Quiz 5: Stroke, SIRS, Shock, Sepsis, Blood clots Flashcards
Why do we want to know if our patients are on anti-coagulation medications?
We conduct procedures that may cause bleeding.
What are the two pathways that can be activated during a blood clot?
Intrinsic - changes to vascular epithelium
Extrinsic - tissue damage (trauma)
What is the material that holds clots together?
Fibrin
T/F: The body is always working towards homeostasis.
True.
When balance of homeostasis is disrupted, it can lead to the development of:
Coagulopathies - leading to hypercoagulability (likely to develop excessive clots) or bleeding disorders (excessive bleeding)
If a blood clot travels to another location, it is a(n):
a. thrombus
b. emboli
c. coagulation
d. all of the above
b. emboli
If a blood clot remains in the vein, it is a(n):
a. thrombus
b. emboli
c. coagulation
d. all of the above
a. thrombus
T/F: Antithrombotics are to prevent further formation of clots, while thrombolytics are to break up existing clots.
True.
Which diagnostic is the GOLD standard for detecting pulmonary embolism?
a. V/Q scan
b. hemotology
c. CT pulmonary angiogram
d. MRI
c. CT pulmonary angiogram
Which diagnostic test for pulmonary embolism is very accurate but very invasive?
a. pulmonary angiogram
b. hemotology
c. CT pulmonary angiogram
d. MRI
a. pulmonary angiogram
Which of the following are preventative treatments of PE?
- Ambulating
- Exercise while sitting
- Compression stockings
- Drinking lots of fluids
1, 2, 3, and 4
T/F: Cerebrovascular Accidents can be identified as mini strokes.
False. CVA is a stroke that can be ischemic or hemorrhagic. Transient Ischemic Attack is a mini stroke.
T/F: TIAs are associated with higher chance of stroke.
True
What is the acronym used for identifying a patient with a stroke?
F-A-S-T
Loss of blood flow, therefore blocked blood vessels that cannot supply the brain tissue with oxygenated blood, best describes which type of stroke?
Ischemic (embolic):
Embolism, arteriosclerotic, vasoconstriction.
What is the best treatment for ischemic strokes?
Thrombolytic medications to break up clot and and restore blood flow
Chance of bleeding.
Option 2: Vascular stenting/surgery
Patient had an aneurysm post surgery and is now bleeding inside the brain. What type of stroke is this?
Hemorrhagic stroke (bleeding): Post traumatic/surgical, aneurism, antiocoagulant therapy.
Which of the following are treatments for hemorrhagic strokes?
- Preventing hypertension
- Keep HOB elevated
- Minimize pt stimulation
- Reverse anticoagulation if possible
- Embolization, craniotomy
All of the above
What is the time frame for door to needle stroke protocol?
60 min or less
What acronym is associated with the treatment of ACS?
a. F-A-S-T
b. M-O-N-A
c. A-B-C-D-E
d. P-E-R-R-L-A
b. M-O-N-A
Morphine - relieve chest pain/cardiac workload
Oxygen - reduce myocardial workload
Nitroglycerine - dilate coronary arteries to improve blood flow
Aspirin - prevent further clotting
T/F: You should always obtain a 12-lead EKG for ACS.
True.
This will show cardiology if there is a blockage and where exactly it is located. Monitor patient closely for deterioration and have crashcart nearby.
What is the goal time for Percutaneous Coronary Intervention (PCI)?
a. 30 minutes
b. 60 minutes
c. 90 minutes
c. 90 minutes
90 minute door to balloon time or less.
What is the goal time for fibrinolytic therapy?
a. 30 minutes
b. 60 minutes
c. 90 minutes
a. 30 minutes
30 minute door to needle time or less.
