Venous Insufficieny

Question 1

Venous Pathophysiology

Answer 1

weak valves>low venous return>inc vein pressure

Question 2

venous valves purpose

Answer 2

prevent deoxy blood backflow, keep moving to heart

Question 3

thrombus formation

Answer 3

clump, clotting, coagulation cascade, stop bleeding

Question 4

venous pressure: 3 symptoms

Answer 4

edema, venous ulcers, venous dermatitis

Question 5

venous ulcers interventions

Answer 5

elevate, compression, exercise

Question 6

brown skin color due to

Answer 6

iron seeping thru veins

Question 7

venous ulcers: 3 characteristics

Answer 7

superficial, pink, uneven edges, above ankle

Question 8

why venous ulcer superficial vs arterial ulcer

Answer 8

arterial necrosis, dead tissue, deeper wound

Question 9

peripheral venous disease pulses

Answer 9

normal, no problem with oxy in tissues +2

Question 10

venous insufficiency pain

Answer 10

ache, cramp, dull b/c water congestion vs artery sharp

Question 11

venous peripheral disease skin appearance

Answer 11

edema, think, tough, brawny

Question 12

how to promote venous circulation

Answer 12

exercise, intermittent compression therapy

Question 13

calf function

Answer 13

act as pump for blood, contract push blood to heart

Question 14

obese patient, postsurgical wear compression socks

Answer 14

always

Question 15

VTE venous thromboembolism aka

Answer 15

DVT deep vein thrombosis

Question 16

DVT description

Answer 16

blood clot in venous system usually lower extremity

Question 17

Virchow’s triad 3 causes thrombosis formation

Answer 17

statis of blood, injury to vessel, hypercoagulation

Question 18

injury to blood vessels include

Answer 18

smoking, trauma

Question 19

coagulation purpose

Answer 19

platelets form together to clot and stop bleeding

Question 20

pregnancy risk factor DVT

Answer 20

uterus presses against IVC, inc in clotting factors

Question 21

atrial fibrillation risk factor DVT

Answer 21

artery not contracting regular, blood static>clot

Question 22

Homan’s sign

Answer 22

calf pain on dorsiflexion of foot when raised

Question 23

DVT clinical manifestations

Answer 23

unilateral pain, swell/warm extremity, inc calf size

Question 24

clot care

Answer 24

bed rest, ambulate can dislodge clot, no compression

Question 25

DVT primary cause

Answer 25

prolonged sitting, crossed legs

Question 26

DVT diagnostics: Lab

Answer 26

CBC, D-dimer

Question 27

DVT diagnostics: Non-invasive

Answer 27

venous-duplex ultrasound, sound waves show vein

Question 28

DVT diagnostics: Invasive

Answer 28

contrast venography, computed tomography

Question 29

contrast venography

Answer 29

dye injected in vein>xray>slow blood move>clot

Question 30

computed tomography venography

Answer 30

images used for pulmonary embolism (PE)

Question 31

DVT treatment

Answer 31

anticoagulant or thrombolytic therapy, greenfield filter

Question 32

greenfield or IVC filter

Answer 32

vascular filter placed in IVC to prevent PE

Question 33

thrombolytic therapy tPA purpose

Answer 33

dissolve, break clot, done in ICU, only on large clot

Question 34

anticoagulant meds DVT: 2 types heparin

Answer 34

unfractionated heparin (Heparin), LMWH (Lovenox)

Question 35

unfractionated heparin (UFH) aka Heparin

Answer 35

fast acting w/ antithrombin IIa: prevent clot formation

Question 36

Heparin care

Answer 36

monitor aPTT, IV, 2 RNs verify, bolus then drip

Question 37

Heparin solution

Answer 37

25,000 units in 250 mL D5W

Question 38

heparin role

Answer 38

prophylactic doesn't break clot

Question 39

thrombus vs thrombosis

Answer 39

thrombus-healthy response to injury to prevent bleeding, thrombosis- clotting in healthy blood vessel

Question 40

embolism

Answer 40

dislodgment of thrombus, travel via blood thru body

Question 41

pulmonary embolism (PE)

Answer 41

thrombus lodges in pulmonary artery

Question 42

heparin or LMWH given at home?

Answer 42

no

Question 43

aPTT definition

Answer 43

activated partial thromboplastin time, how long for blood to clot

Question 44

aPTT purpose, range

Answer 44

lab value for Heparin patient. normal 25-35 seconds

Question 45

aPTT = PTT for DVT patient time goal

Answer 45

1.5 to 2.5 times PTT control value/normal 50-90 sec

Question 46

aPTT low, less than 50 seconds means

Answer 46

blood clot too fast, heparin goal to prevent clot

Question 47

aPTT high, over 90 seconds

Answer 47

clotting too slow, if injured do need to clot/stop bleed

Question 48

Heparin complications: 2

Answer 48

bleeding, HIT (Heparin induced thrombocytopenia)

Question 49

HIT Heparin induced thrombocytopenia definition

Answer 49

low platelet count and thombosis

Question 50

HIT Heparin induced thrombocytopenia timing

Answer 50

6-14 days after start of Heparin - immune disorder

Question 51

clot dissolution in healthy blood vessel

Answer 51

plasmin a clot dissolving enzyme is released

Question 52

3 types venous clots

Answer 52

superficial venous thrombosis, DVT, PE

Question 53

warfarin (coumadin) antagonists/antidote

Answer 53

vit K and fresh frozen plasma (clotting factors) stop bleeding faster than vit K which takes a few days

Question 54

warfarin timing

Answer 54

3-5 days, long term maintenance

Question 55

warfarin action

Answer 55

inhibit synthesis of vit K dependent clotting factors in liver

Question 56

warfarin/coumadin labs

Answer 56

PT prothrombin time test and INR a ratio of PT

Question 57

PT prothrombin time test is

Answer 57

prothrombin protein produced by liver to form clot, INR shows effectiveness of warfarin med.

Question 58

PT/INR preoperative because

Answer 58

shows ability to clot prior to surgery

Question 59

INR range

Answer 59

normal, health 1.0, warfarin patient 2.0-3.0, stop heparin or LWMH when target range met

Question 60

INR range meaning

Answer 60

2.0-3.0 heparin patient clotting appropriate time. above 3.0 clotting too slow for hep patient, below 2 too fast

Question 61

heparin antagonist/reversal agent

Answer 61

protamine sulfate

Question 62

warfarin/coumadin reversal agents

Answer 62

vit K, and FFP