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Clotting Flashcards

1
Q

Heparin is __ acting

A

Rapid acting

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2
Q

What labs should the nurse monitor while her pt. is on a heparin drip?

A

PTT

K+ (can cause hyperkalemia)

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3
Q

Antidote for Heparin

A

Protamine Sulfate

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4
Q

Enoxaparin antidote

A

Protamine Sulfate

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5
Q

Warfarin is ___ acting

A

Delayed acting

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6
Q

Warfarin indication

A

Prevention of DVT, PE

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7
Q

What labs should the nurse monitor if her pt. is on Warfarin?

A

PT and INR

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8
Q

Antidote for Warfarin

A

Vitamin K

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9
Q

Side effect of Warfarin

A

Terotegenesis

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10
Q

Alteplase drug classification

A

Thrombolytic - breakdown clots

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11
Q

Major adverse effect of Alteplase

A

Bleeding

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12
Q

Blood transfusions are only administrated with that type of IV fluid?

A

Isotonic - NS

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13
Q

What is common gauge size for blood admin?

A

18-20

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14
Q

Universal blood donor

A

O-

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15
Q

Universal blood receiver

A

AB+

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16
Q

When starting a blood transfusion the blood must be verified by __ ____

A

2 nurses

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17
Q

The nurse must stay in the room for ___ min after starting the blood transfusion

A

15 min

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18
Q

Pt. receiving blood after 2 hours. the pt. is having a reaction. What is the nurse’s first action?

A

Stop the infusion

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19
Q

Pt. receiving blood after 2 hours. the pt. is having a reaction. Nurse stops the infusion. can the nurse save the rest of the blood for later?

A

No, after 4 hours of the blood being out of the blood bank to blood has to be sent back

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20
Q

Stages of Hemostasis

A 
Vasospasm
Formation of platelet plug
Clot formation
Clot retraction
Fibrinolysis
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21
Q

Von Willebrand’s Factor

A

Necessary for platelets to be able to stick together

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22
Q

Clot retraction function:

A

Platelets contract and pull injury together and release growth factor to stimulate tissue repair

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23
Q

Intrinsic Pathway

A

Injury occur inside the blood vessel
Slower (more steps)
Measured by PTT

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24
Q

Hageman Factor

A

Factor XII

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25
Extrinsic Pathway
Injury due to elements outside the blood vessel Faster Measured by PT
26
Final Clotting Pathway
Prothrombin to thrombin to fibrinogen to fibrin
27
Intrinsic pathway lab
PTT
28
Extrinsic pathway lab
PT
29
How do antibiotics affect clotting?
They decrease Vitamin K levels | Decrease ability to clot
30
How does aspirin, salicylates, clopidogrel, NSAIDs, thiazide diuretics, antibiotics, heparin affect clotting?
Interfere with platelet production or function (Decrease clotting)
31
How does amiodarone, steroids, warfarin, and low weight heparin affect clotting?
Interfere with coagulation factors
32
Class of drug that breaks down clots
Fibrolytics/Thromobolytics (TPA)
33
True/False: Anticoagulants break down clots that have already formed
False, anticoagulants only prevent more clots from forming
34
What time frame must fibrinolytics be given if a pt. is currently presented to ER with MI/Stroke
Must be given within 3-4 hours of the ischemic symptoms
35
Normal PTT level
60-70 secs
36
Normal PT level
10-13 secs
37
Normal INR level
0.8-1.2 secs
38
Normal RBC Male
4.71-5.1
39
Normal RBC Female
4.2-4.8
40
Normal WBC
4,500-11,000
41
Normal Hemoglobin Male
13.5-16.5
42
Normal Hemoglobin Female
12-15
43
Normal Hematocrit Male
43-49%
44
Normal Hematocrit Female
38-44%
45
What disease can result from bone marrow suppression?
Anemia | Thrombocytopenia
46
Symptoms of Anemia
``` Pale skin, lips, nails Fatigue Dizziness Weakness HA SOB Tachypnea Tachycardia ```
47
Neutropenia symptoms
No symptoms unless have infection
48
Most common site for bone marrow biopsy?
Posterior superior iliac crest
49
Thrombocytopenia
Low platelets
50
Neutropenia
Low WBCs
51
Causes of thrombocytopenia
``` Malignancy Sulfa meds Infection Autoimmune conditions DIC ```
52
Most common autoimmune platelet disorder
Immune thrombocytopenia purpura
53
Immune thrombocytopenia purpura
Usually follows viral infection | Immune mediated platelet destruction faster than normal
54
Disseminated Intravascular Coagulation
Follows severe trauma | Pt. clots too much and exhausts clotting factors then not able to clot which leads to lots of bleeding
55
Symptoms of Thrombocytopenia
``` Bruising Pink urine Nosebleed Small red/purple spots Bleeding that does not stop w/ pressure ```
56
Precautions for thrombocytopenia
Stop NSAIDS or aspirin if can Use soft toothbrush Use electric razor Encourage shoes when out of bed Maintain clutter free environment Use stool softener - avoid straining Avoid rectal thermometers, suppositories, enemas Do not blow nose Apply pressure for no less than 5 min after cut Arterial procedures should be kept to a minimum
57
Heparin given ___ (route) can cause ___
Heparin given IM can cause severe hematomas
58
___ nurse always check dose of heparin before it is given
2 nurses always check dose of heparin before it is given
59
Pt. with immune thrombocytopenia purpura is at risk for:
Bleeding
60
"-ase" drugs
Fibrinolytics
61
Platelet inhibitor
Clopidogrel
62
Clotting factors for Intrisic
XII, XI, IX | All "X" factors but not X
63
Clotting factor of extrinsic
III, VII | 3+7= 10
64
Anticoagulants effect what clotting factors
II VII IX X
65
``` The nurse is assigned to a patient with thrombocytopenia. What is the priority goal of nursing care? A. Prevention of infection B. Prevention of injury C. Prevention of dehydration D. Prevention of nutritional deficit ```
B - b/c low platelets high risk for injury and bleeding

Med Surg (22 decks)

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