week 2 -- PE, chest trauma, valve diseases, & aneurysms Flashcards
common cause of a PE
DVT
ABG’s with a PE tell you
intubate or escalate O2
D-dimer
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
if a patient w allergy to iodine/shellfish cannot do angiography to diagnose PE then they will do a
ventilation perfusion scan—– shows circulation of air and blood in the lungs
gold standard to diagnose PE
pulmonary angiography — allergy to shellfish & iodine
6 ways to diagnose a PE
- pulmonary angiography (gold standard)
- ABG
- Ventilation perfusion
- Ct Scan
- chest x-ray
- d- dimer
interventions for PE
- initiate o2 & high - fowlers (90 degrees)
- iv access
- vitals
INR range
describes blood clotting
0.8 to 1.1
goal of INR when on warfarin
2 to 3
normal pT time
11 to 12.5 seconds
normal ApTT time
30 to 40 seconds but 1.5 to 2.5x more w heparin
low molecular weight heparin
enoxaparin
anticoagulants are contraindicated in
peptic ulcer disease
uncontrolled HTN
stroke
trauma
thrombolytic agents are used for
bigger clots
ALTEPLASE
reteplase
tenecteplase
- -eplase
therapeutic procedures for a PE
embolectomy
vena cava filter
normal PaO2
80 to 100 mmhg
vitamin K foods on wafarin
do not increase or decrease
teaching to prevent DVT/PE
walk 5 min every hour
compression stockings
dorsi-plantar flexion
s/s of decreased cardiac output
hypotension
tachycardia
JVD
cyanosis
syncope
antidote for heparin
protamine sulphate
antidote for warfarin
vitamin K
a nurse is assessing a client who has a pulmonary embolism. Which of the following manifestations should the nurse expect? sap
- bradypnea
- pleural friction rub
- hypertension
- petechiae
- tachycardia
- pleural friction rub
- petechiae
- tachycardia
** tachypnea
**hypotension
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?
- notify the provider
- administer heparin via IV infusion
- administer oxygen therapy
- obtain a CT scan
- administer oxygen therapy
**ABC’s
BUN range
7 to 20
creatinine range
0.7 to 1.3