Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adult health 2 > Exam 2: Cardiac > Flashcards

Exam 2: Cardiac Flashcards

(79 cards)

Start Studying
1
Q

When a thrombus becomes dislodged and travels what is our biggest life threatening concern

A

that it will travel to the right side of the heart and become a pulmonary embolus – life threatening

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

What is a DVT

A

thrombi developed from platelets, fibrin, RBC, WBC in areas where blood flow is slow or turbulent

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

What 3 things are involved with the etiology virchow’s triad

A

Blood: hyper-coagulability
Vessel: vascular damage
Flow: coagulatory stasis

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

What are risk factors for deep venous thrombosis

A

heart disease
dehydration
immobility (BR for more than 72 hours, air travel for longer than 4 hours)
paralysis
incompetent vein valves
obesity
pregnancy
surgery
age over 40
female

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

Risk factors for vessel wall injury

A

trauma (fracture–long bones and pelvis, burns)
infection
venipuncture
intravenous infusion of irritant solutions
central and peripheral intravenous cath
history of DVT or varicose veins
previous major surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk factors of hypercoagulability

A

alterations in hemostatic mechanisms (hemolytic anemias, increased viscosity, inherited coagulation disorders)
trauma or surgery
malignancy
oral contraceptives use
dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical manifestations of the DVT

A

local pain or tenderness
unilateral edema or swelling
may be bilateral if DVT is located in vena cava
local warmth, redness
mild fever
tender, palpable venous cord in popliteal fossa
positive homan’s signs

no symptoms in 50% of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do we diagnose a DVT…

Noninvasive:
Invasive:
Other exams:

A

Noninvasive: doppler studies, impedance plethysmography

invasive: venogram

Other: D-dimer, radio labeled fibrinogen scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Prevention of a DVT

A

pharm prophylaxis of anticoagulant

mechanical prophylaxis: reduce risk factors as appropriate–immobility, hydration, use of pneumatic devices

Lifestyle modifications: avoid oral contraceptives and smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indications for enoxaparin (lovenox)

A

total hip arthroplasty
hip fracture
total knee arthroplasty

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

Indications for danaparoid (Orgaran)

A

total hip arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indications for Dalteparin (Fragmin)

A

total hip arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Indication for ardeparin (Normiflo)

A

total knee arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anticoagulant therapy will _________

A

prevent further clot development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What to know about heparin

A

SQ or IV

Monitor PTT, H/H, platelets

Assess for bleeding

Initiate bleeding precautions–avoid IM injections, use of razors, soft toothbrushes

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

Antidote for heparin

A

protamine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indications coumadin (Warfarin)

A

PO–Initiate concurrently with Heparin therapy

Monitor PT/INR, H/H

teach patient long term implications, dietary considerations, medic alert ID, bleeding precautions

Monitor for signs of bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Antidote for Warfarin

A

Vitamin K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_______ is a highly selective direct thrombin inhibitor

A

Bivalirudin (Angiomax)

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

Thrombolytic therapy

A

Activate the conversion of plasminogen to plasmin which actively dissolves the clot

We get worried for bleeding

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

Additional treatments of DVT’s

A

possible bedrest

pain management

monitor for complications of DVT: PE, Vena cava interruptions/filter

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

Pulmonary embolisms present with

A

change in LOC, dyspnea, SOB, productive cough, tachycardia, decreased oxygen saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are indications for vena cava filter placement

A

recurrent thromboembolisms despite anticoagulation

confirmed deep venous thrombosis or thromboembolism with a contraindication to anticoagulation therapy

complication of anticoagulation requiring discontinuation of therapy

recurrent pulmonary embolism with associated pulmonary hypertension and cor pulmonale

free-floating thrombus

postpulmonary embolectomy

prophylaxis in high risk patients

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

Varicose veins are

A

prominent, torturous dilated veins effecting the lower extremities, gravity on venous pressure, valvular incompetence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
epidemiology of varicose veins
women in multi pregnancies, increase incidence in women-elderly
26
Etiology of varicose veins
hereditary factors, obesity, prolonged standing, chronic disease
27
Symptoms of varicose veins
possibly asymptomatic or swelling, heaviness, pressure, discomfort, nocturnal cramps
28
Diagnosis of varicose veins
Noninvasive trendelenburg's test
29
Treatment of varicose veins
dependent on the severity of varicosities --> elastic stockings, decrease prolonged standing, lifestyle modifications, avoid tight fitting clothes
30
Treatment options of varicose veins
sclerotherapy laser ablation therapy ligation and stripping surgical procedure
31
What is sclerotherapy
injection of an irritating solution which leads to fibrosis and obliteration of the vein lumen outpatient, elastic compression stocking are worn
32
What is laser ablation therapy
nonsurgical approach using laser fiber contact inside the vein that seals the vein, outpatient compression stockings
33
Venous ulcers
chronic venous insufficiency (common in legs)
34
Etiology of venous ulcers
DM, RA, venous stasis, trauma, pressure
35
Pathophysiology of venous ulcers
leg veins and valves fail to keep blood moving forward, resulting in ambulatory venous htn serious fluid and RBCs leak from the capillaries and venules into the tissue. This produces edema and chronic inflammatory changes Enzyme's in the tissue break down RBCs causing the release of hemosiderin. This causes the brownish skin discoloration. Skin and subcutaneous tissue around the ankle are replaced by fibrous tissue, resulting in thick, hardened, and contracted skin
36
Wound management includes
Compression: Unna's boot Debridement Topical therapy: hydrogels, calcium alginate wound dressing: wet to dry, duoderm vacuum assisted closure hyperbaric oxygenation grafting
37
PVD: ______ extremities are most often involved
lower
38
PVD pathophysiology
The most common cause of PVD is atherosclerosis. This is the buildup of plaque inside the artery wall. Plaque reduces the amount of blood flow to the limbs. It decreases the oxygen and nutrients sent to the tissue. Blood clots may form on the artery walls. This makes the inner size of the blood vessels even smaller and blocks off major arteries
39
Complications of PVD
Infection, ulceration, occlusion ischemia, ulcerations, gangrene, amputation
40
Risk factors of PVD
male increasing age smoking HTN atherosclerosis obesity DM stress family history sedentary lifestyle hyperlipidemia
41
Clinical manifestations of occlusive arterial disease
Intermittent claudication rest pain in advanced disease diminished hair growth on affected extremities thick, brittle, slow-growing nails Shiny, thin, fragile, taut skin dry, scaly skin cool skin temperature diminished or absent pulses pale, blanched appearance w/ extremities elevation red coloration w/ extremities in dependent position decreased motor function ulcer formation with advanced disease ankle brachial index of 0.5-0.95
42
What does ankle brachial index measure what is the normal and abnormal value
difference in upper extremities and lower extremities blood pressures normal: 1 arterial insufficiency: 0.5-0.95 ischemic rest pain: 0.5 or less (ultrasound, exercise testing, and arteriography)
43
Management of the patient with PVD
lifestyle modifications/positioning interventional radiologic procedures surgical management: bypass grafting
44
complications of PVD
re thrombosis, embolism, vasospasm, bleeding
45
Complications with management of arterial ulceration treatment
intermittent claudication small, circular, deep ulcerations--gangrene toes, web spaces between toes, medial side of foot treatment: see venous ulcer care, possible amputation
46
What is the goal with a patient that is going to undergo amputation
preserve as much functioning as possible, while removing infected or necrotic tissue
47
Amputation: elevate the stump for
first 24 hours
48
Crutch walking: an accurate measurement of the client for crutches is important because what is it
an incorrect measurement could damage the brachial plexus the distance between the axilla and the arm pieces on the crutches should be two finger widths in the axilla space the elbow should be slightly flexed 20 to 30 degrees when walking
49
Crutch walking: when ambulating with the client, stand on the
affected side
50
Crutch walking: instruct the client to never rest
on the axilla of the axillary bars
51
Crutch walking: instruct the client to look
up and outward when ambulating
52
Crutch walking: upstairs
walk close to the first stair and hold onto the stair rail hold onto the rail with one hand and the crutch with the other push down on the stair rail and the crutch and step up with the good leg If not allowed to place weight on the "bad" leg, hop up with the "good" leg If able to place weight, bring the "bad" leg and the crutch up beside the good leg ***Lead with good leg***
53
Crutch walking: down stairs
walk to the edge of the stairs in the same way place the "bad" leg and the crutch down on the step below; support weight by leaning on the crutches and the stair rail bring the "good" leg down remember the "bad" leg goes down first and the crutch moves with the "bad leg"
54
What is buerger's disease (thromboangiitis obliterans)
obstructive vascular disorder caused by inflammation in the arteries and veins
55
What is the etiology of buerger's disease (thromboangiitis obliterans)
Men 20 to 40 years of age, increase in middle east, asia and jewish heritage
56
buerger's disease (thromboangiitis obliterans) disease only occurs in ______________
SMOKERS
57
buerger's disease (thromboangiitis obliterans) predominantly effects
the lower extremities
58
buerger's disease (thromboangiitis obliterans): pathophysiology
effects small and medium arteries and veins --> progressive claudication, cyanosis, coldness, rest pain
59
buerger's disease (thromboangiitis obliterans): management goal
arrest disease process and prevent amputation
60
buerger's disease (thromboangiitis obliterans): treatment
smoking cessation calcium channel blockers Iloprost thrombolytics possible amputation patient/family teaching
61
Raynaud's disease
episodic vasospasm involving the arteries of the fingers and toes
62
Raynaud's disease: etiology
women exposure to stress, tobacco, caffiene, cold, vibration
63
Raynaud's disease: characteristics
symmetrical/bilateral ischemic phase-cold, pale, numb hyperemic phase redness, swelling, throbbing pain lasts minutes--may persist for hours
64
Raynaud's disease: Complications
ulceration, gangrene
65
Raynaud's disease: management
mild--no treatment necessary to avoid precipitating factors drugs: CCB, vascular smooth muscle relaxant, vasodilators, iloprost sympathectomy patient/family teaching
66
Acute arterial occlusive disease: pathophysiology
Acute arterial occlusion, also known as acute limb ischemia, is a medical emergency that occurs when a peripheral artery is suddenly blocked, preventing blood flow to a limb
67
Acute arterial occlusive disease: complications
necrosis, gangrene, amputation
68
Acute arterial occlusive disease: 6 P's
pain pallor pulselessness paresthesia poikilothermia paralysis
69
Acute arterial occlusive disease: diagnosis
physical exam, ultrasound, angiography
70
Acute arterial occlusive disease: management
anticoagulants, thrombolytics, CCB, pain medication endovascular procedures-balloon angioplasty surgical treatment-embolectomy
71
Acute arterial occlusion: guidelines for safe practice
monitor the affected limb for any change in circulatory status monitor temp, color, sensation, and pain monitor peripheral pulses keep the extremities warm, but don't apply direct heat avoid chilling maintain BR unless activity is specifically ordered keep the extremities flat or in slightly dependent position to promote perfusion use an overbed cradle to protect a painful extremity from the pressure of linens use a sheepskin and 4-in foam mattress beneath the extremity do not elevate the bed at the knee; no crossing legs keep the head of the bed low to support circulation to the lower extremities
72
Aneurysms
weakness, out pouching or dilation of an artery
73
Aneurysms commonly occur in
aortic-thoracic or abdominal
74
Aneurysms etiology
men 50 to 70 atherosclerotic disease, trauma, syphilis, congenital, infection smoking, HTN, PVD, hyperlipidemia, genetic disposition
75
Types of aneurysms: fusiform
entire circumferential segment of the vessel--> diffuse dilated lesion
76
Types of aneurysms: saccular
Involve only a portion of the circumference of the vessel, appears to have an out pouching
77
Types of aneurysms: myctotic
rare; infectious aneurysms of the aorta caused by... staph strep salmonellae
78
Types of aneurysms: pseudoaneurysms
adventitia is dilated, although the media and intimal layers are unaffected --> clots can mimick this
79
Aneurysms: characteristics

Adult health 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions