Exam 1 study guide 2.0

Question 1

stasis of blood
vessel damage
increased blood coaguality

Answer 1

virchow triad

Question 2

refers to thrombus formation in the deep veins, usually in the thigh or calf, but sometimes in the arm (e.g., patients with peripherally inserted central catheters).

Answer 2

Deep vein thrombosis (DVT)

Question 3

A physiological process in
which blood is converted from
a liquid to a semisolid gel

Answer 3

clotting

Question 4

Treatments:
 Medicine:
 Anticoagulants
 Fibrinolytic drugs
 NSAIDS
 Procedures:
 Venous Thrombectomy
 Vena Cava filter

Answer 4

DVT treatments

Question 5

The primary pharmacologic treatment for the prevention and management of DVT is anticoagulant therapy which consists of

Answer 5

vitamin K antagonists (e.g., warfarin), indirect and direct thrombin inhibitors, and factor Xa inhibitors

Question 6

Endovascular management is necessary for DVT when anticoagulant or thrombolytic therapy is contraindicated, the danger of PE is extreme, or venous drainage is so severely compromised that permanent damage to the extremity is likely. A thrombectomy may be necessary.

Answer 6

venous thrombectomy

Question 7

A _____ may be placed at the time of the thrombectomy or thrombolysis; this filter traps large emboli and prevents PE

Answer 7

vena cava filter

Question 8

When performing the nursing assessment, key concerns include

Answer 8

limb pain
feeling of heaviness
functional impairment
ankle engorgement
edema
increase in surface temperature
and areas of tenderness or superfical thrombosis

Question 9

If the patient is receiving anticoagulant therapy, the nurse monitors laboratory values as indicated. The aPTT, PT, INR, ACT, hemoglobin and hematocrit values, platelet count, and fibrinogen levels can be affected, depending on the anticoagulant prescribed;

Answer 9

baseline assessment before initial therapy

close observation to detect bleeding, if bleeding occurs it must be reported and therapy reversed

Question 10

Potential complications of anticoagulant therapy consist of bleeding, thrombocytopenia, and drug–drug interactions.

Answer 10

be familiar with medications approved to reverse effects of various anticoagulants, and educate patients and caregivers on ways to reduce these potential risks

Question 11

Elevate feet and lower legs periodically above heart level when the patient is on bed rest to help empty and collapse superficial and tibial veins.

Active and passive leg exercises, especially those involving calf muscles, increase venous flow.

Early ambulation is the most effective measure to prevent venous stasis.

Walking is encouraged after anticoagulation therapy has been initiated.

Walking is preferred over standing or sitting for long periods.

Once ambulatory:

Avoid sitting for more than 1 hour at a time.

Aim to walk at least 10 minutes every 1–2 hours.

When unable to ambulate (e.g., during long trips), perform active and passive leg exercises frequently.

Deep breathing exercises help by increasing negative thoracic pressure, which assists in emptying large veins.

Answer 11

positioning the body after DVT therapy

Question 12

fluid collects in the lungs, patient may feel short of breath with activity or laying down

Answer 12

left sided heart failure

Question 13

fluid begins to collect in the feet and lower legs. pitting edema.

Answer 13

right side heart failure

Question 14

dyspnea
yellow secretions
stridor
pulmonary crackles
nasal flaring, grunting, retracting
elevation in RR
activity intolerance

Answer 14

DYSPNEA= left sided heart faliure

Question 15

enlarged liver
distended neck veins
enlarged spleen
most edema in LE
ascites, anorexia

Answer 15

edema= right sided heart failure