Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3512 - Class 1-6 > Week 4 - DVT > Flashcards

Week 4 - DVT Flashcards

1
Q

what is DVT

A
  • disorder involving a thrombus in a deep veing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what 2 veins does DVT typically effect

A
  • femoral

- iliac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the 3 main factors in the cause of venous thrombosis

A
  • venous stasis
  • endothelial damage
  • hyerpcoaguable blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are risk factors for venous stasis (7)

A
  • obesity
  • pregnancy
  • HF
  • afib
  • long trips w/o regular exercise
  • prolonged surgical procedure
  • immobolity for long periods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are causes of endothelial damage (7)

A
  • surgery
  • imtravascular catheterization
  • trauma
  • burns
  • chemo
  • DM
  • sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can cause hypercoaguability of blood (4)

A
  • sepsis
  • oral contra
  • smoking
  • hematological disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are symptoms of DVT (8)

A
  • unilateral leg edema
  • extremitity pain
  • sense of fullness in thigh/calf
  • paresthesias
  • warm skin
  • erythema
  • fever
  • positive Homen’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is a positive homen’s sign

A
  • pain on forced dorsiflexion of the foot when the leg is raise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are complications of DVT (4)

A
  • PE (life threatening)
  • chronic venous insufficiency
  • phlegmasia cerula dolens
  • venous leg ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are S&S of chronic venous insufficiency (5)

A
  • persistent edema
  • increased pigmentation
  • secondary varicosities
  • ulceration
  • cyanosis of limb

when limb is placed in dependent position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what types of care are done for DVT (3)

A
  • prevention and prophylaxis
  • drug therapy
  • surgical therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are ways to prevent DVT in pts who are at risk (4)

A
  • mobilization = easiest and most cost-effective method
  • compression stocking
  • sequential compression devices
  • preventative anticoag
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some ways to mobilize to prevent DVT (3)

A
  • if on bed rest, turn q2h
  • flex & extend feet, knees, hip q2-4 h
  • ambulate 4-6 x/day as tolerates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are sequential compression devices

A
  • inflatable garments wrapped around the legs that apply intermittent external pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what meds are used routinely for prevention and treatment of DVT

A
  • anticoags
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the goal of anticoag therapy (4)

A
  • prevent clot formation
  • prevent propagation of clot
  • prevent development of new thrombi
  • prevent embolization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are 4 major classes of anticoag therapy

A
  • vitamin K antagonist
  • direct thrombin inhibitor
  • indirect thrombin inhibitor
  • factor Xa inhibitor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

anticoagulant therapy does not…

A
  • dissolve the clot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what type of med is not recommended for DVT thromboprophylaxis

A
  • aspirin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is a type of vitamin K antag

A
  • warfarin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how long does it take for warfarin to be effective

A
  • 48-72 hr to affect PT time

- several days for maximum effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

due to the time it takes for warfarin to be effective, what is required

A
  • overlap of a parental anticoag (ex. unfractioned heparin, low molecular weight heparin) for at least 5 days
  • once warfarin at therapeutic lvl, d/c heparin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what blood coag test should be monitored w warfarin

A

INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

a diet that frequently varies in _____, makes it difficult to achieve and maintain therapeutic INR w warfarin

A
  • vitamin K
25
Q

what is the normal INR time? therapeutic?

A
  • normal = .81-1.2

- therapeutic = 2-3

26
Q

what are 2 classes of indirect thrombin inhibitors

A
  • unfractioned heparin

- low molecular weight heparin

27
Q

what blood coagulation test should be monitored w heparin

A
  • aPTT (PTT)
28
Q

what is a serious s/e of heparin

A
  • heparin induced thrombocytopenia
29
Q

what is the benefit of LMWH (4)

A
  • more predictable dose response
  • lower incidence of bleeding complications
  • less likely to cause HIT and osteoporosis
  • do not require anticoag monitoring and dose adjustment
30
Q

what is a type of direct thrombin inhibitor

A
  • hirudin
31
Q

what meds are used for DVT prophylaxis (4)

A

low dose

  • UH
  • LMWH
  • warfarin
  • fondaparinux
32
Q

what anticoag meds are used for DVT treatment (4)

A
  • LMWH
  • UH
  • fondaparinux
  • warfarin
    for at least 5 days or until INR is 2 or higher
33
Q

what thrombolytic therapy is used for DVT (5)

A
  • catheter directed admin of a thrombolytic drug
  • tPa/alteplase
  • angioplasty
  • stents
  • mechanical thrombectomy
34
Q

what is the normal aPTT time? therapeutic?

A
  • normal = 30-40 sec

- therapeutic = 46-70 sec

35
Q

what is discharge teaching for anticoag therapy (9)

A
  • contact EMS for bleeding that doesn’t stop (10-15 min)
  • take med at same time everyday
  • frequent follow ups for bloodwork
  • avoid contact sports (d/t risk for trauma)
  • use soft bristled toothbrush
  • limit alcohol (1oz/day)
  • wear medic alert bracelet
  • inform all HCP of anticoag therapy (including dentist)
  • avoid changes in eating habits (espec vit K)
36
Q

what should a pt on anticoag therapy report (6)

A
  • tarry stools
  • severe headache
  • stomach pain
  • confusion
  • dizziness
  • bruising
    that is more than normal
37
Q

what should pts on anticoag therapy not take (3)

A
  • NSAIDs
  • ASA
  • many herbal drugs
38
Q

what is a type of surgical therapy for DVT (2)

A
  • open thrombectomy

- inferior vena cava interruption

39
Q

describe teaching for a pt with DVT (10)

A
  • modification of risk factors
  • use of compression stockings
  • avoid constrictive clothing
  • avoid standing or sitting in motionless, lep-dependent position
  • frequent knee flexion, ankle rotation and active walking during long periods of sitting or standing
  • wear compression stocking or take 1 dose of LMWH before long flight
  • S&S of PE
  • med education
  • apply pressure for 10-15 min if bleeding occurs
  • proper hydration to avoid hypercoagulability of blood
40
Q

what is chronic venous insufficiency

A
  • a condition in which the valves in the veins are damaged causing retrograde blood flow, swelling & pooling of blood in legs
41
Q

what can CVI lead to

A
  • venous leg ulcers
42
Q

what impact does CVI have on hydrostatic P and wat does this cause

A

= increased hydrostatic pressure

= serious fluid & RBCs leak from capillaries into tissue resulting in edema & skin irritation

43
Q

what are symptoms of CVI (5)

A
  • edema
  • itching
  • stasis dermatitis (eczema)
  • skin hyperpigmentation (brown, leathery)
  • venous ulcers
44
Q

where are venous ulcers often located

A
  • medial mallelous
45
Q

describe manifestations of venous ulcers (3)

A
  • painful (may be worse when in dependent position)
  • irregular borders
  • lots of drainage
46
Q

describe collaborative care for venous ulcers (9)

A
  • compression bandages
  • moist enviro dressings
  • balanced diet
  • maintain normal BG if has DM
  • prevent and assess for S&S of infection
  • proper skin care & non scented moisturizers
  • daily walking program
  • avoid standing or sitting for too long
  • elevate legs to reduce swelling
47
Q

what are compression bandages imp for? (3)

A
  • treatment of CVI
  • venous ulcer healing
  • prevention of ulcer recurrence
48
Q

how do compression bandages help w treatment of venous ulcers and CVI (2)

A
  • constrict the veins

- improves fnxn of venous valves

49
Q

describe the diet for someone w venous ulcers (6)

A
  • adequate protein
  • cal
  • vitamin A
  • vitamin C
  • zinc
  • weight loss diet

*all imp for healing)

50
Q

what foods are high in vitamin A

A
  • green leafy veggies
51
Q

what foods are high in vitamin C (3)

A
  • citrus fruits
  • tomatoes
  • canteloupe
52
Q

what food are high in zinc (2)

A
  • meat

- seafood

53
Q

what are signs of infection in a venous ulcer (8)

A
  • change in quanitity, color, or odour of drainage
  • presence of pus
  • erythema of wound edges
  • increased local pain and/or edema
  • dark colored granulation tissue
  • induration around wound
  • delayed healing
  • cellulitis
54
Q

if signs of infection are present in a venous ulcer, what should you do

A
  • get wound culture before instituting ab
55
Q

what is the usual treatment for infection in a venous ulcer (3)

A
  • debridement
  • wound excision
  • systemic antibiotics
56
Q

what should you teach a pt with venous leg ulcers and CVI (9)

A
  • avoid trauma to limbs
  • teach proper skin care
  • teach how to use compression stockings
  • proper foot and leg care
  • w each dressing change, assess the wound for signs of infection
  • avoid standing or sitting for long periods of time
  • elevate legs to reduce edema
  • daily walking program once ulcer heals
  • prescription graduated compression stocking worn daily and replaced every 4-6 mo.
57
Q

describe what to teach a pt r/t proper foot and leg care w CVI and venous leg ulcer (2)

A
  • daily moisturizing to decrease itching and prevent cracking
  • avoid scented moisturizers
58
Q

can compression bandages be used for both arterial and venous issues?

A

no never use for arterial

NURS 3512 - Class 1-6 (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions