombin inhibitor like:
argatroban
-rivaxaban (xarelto)
-dabigatran (pradaxa)
-bivalirudin (angiomax)
-give protamine sulfate if necessary
-platelet transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ITP

A

platelets become coated w/ antibodies

body sees them as foreign and spleen destroys them

platelet survive 1-3 days

acute: resolves on it’s own
chronic: corticosteroids, immunoglobulins, splenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thrombocytic Thrombocytopenia Purpura

A

unsure of cause

medical emergency

s/sx = thrombocytopenia, anemia, neuro symptoms, fever

tx = FFP, plasmapheresis, antiplatelets, corticosteroids, chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anemia: Caues

A

Decreased RBC production:

  • decreased iron from liver
  • decreased nutrients from GI tract
  • decreased erythropoietin from kidney

Direct Blood Loss

Increased RBC Destruction/Hemolysis

  • sickle cell disease
  • meds
  • incompatible blood (transfusions)
  • trauma (cardiopulmonary bypass machine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anemia: S/Sx

A

mild anemia (Hgb 10-12):

  • exertional dyspnea
  • palpitations

moderate anemia (Hgb 6-10):

  • palpitations
  • dyspnea
  • “roaring in the ears”
  • fatigue

severe anemia (Hgb < 6):

  • pallor, jaundice, pruritus
  • smooth tongue
  • tachycardia
  • angina, HF, MI
  • orthopnea
  • dyspnea at rest
  • bone pain
  • sensitivity to cold, weight loss, lethargy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anemia: Tx

A
  • replacing blood volume to prevent shock
  • identifying source of bleeding and stopping
  • supplemental iron (PO or IV)
  • meds: erythropoietin (for those with kidney dysfunction)
  • O2
  • dietary and lifestyle changes
  • alternate rest and activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DIC: Causes

A 
sepsis
surgery
trauma
cancer
complications from pregnancy/childbirth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DIC: Dx

A

lab testing

  • platelet count
  • PT/INR
  • aPTT
  • fibrin split products (clots mad and broken down forms FSP and indicates widespread dissolving clots)
  • D-dimer

*elevated FSP and D-dimer are highly predictive of DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DIC: Tx

A
  • prevention
  • find cause and tx
  • replacement of clotting factors (packed RBCs, FFP, Platelets, Cryoprecipitate)
  • anticoagulants (when thrombosis predominates - heparin, thrombin inhibitors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cryoprecipitate

A

FFP + platelets

18
Q

PAD

A

thickening of artery walls

likely to have coronary artery disease

RF: smoking, hyperlipidemia, diabetes, HTN, family hx, obesity, stress

19
Q

PAD: S/Sx

A
  • affects lower extremities
  • intermittent claudication
  • paresthesia
  • shiny, taut, hairless lower extremities
  • diminished or absent pulses
  • pallor in response to leg elevation
  • dependent rubor
  • delayed wound healing
  • arterial ulcers over bony prominences
  • rest pain in toes
20
Q

PAD: Dx

A
  • doppler u/s
  • ankle-brachial index (divide the ankle systolic BP by the higher left and right brachial systolic BP)
  • angiography
  • MRI
21
Q

PAD: Tx

A
  • modify risk factors
  • decrease HTN
  • lipid management
  • exercise therapy (walking, pool activities)
  • weight loss
  • meds: antiplatelets, ACE inhibitors
22
Q

DVT

A

results from Virchow’s triad:

  • venous stasis
  • hypercoagulability
  • endothelial injury
23
Q

DVT: S/Sx

A

in 50% of people:

  • warmth
  • redness
  • pain
  • swelling
24
Q

Venous Thrombosis: Risk Factors

A
  • advanced age
  • obesity
  • recent surgery
  • previous clot
  • stoke
  • OCP
  • pregnancy
  • smoking
  • long distance travel
25
Q

Venous Thrombosis: Prevention

A

in hospital:

  • compression stockings
  • SCDs
  • heparin/LMWH (Lovenox)
26
Q

Venous Thrombosis: Tx

A
  • IV Heparin
  • Thrombin inhibitors
  • IVC filter
27
Q

Acute PE: Definitions

A

Massive:

  • sustain hypotension
  • inotropic support required
  • PEA or bradycardia w/ shock

Submassive:
-myocardial necrosis or RV dysfunction w/ no systemic hypotension

Low Risk:
-normal levels of biomarker, no systemic hypotension or RV dysfunction

28
Q

PE: Risk Factors

A

DVT is the primary cause

in hospitalized pts:

  • DVT
  • more than 7 days of immobilization
  • obesity
  • post op
29
Q

PE: S/Sx

A
  • dyspnea
  • chest pain w/ inspiration
  • calf or thigh pain and/or swelling
  • cough
  • orthopnea (2+ pillow)
  • wheezing
30
Q

PE: Dx

A
  • V/Q scan
  • pulmonary angiogram
  • spiral CT
  • doppler
  • D-dimer
31
Q

PE: Tx

A
  • HOB up
  • O2
  • call provider
  • bed rest to keep clots from moving
  • clot control: heparin > coumadin, thrombolytics, catheter directed thrombosis, embolectomy, IVC filter
32
Q

Hospital Risk Assessment for DVT

A

low risk:

  • age < 40
  • minor surgery

moderate risk:

  • age > 40
  • minor surgery
  • additional risk factors

high risk:

  • age > 60
  • surgery

highest risk:

  • age > 40 w/ multiple risk factors
  • hip or knee surgery/interventions
  • major trauma
  • SCI
33
Q

Hospital Interventions for DVT Prevention

A

low risk:

  • early ambulation
  • elastic stockings/or SCDs

moderate risk:
-heparin or LMWH (Lovenox)

high risk:
-same as moderate

highest risk:

  • LMWH, fodaprimnux, or warfarin
  • SCDs
34
Q

Aneurysm

A

outpouching of dilated vessel wall

most commonly caused by atherosclerosis

True: wall of the artery forms the aneurysm w/ one vessel layer intact

False (Pseudo): disruption of all arterial wall layers w/ bleeding contained

usually occurs below renal arteries

35
Q

Aneurysm: S/Sx

A
  • often asymptomatic until pain begins
  • JVD
  • edema in face and arms
  • pulsatile mass in periumbilical area
  • may present as kidney stones
  • sharp pain
  • tearing feeling radiating to back
  • older adults may have vague symptoms such as hypotension
36
Q

Aneurysm: Rupture

A

results in hypovolemic shock

grey turner’s sign if AAA (bruising on flank)

monitor w/ CT, u/s, MRI, angiography, lab tests

requires immediate surgical repair

37
Q

Aneurysm: Surgery

A

graft
autotransfusion

*still can develop aneurysm above graft, thrombosis, or infection

38
Q

Aneurysm: Pre-op Interventions

A
  • NPO
  • bowel prep
  • skin cleaning
  • beta blockers given if hx of CVD
39
Q

Aneurysm: Post-op

A
  • diuretics and antihypertensives (don’t want unnecessary pressure/stress)
  • monitor ABGs, EKG, pain
  • aseptic technique on all arterial lines or invasive monitoring lines
  • if pt has NGT, monitor output and do oral care until NPO status is discontinued
  • assess LOC and neuro status (at risk for stroke)
  • monitor peripheral pulses
  • monitor urine output
40
Q

Aneurysm: Discharge Instructions

A
  • avoid heavy lifting for 6 weeks post-op (>10lbs)
  • report fever, pain, or drainage from incision
  • monitor extremities (CMS)
  • make sure they are urinating to ensure kidneys are perfusing

Critical Care (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions