week 2 -- PE, chest trauma, valve diseases, & aneurysms

Question 1

common cause of a PE

Answer 1

DVT

Question 2

ABG’s with a PE tell you

Answer 2

intubate or escalate O2

Question 3

D-dimer

Answer 3

tells you how much fibrins were relaeased to take apart a clot

**higher # = more likely of a clot

**expected rage is less than 0.4 mcg/mL

Question 4

if a patient w allergy to iodine/shellfish cannot do angiography to diagnose PE then they will do a

Answer 4

ventilation perfusion scan—– shows circulation of air and blood in the lungs

Question 5

gold standard to diagnose PE

Answer 5

pulmonary angiography — allergy to shellfish & iodine

Question 6

6 ways to diagnose a PE

Answer 6

1. pulmonary angiography (gold standard)
2. ABG
3. Ventilation perfusion
4. Ct Scan
5. chest x-ray
6. d- dimer

Question 7

interventions for PE

Answer 7

1. initiate o2 & high - fowlers (90 degrees)
2. iv access
3. vitals

Question 8

INR range

Answer 8

describes blood clotting

0.8 to 1.1

Question 9

goal of INR when on warfarin

Answer 9

2 to 3

Question 10

normal pT time

Answer 10

11 to 12.5 seconds

Question 11

normal ApTT time

Answer 11

30 to 40 seconds but 1.5 to 2.5x more w heparin

Question 12

low molecular weight heparin

Answer 12

enoxaparin

Question 13

anticoagulants are contraindicated in

Answer 13

peptic ulcer disease
uncontrolled HTN
stroke
trauma

Question 14

thrombolytic agents are used for

Answer 14

bigger clots

ALTEPLASE
reteplase
tenecteplase

• -eplase

Question 15

therapeutic procedures for a PE

Answer 15

embolectomy
vena cava filter

Question 16

normal PaO2

Answer 16

80 to 100 mmhg

Question 17

vitamin K foods on wafarin

Answer 17

do not increase or decrease

Question 18

teaching to prevent DVT/PE

Answer 18

walk 5 min every hour
compression stockings
dorsi-plantar flexion

Question 19

s/s of decreased cardiac output

Answer 19

hypotension
tachycardia
JVD
cyanosis
syncope

Question 20

antidote for heparin

Answer 20

protamine sulphate

Question 21

antidote for warfarin

Answer 21

vitamin K

Question 22

a nurse is assessing a client who has a pulmonary embolism. Which of the following manifestations should the nurse expect? sap

1. bradypnea
2. pleural friction rub
3. hypertension
4. petechiae
5. tachycardia

Answer 22

2. pleural friction rub
3. petechiae
4. tachycardia

** tachypnea
**hypotension

Question 23

client has acute dyspnea & diaphoresis. client states “I am anxious & unable to get enough air”. vitals are HR 117/min, RR 38bpm , temp 101.2, and bp of 100/54. what is the nurses priority?

1. notify the provider
2. administer heparin via IV infusion
3. administer oxygen therapy
4. obtain a CT scan

Answer 23

3. administer oxygen therapy

**ABC’s

Question 24

BUN range

Answer 24

7 to 20

Question 25

creatinine range

Answer 25

0.7 to 1.3

Question 26

INR range when on warfarin

Answer 26

2 to 3