NEW STUDY GUID 3 Flashcards
what isatrovasatin, lipitor?
statin
what is
herapin
enoxaparin, levonax?
anticuagolents
what is
asprin, ecorine
antiplatelet actions
what is
clopidogrel, plavix
anti-coagolants
what is
metroprolol, lopresor, toprol xl
beta blokers
what is
nifedipine (Adalat, Procardia),
amlodipine (Norvasc)
calcium channel blockers
what is
niroglycerin, tridil, nitrostat
vasodilator
What Medication
reduce total cholesterol when used for an extended period.
reduce cholesterol synthesis in the liver and increase clearance of LDL from the blood.
contraindicated in patients with active liver disease or during pregnancy
statins
isatrovasatin, lipitor
What Medication
Prevents intracoronary thrombosis in patients who are hospitalized with ACS
anticoagulents
herapin
enoxaparin, levonax
What Medication
Inhibits platelet aggregation to prevent clot development
antiplatelets
asprin, ecorine
What Medication
Inhibits the sympathetic nervous system response to physical activity
decreases cardiac workload and oxygen consumption
beta blockers
metroprolol, lopresor, toprol xl
What Medication
Reduces blood pressure, which decreases workload and oxygen demands Particularly beneficial in patient with HTN, diabetes, renal disease, and heart failure
ace inhibitors ARB
lisinopril (Zestril),
losartan (Cozaar)
What Medication
Used when patients cannot tolerate beta blockers
Lowers blood pressure and increases blood flow through the coronaries
prevents coronary artery spasms in Prinzmetal’s/variant angina
calcium channel blockers
linsinopril, zestril
losartan, cozaar
What Medication
Dilates coronary arteries to improve blood flow and oxygen supply to the myocardial cells Can also be given to reduce afterload
vasodilators
what is
lisinopril (Zestril),
losartan (Cozaar)
ace inhibitor
what are
Cholesterol
Low-density lipoproteins (LDLs)
High-density lipoproteins (HDLs)
Triglycerides
lipid panel
what are
Platelets
Fibrinogen levels
Prothrombin time (PT)
Partial thromboplastin time (PTT)
International normalized ratio (INR)
coagulation studies
what are
Creatine kinase myocardial bands (CK-MB)
Troponin
Myoglobin
Brain natriuretic peptide (BPN)
markers of heart disease
what kind of PB is
120/80
normal
what kind of PB is
S=120-9
D-less than 80
elevated
what kind of PB is
S=130-9
D=80-89
stage 1
what kind of PB is
S=140 or highr
D=90mm or higher
stage 2
whar kind of BP is
S= 80 or higer
D 120 or higher
hypertension crisis
lab values
woman
RBC
hematocrit
hemoglobin
3.61-5.11
36-48 %
11.7-15.5
lab values
man
RBC
hematocrit
hemoglobin
4.21-5.81
42-52 %
14-17.3
lab values
wbc
4.5-11.10
lab value
platelets
150-450 thosand
lab value
PT
10-23 seconds
lab value
Cholesterol
less than 200
lab value
Low-density lipoproteins
LDL
less than 100
lab value
High-density lipoproteins
HDL
grater than 40-60
lab values
Triglycerides
Less than 150
lab value
Fibrinogen levels
200–400
lab value
Partial thromboplastin time (PTT)
25–35 seconds
lab value
International normalized ratio (INR)
<2.0
what foods are high in
iron
Beets
Dark green vegetables
Dried beans, legumes
Fortified grains (breads, cereal)
Meat
BEATS
BEANS; LIMA, LAGUNES
CLAMS
DATES
DARK GREEN VEGETABLES
DRIED NUTS
ENRICHED AND WHOLE GRAIN CEREALS
FORTIFIED BREADS AND CERIALS
MEAT
Heart
Liver
OYSTERS
SPINIACH
what foods are high in
folic acid
Dark green vegetables
Dried beans, legumes
Fortified grains (breads, cereal)
Nuts
Bran
Yeast
what foods are high in
vit b12
Meat
Eggs
Dairy products
Seafood
what are
The American Heart Association “Life’s Simple 7”:
The American Heart Association “Life’s Simple 7”:
- No smoking
- of cigarettes or other tobacco products - Maintain a normal body weight
- Exercise
- for at least 150 minutes with moderate-intensity activity, or 75 minutes of vigorous-intensity activity, or a combination of each per week - Eat a healthy
- diet that follows the current American Heart Association recommendations - Maintain total cholesterol level less than 200 mg/dL
- Keep BP less than 120/79 mm Hg
- Keep fasting blood glucose less than 100 mg/dL
name the characteristics of
Unstable angina
No elevation in cardiac markers
Maypresent with nonspecific or transient ST segment depresions or elevations
name the characteristics of
Non-ST Elevation Myocardial Infraction
Elevated cardiac markers
ST depresions (0.5mm at least) or T wave inversions (1.0) mm at least) without Q waves in 2 contiguous leads with prominent R waves or R/S ratio>1
name the characteristics of
ST Elevation Myocardial Infraction
Elevated cardiac markers
ST elevations
what disease has a bruits sound?
hypertension
what high levels indicate an increased risk for atherosclerosis.
high LDL
what low levels
indicate an increased risk for atherosclerosis.
low HDL
what disease has this medication and
what is this medication?
isoenzyme marker specific to cardiac tissue- asses damage
CK-MB-
what disease has this medication and
what is this medication?
general marker of cellular injury, it asses muscle damage, 3-36 hrs
myocardial infraction
Creatine kinase (CK)
what disease has this medication and
what is this medication?
proteins expressed in the heart- marker of cardiac damage. Can stay elevated form 4hrs to 10 days
myocardial infraction
Troponin T/I-
what disease has this list of medications?
MONA
Morphine
Oxygen
Nitriate
Asprin
myocardial infraction
what diease has these manifestations?
- Sudden onsent of symptoms that require immidiate attention
Acute heart failure
what diease has these manifestations?
- Stable with treatment and management
Chronic heart failure
what medication
is used to control the sympathetic nervous system in hf to decrees cardiac workload
Beta blockers
what medication
-Decrease preload in patients with fluid retention
Aldosterone antagonist diuretics
what medication
-Used to control RAAS compensatory response and reduce after load
A C E inhibitors
what medication
-Used to increase cardiac contractability and reduce heart rate
Digoxin
what are these called?
Troponin I/T- used to rule out acute ischemic event
BNP, N-terminal, are increased because of overstretching of the heart
cardiac biomarkers
what disease has this teaching?
green leafy vegetables contain Vitamin K wich is the antidote for warfarin.
when achieving therapeutic range for the INR, a change in the consuption of green leafy vegetables will change the anticoagulation effects in the body
deep vain thrombosis
Where is Iron absorbed
Duodenum
Where is folic acid absorbed
Jejunum
What does aPTT monitor?
it monitors the response to thrombin inhibitor therapy
What evaluates the effectiveness of Warfarin (coumadin)
PT/INR
What is a coenzyme in the DNA Synthesis & RBC
Vit b 12
What anemia has this as a diagnostic test
Serum ferrin levels
IDA
What happens to the older client’s PTT, RBCs as they age?
Bonemarrow ages and fewer blood cells are produced
of RBC, Hgb, Hct levels are reduced wich contributes to fatgue
Body water decreases= less fluids in the blood stream with decreased fluid volume lower levels of plasma proteins
what type of angina is this?
Chest pain or discomfort associated with physical activity
Liked to fixed plaque formation as is predictable
Symptoms alleviated with rest/ medications
Nitrate= nitroglycerin, dilate the artery
stable angina
what type of angina is this?
Chest pain that occurs at rest
Is the initial phase of Acute coronary syndrome (ACS)
Caused by acute decrees in blood flow through the coronaries to the myocardial tissue.
Precursor to MI
unstable angina
what type of angina is this?
Variation of unstable angina
Blockage caused by coronary artery spasm not plaque formation
prinzemtals angina
what disease has these medications?
Nitrates- vasodilators
Nitroglycerin (tridil, nitrostat) = dilate the coronary arteries, improving oxygen-rich blood flow to the heart
Can be given to reduce afterload
Asprine
Morphine
Betablockers/calcium channel blockers
Satin medicaton- reduce cholesterol and plaque
angina
what disease has this teaching?
Educate patient on the risk of hypotension with coadministration with nitroglycerin
angina
what disease has this management?
Stop and rest
Nitroglycerin tabs
Put under tongue
Do not exceed more than 3 doses 5 minutes apart
angina
what disease has this effect
Plaque within the lumen of the vessels, is the principal cause of obstruction to blood flow
Atherosclerosis
what disease has this effect?
it begins with an injury to the endothelium that causes an inflammatory response
Atherosclerosis
what disease has these side effects of smoke?
Atherosclerosis
Worsens atherosclerosis and accelerates its growth in the coronary arteries, aorta, and arteries in the legs
It does not directly cause atherosclerosis
Smoke and the by products of tobacco cause vasoconstriction, hypertension, endothelial cell death, platelet dysfunction, increase circulating cholesterol
Increased risk of coronary artery disease 2-4X
what disease has this teaching? SATA
Medication regimen
Angina management
Bleeding precautions
Risk factor reduction
When to call emergency services
Encourage cardiac rehabilitation
Coronary Artery Disease
what disease has this teaching? SATA
Medication regimen
Angina regimen
Bleeding precautions if on anticoagulants
Risk factors that reduce the strategies; physical activity, blood pressure management, healthy/weight loss, smoking cessations, decreased alcohol consumption, control of glucose
When to call providers or emergency services
Encourage participation in cardiac rehabilitation for ACS patients after PCI or CABG (Coronary artery bypass graft)
Coronary Artery Disease
what disease has this management?
Prevention and early treatment
Identify people at high risk
Controlling modifiable risk factors
Encourage lifestyle change
Coronary Artery Disease
what disease has this managment?
Obtain ECG with the occurance of chest pain
Administer:
oxygento keep saturation grater than 93%
Obtain ECG with the occurance of chest pain
nitroglycern as ordered
asprin as ordered
morphine as ordered if nitroglycerin dos not relieve pain
beta blockers/ calcium blokers
statin medication as ordered
Coronary Artery Disease
what disease has these risk factors?
Modifiable
Non modifiable
Higher in Caucasian men
Hispanic woman
Posmenopausal woman
Coronary Artery Disease
what disease has this Purpose of oxygen use
Supplemental oxygen optimizes oxygen delivery to the myocardium
Cardiac dysrhytmias, especialy tachycardia, and anxiety increse myocardial oxygen consuption
Coronary Artery Disease
what disease has this teaching?
Medication regimen
Angina management
If angina occurs stop activity. Take nitroglyceryn tabs. Do not exceed 3 doses 5 min apat.
Bleeding precautions if on anticoagulants
Risk factor reduction strategies: physical activity, blood pressure management, healthy diet/weight loss, smoking cessation, decreased alcohol consumption, control of glucose
When to call providers or emergency services
Encourage participation in cardiac rehabilitation for ACS patients after PCI or CABG.
Coronary Artery Disease
what are these called?
Cigarette smoking
High total cholesterol, high LDL level, low HDL levels, and high triglycerides
Hypertension
Diabetes
Obesity, particularly central obesity
Sedentary lifestyle/physical inactivity
Stress
excessive alcohol consumption
modifiable risk
what are these called?
Gender
Race
Age older than 45 for men
Genetics/family history
Being postmenopausal
non-modifiable
what desease has this medication for management
ace inhibitors
calcium channel blockers
stating
Coronary Artery Desiease
what medication
Reduces blood presure, wich decresed work load and oxygen demands
Particularly benificial in patient with HTN, diabetes, renal disease and heart failure
ACE inhibitors
Lisinopril (zestril)
Losartan (cozaar)
what medication
Used when patient cannot tolorate beta blockers or in patietns with HF
Lowers blood presure and increased blood flow through the coronaies
Also prevents coronary artery spasims in prinzmetal’s variant angina
calcium chanel blockers
Nifedipine (adalt,procardia)
Amlodipine (norvasc)
what medication
Reduce total cholesterol when used for an extended epriod of time
They reduce cholesterol synthesis in the liver and increse clearance of LDL from blood
statins
Atrovanstain (lipitor)
Simvanstain (zocor)
what foods interfere with the efficacy of warfarin.
Limit foods high in vitamin K;
what is the antidote for warafin?
Vit. K
when achieving therapeutic range in
“……”
a change in the consumption of green leafy cegetables will change the anticoagulation effects on the body
INR
what disease has this teaching?
Disease process/lifestyle modifications
Exercise regimen that includes aerobic exercise
Cardiac-prudent diet that minimizes saturated fats
Smoking cessation
Medications
warferin
Bleeding precautions
Diet
Deep Vein Thrombosis
what is monitored through monitored through the the
activated partial thromboplastin time (aPTT)
heparin
when is aPTT is drawn and then repeated every 4 to 6 hours to monitor therapy
before heparin therapy
what is the therapeutic goal of heparin therapy?
The therapeutic goal is 1.5 to 2.5 times the normal value, or 40 to 90 seconds.
what will happen If the initial aPTT is below the designated therapeutic level
an additional heparin bolus may be given along with an increase in the rate of the infusion.
what disease has this
Epidemiology?
65 years or older
African american
Overweight
Heart Failure
what deseae has these
risk factors?
CAD
Hypertension
Diabetes millitus
Metabolic syndrome
Obesity
Smoking
high sodium diatery intake
Heart Failure
what disease progressive disease is characterized by myocardial cell dysfunction, resulting in the inability of the heart to pump enough cardiac output to meet the demands of the body
Heart Failure
what desease has these manifestations?
- Jugular vein distention
- Dependent edema
- Hepatomegaly
- Ascites
right sided heart faiulure
what desease has these manifestations?
Shortness of breath or dyspnea or orthopnea
- Crackles on auscultation
- Pale color, weak pulses, cool temperature in extremities, delayed capillary refill
- Fatigue, weakness
left sided heart failure
in what desease does S3 sound means heart failure is getting worse
heart failure
what disease has this diagnostic test
cardiac biomarkers, serum electrolytes complete blood count, urinalysis, glucose level, fasting lipid profile, liver function testing renal function tests.
heart failure
what are these called?
History of hemorrhagic stroke
Active intracranial neoplasm
Recent surgery
Recent trauma (less than or equal to 2 months)
Active or recent internal bleeding (6 months)
Absolute Contraindications to Thrombolytic Therapy
Severe hypertension (SBP greater than 200 mm Hg or DBP greater than 110 mm Hg)
Nonhemorrhagic stroke (within 2 months)
Surgery in past 10 days
Thrombocytopenia (platelets less than 100,000)
History of bleeding tendencies
Relative Contraindications to Thrombolytic Therapy
what disease has these medications?
*Beta blockers
Used to control the sympathetic nervous system in hf to decrees cardiac workload
*Aldosterone antagonist diuretics
Decrease PRELOAD in patients with fluid retention
*A C E inhibitors
Used to control RAAS compensatory response and reduce AFTER LOAD
*Digoxin
Used to increase cardiac CONTRACTABILITY and reduce heart rate
heart failure
what disease has this Management
Symptom monitoring
Medication adherence
Lifestyle changes
Daily weight taken to monitor fluid retention
Sodium restricted diet
maintain weight
heart failure
what disease has this Actions
Oxygen therapy
Elevate head of bed
Administer medication as ordered;
- diuretics- decrease volume, preload
- ace inhibitor- decrease workload
- beta blockers-reduce oxygen consumption
- inotropic agents-enhace contractility
Fluid and sodium restriction
heart failure
what is inability of the right side to pump blood to the pulmonary vaculature called?
right sided hear failure
what disease has this managment?
- no smoking of cigarrettes or other tobacco products
- maintain normal body weight
- Excesise for at least 150 min with moderate intensity activity, or 75 min of vigorus- intensity activity or a combination per week
- Eat a healthy diet that follows the curret american heart assosiation recommendations
- Mailtain cholesterol levels less than 200mg/dl
- Keep BP less than 120/79
- Keep fasting glucose less than 100mg/dL
Myocardial Infarction
what would not be used in a patient suffering a right coronary artery MI experiencing bradycardia
Beta blocker therapy
what disease has this medications
Oxygen- patient with less than 90% SPo
Sublingual nitroglycerine (SL)-dialate coronary arteries, if in 3 doses it does not work you must then start and IV nitroglycerine
Asprin- prevent blood clots
Morphine sulfate- for pain
Mayocardial Infractions
what disease has this medications
IV nitroglycerin
Morphine sulfate
β-adrenergic blockers
Angiotensin-converting enzyme inhibitors
Antidysrhythmia drugs
Cholesterol-lowering drugs
Stool softeners
Mayocardial Infractions
what disease has this medications
MONA
Morphine
Oxygen
Nitriate
Asprin
Mayocardial Infractions
what diease has this diagnostic ECG, echocardiogram (echo), stress testing, and coronary angiography.
Mayocardial Infractions
what has become the gold standard for diagnosis of MI.
An ECG
what disease uses these for diagnostic?
Troponin T/I- protiens expresed in the heart- marker of cadiac damage. Can stay elevated form 4hrs to 10 days
Creatine kinase (CK)- general marker of cellular injury, it asses muscle damage, 3-36 hrs
CK-MB- isoenzyme marker specific to cardiac tissue- asses mayocardial damage
Mayocardial Infractions
what kind of desiease occurs when the blood vessels that deliver oxygen-rich blood to the heart muscle become obstructed or dysfunctional.
Coronary Artery Disease
what medication
Prevents platelets from forming new clots or increasing the size of the present clot
Antiplatelet
Aspirin, clopidogrel (Plavix), eptifibatide (Integrilin)
what medication
Prevents formation of new clots
Anticoagulant
Heparin, enoxaparin (Lovenox), Factor XA inhibitors
what medication
Relieves chest pain
Narcotic
Morphine sulfate, hydromorphone (Dilaudid)
what medication
Decreases myocardial workload thus myocardial oxygen demand, limiting extension of injury
Beta blocker
Metoprolol (Lopressor), Atenolol (Tenormin
what medication
Dilate coronary arteries to increase blood flow to the heart muscle and relieve chest pain
Nitrates
Nitroglycerin (Nitro-BID)
what medication
Revascularization of the heart muscle by dissolving clots in arteries
Thrombolytics
Alteplase (Activase), reteplase (Retavase)
what kind of disease refers to the destruction of heart muscle from lack of oxygenated blood supply. The most common cause of this obstruction is atherosclerosis.
Mayocardinal infraction
what is is the gradual buildup of plaque inside the wall of the artery.
Atherosclerosis
what kind of disease is it When a blood clot or other particulate matter travels to the lungs, it lodges in the pulmonary artery and blocks blood flow
DTV
what disease is a common atherosclerotic vascular disease. characterized by vessel wall thickening, plaque formation, and a progressive narrowing of the carotid artery.
Carotid Artery Disease
what disease is An aneurysm is a permanent localized dilation of an artery that forms when the middle layer (media) of the artery is weakened, producing a stretching effect in the inner layer (intima) and outer layers of the artery.
Aortic Artery Disease
what medication has this teaching? SATA
- Immediately report blood in sputum, emesis, stool, or urine.
- Take the medication at the same time every day.
- Never skip a dose of the medication.
- Have laboratory values (international normalized ratio [INR]) checked on a regular basis.
- Ensure that laboratory levels are safe to continue current dosage or change dosage.
- Limit intake or maintain a consistent intake of green leafy vegetables that contain vitamin K (kale, spinach, collard greens, broccoli, okra, cabbage) that may counteract the action of warfarin.
- Consult with your care provider before taking aspirin or Plavix in addition to warfarin.
- Limit any physical activities that will increase bleeding risk such as contact sports.
- Use an electric razor when shaving. 10. Use a soft toothbrush.
warfin
what has this
Pathophysiological processes
describes the factors implicated in the formation of a venous thrombosis; decreased flow rate of the blood or stasis of blood flow, damage to the blood vessel wall; endothelial injury, and an increased tendency of the blood to clot (hypercoagulability).
Virchow’s triad
what disease has this Genriatric /gentrological considerations
Occur between 60 and 90 years of age.
Rupture is likely with coexisting hypertension and with aneurysms more than 6 cm wide.
Aortic Artery Disease
what is this procedure called?
esection and repair- aneurysm is excised, and a graft is applied.
Aneurysmectomy-
what disease has this action
in what position should you place a patient who is Post-CEA
why?
Carotid Artery Disease
Keep head in neutral position
Decreases strain on incision site and carotid artery.
what disease has this actons?
Administer antihypertensive medication as ordered to maintain BP below 140/90 mm Hg
- Administer lipid-lowering medication as ordered
- Administer antiplatelet aggregates as ordered
- Manage diabetes mellitus/maintain blood glucose within normal levels
Carotid Artery Disease
what nerve has this assesment?
Tongue control and movement, ask patient to stick out tongue
XII: Hypoglossal
what nerve has this assesment?
Shrug shoulders, rotate head side to side
XI: Spinal accessory
what nerve has this assesment?
Swallowing, gag reflex, ask the patient to say “Ah”
X: Vagus
what nerve has this assesment?
Symmetry of face when smiling and showing teeth
VII: Facial
what is the gold standard for diagnosis of the severity of carotid artery disease.
carotid angiography,
what is a complications from Carotid artery?
stroke
what disease has these manifestations?
Asymtpmatic until the lumen of the vessel is obstructed to the point that cerebral perfusion is impaired
sudden weakness, sometimes noted more on one side than the other,
dizziness and loss of coordination,
difficulty talking,
facial droop,
sudden vision problems,
sudden and severe headache.
Carotid Artery Disease
what disease has this
Teaching
Positioning
Inspect feet daily
Report chest discomfort or neurological changes immediately
Lifestyly changes consistant with the management of athrosclerosis
Peripheral Artery Disease
what disease has these
Actions
Administer medications as ordered
Antihypertensives
Antiplatelet agents
cilostazol
Proper positioning
Peripheral Artery Disease
what disease has these
Assessment
Bilateral blood presure
Palpate all pulses on both legs
Visual assesment of feet and limbs
Temperature
Asses pain
Peripheral Artery Disease
what anemia has this
Manifestations Manifestation
Neurological
Lhermittes sign
Numbness, tingling, burning in hands or feet
Altered mood status (confused, dementia)
Depression/confusion
Mood swings
Coordination and balance
Impaired balance/taste, stinging sensation on the tong
Verbal disturbances
b12
what anemia has this Medications
injections
Oral supplementation
b 12
what anemia ahas this manifestations?
Glossitis ( smooth, shiny toung)
Koilonychia (spoon shaped nails)
Iron dificiency anemia
what anemia ahas this manifestations?
Neurological deficits
Paresthesia of feet/fingers
Lhermitte’s sign
Tinnitus
Impaired taste/balance
Depression/confusion
Vit. B Deficiency
what anemia ahas this manifestations?
Mood changes
Increased bleeding risk
Neural tube defects in infants
Folic Acid
what anemia ahas this manifestations?
Frequent infections
Bruising
Nosebleeds
Gum bleeding
Aplastic anemia
what anemia ahas this manifestations?
Jaundice
Dark urine
Splenomegaly
G6PD
what anemia ahas this manifestations?
Pruritis
Facial flushing
Splenomegaly
Vison problems
Weight loss
Nose bleed
Bleeding gums
Hypertension
thromboembolism
Polycythemia
what anemia has this teaching?
Dietary sources
Immediately report any clinical manifestations of fatigue, shortness of breath, dizziness, and confusion
Prenatal teaching
Need for supplementation
folic acid
what anemia has this epidemiology?
Inadequate dietary intake
folic acid
what anemia has this teaching?
Dietary sources of folate/folic acid
Immediately report any clinical manifestations of fatigue, SoB, dizziness, confusion
Prenatal teaching
Need for supplementation
folic acid
what anemia has this
Pathophysiology/Epidemiology
Develops due to bone marrow depression or damage or damage
Aquired secondary to infetions like hepatitis & HIV
High dose radiation (chemotherapy)
Inherited bone marrow dysfunction
aplastic anemia
what anemia has this?
Medical Management/Treatment-
Blood transfusion- primary treatment
Bone marrow transplant from an HLA- matched sibling doner
Stimulating bone marrow production with neupogen,epogen
Over 60yrs immunosuppressive therapy is preferred
aplastic anemia
what anemia has this Complications
Hemorrhage & infection due to decreased platelets and WBC
Risk of GVD due to bone marrow transplant
aplastic anemia
what is the PERFERED treatment of aplastic anemia?
Bone Marrow Transplant is the PERFERD treatment
From a HLA-matching doner
what is the PRIMARY treatment of aplastic anemia?
Blood transfusions is the PRIMARY treatment.
If the patients get too many blood transfusions it puts them at risk for bone marrow transplantation rejection because the transfusion has sensitized that person
what can puts them at risk for bone marrow transplantation rejection because the transfusion has sensitized that person
too many blood transfusions
what anemia has this Management-diagnosis
Heinz bodys blood smear
(Accumulation of deragated Hbg in RBCs)
Avoid faba beans
G6PD
what anemia has this
Epidemiology
Occurs in response to the body’s hypoxic state
Occurs from high altitudes and heavy smoke
WBC/platelet counts remain normal in the presence of the increased RBC production
Secondary polycythemia vera
what anemia has this Symptom management
Reduce hyperviscosity and prevent hemorrhage
Therapeutic phlebotomy
Remove blood and reduce viscosity
polycythemia vera
what is the purpose of radiation in polycythemia vera
Suppress bone marrow production
hydroxyurea, interferon
what anemia has this
Nursing management- actions
Obtain routine CBCs
Increase fluis intake
Ensure adequate rest
Elevate lower extremities when sitting
Modify cardiovascular risk factors
polycythemia vera
what anemia has this
Complications
Repeated phlebotomy can cause iron deficiency
Thombosis
Leads to pulmonary infraction
Hemorage
Gatrointestinal hemorage
Acute myelogenous anemia
Heart failure
polycythemia vera
what is (plasma product rich in factor VIII) may be employed to maintain hemostasis. called?
cryoprecipitate
what anemia has this managment?
treatment with glucocorticoids has proven to be beneficial.
platelet counts by decreasing the antiplatelet antibody production,
Thrombocytopenia
what anemia has this
Manifestations
Ecchymosis
Petechiae
Nosebleeds
Bleeding gums
Black, tarry stool
Hematuria
Thrombocytopenia
what anemia has this Complications-pg 735
Risk of hemorage
Spontanious bleeding
Thrombocytopenia
what anemia has this Nursing Management-action-pg 736
Implement bleeding precautions
Minimize blood loss from lacerations or venepunture
Avoid intramuscular injections
Avoid rectal temperatures, enemas, suppositories, douches
Provide a safe nvironment
Unse minimal inflation when assesing blood presure
Minimize blood draws
Thrombocytopenia
what is this?
It’s a hemorrhagic condition
may occur in patients receiving heparin for an existing thrombus or clot.
patients typically do not have bleeding episodes, and additional thrombi occur or the existing thrombus enlarges
Heparin Induced Thrombocytopenia (HIT)
what is this?
It’s a hemorrhagic condition
Antecedent viral disease that precedes the eruption of petechia or pupura by 1-3 weeks
idiopathic thrombocytopenic purpura (ITP)
what anemia has this
Etiology
Group of bleeding disorders in which, although thrombocytopenia may be present, clotting factors VIII (hemophilia A) and IX (hemophilia B/ Christmas disease) are inadaquate.
Heredatary disorder carried by the females but present in the males
Hemophilia
what anemia has this
Care of the patient
Avoid ,minor,injury it can result in significant blood loss
Hemophilia
what anemi has this
Actions
Implement bleasing procautions
Minimize blood loss from lacerations or venepunture
Avid IM injections
Avoid rectal temperature, enemas, supositories, douches
Provide safe environtment
Use minimal inflation when assesing blood predure
Minimize blood drraws
Hemophilia
what anemia has these Manifestations
Spontanious bleeding
Bleeding in muscles and joints
Hemophilia
normal level of
Creatine kinase myocardial bands (CK-MB)
0–3 ng/mL
normal level of
Troponin
Less than 0.4 ng/mL
normal level of
Myoglobin
0–85 ng/mL
normal level of
Brain natriuretic peptide (BPN)
Less than 100 pg/mL
what disease has this medication?
Diuretics
Antihypertensives
Hypertension
If patient is hypotensive:
Reposition patient flat
Anticipate orders for vasoactive drips or intravenous fluid bolus
If patient is hypertensive:
Maintain head of the bed at 30 degrees
Post-CEA
Keep head in neutral position
Post-CAS
- Encourage fluid intake/Maintain IV fluids
Post-CAS—Renal function
Post-CAS—Renal function
Post-CEA—Cranial nerves, specifically VII, X, XI, and XII
Post-CEA—Cranial nerves, specifically VII, X, XI, and XII
