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Nursing 163 Exam 1 > Unit 1.3 > Flashcards

Unit 1.3 Flashcards

(49 cards)

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1
Q

Types of Emboli that may cause pulmonary embolism

A
  • Air Emboli
  • Thrombus: DVT
  • Fat Emboli: from long bone or Hip Fx
  • Tumor: cells enter blood stream
  • Foreign body: IV catheter
  • Vegetations: growth on valves that break loose
  • Amniotic Fluid emboli; risk @ delivery
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2
Q

Main PE manifestations

A
  • dyspnea (SOB)
  • angina (chest pain)
  • anxiety, sense of impending doom
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3
Q

Other PE manifestations

A
  • increased respiratory rate (tachypnea)
  • increased heart rate (tachycardia)
  • crackles present in lungs
  • low grade fever
  • change in LOC
  • Hypoxia (less O2 in blood)
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4
Q

What is happening in lungs with PE

A
  • vasoconstriction

- brochoconstriction

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5
Q

Stereotypical DVT risk factors (the model)

A

Female 40 year old smoker on oral contraceptive or estrogen therapy.

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6
Q

Dx Tests for PE

A
  • plasma D-dimer (blood test)
  • ABG’s (show hypoxemia & respiratory alkolosis)
  • Coagulation studies (PTT, INR, platelet)
  • Chest CT with contrast
  • Lung scans
  • Pulmonary angiography (if less invasive doesn’t work)
  • Chest Xray
  • Electrocardiography (rule our MI)
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7
Q

Prevention is key to preventing PE. What measures will the nurse use:

A
  • hydration
  • prevent stasis of blood (early ambulation)
  • assess for complications that may cause emboli
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8
Q

If a nurse finds a client with possible PE what actions would they take?

A
  • Give O2 to raise sats
  • Position into high fowlers
  • place lower extremities in dependent position
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9
Q

Placing LE in dependent position achieves what?

A
  • decreased venous return to heart

- decreased load on right side of heart.

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10
Q

Pulmonary embolism can cause heart failure on which side?

A

Right sided heart failure

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11
Q

Special Fat emboli symptom

A

petechiae on chest & arms

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12
Q

Gold standard Dx test for PE

A

Pulmonary angiography, accurate.

-dangerous and rarely ordered

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13
Q

When not to use Chest CT for Dx

A

when client has elevated creatinine.

-iodine is contrast media and kidneys must excrete.

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14
Q

Best pharmacologic therapy for PE

A

Anticoagulant therapy (blood thinners)

  • Heparin
  • Warfarin
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15
Q

What to know about Heparin

A
  • IV or IM
  • monitor PTT range (60-90)
  • therapeutic range is established after 2 consecutive normal range results are received. test must be run at least 6 hours apart
  • Anti-dote = protamine
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16
Q

What to know about Warfarin

A
  • oral anticoagulant
  • monitor INR (2-3)
  • anti-dote = vitamin K
  • teach client to eat consistent leafy greens.
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17
Q

Nurse teaching for anticoagulants

A
  • educate about eating greens
  • inform doctors & dentists about use
  • safety conscious lifestyle choices
  • Electric razors
  • What to look for in stool for GI bleed.
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18
Q

Other treatment for PE

A

Bed rest. decreases demand for O2.

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19
Q

Possible Emergency Nursing Dx for PE

A

-Impaired gas exchange

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20
Q

Other Nursing Dx for PE

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A
  • Ineffective protection
  • Decreased cardiac output
  • Impaired gas exchange
  • Anxiety
  • Activity Intolerance
21
Q

Thromboemboli

Study These Flashcards
A

created by blood clot

22
Q

Embolus

Study These Flashcards
A

debris blocking blood vessel

23
Q

CVA

Study These Flashcards
A

Cerebrovascular accident

OR brain attack

24
Q

Types of CVA

Study These Flashcards
A

Ischemic Stroke

Hemorrhagic Stroke

25
3 types of Ischemic Stroke
TIA Thrombotic Embolic
26
TIA
- transient ischemic attack - narrowing of veins/arteries - Low O2 - temporary - Mini-stroke - May precede a stroke
27
Thrombotic Stroke
- Large cerebral vessel occlusion - by thrombus - often in bifurcating arteries w/ narrowed lumen - older clients when resting
28
Embolic Stroke
- blood clot or debris lodges in cerebral blood vessels - area past clot become ischemic - younger clients, awake & active - possibly a thrombus created in Left chamber of heart
29
FAST
- face - arms - speech - time to call 911
30
Hemorrhagic Stroke
- intracranial hemorrhage - blood vessel ruptures - HTN most common risk - Occurs suddenly during activity - most often fatal
31
Symptoms of Hemorrhagic stroke
- hemiplegia - loss of consciousness - vomit - headache - seizures
32
Common symptoms of stroke
- Weakness of extremities - Sudden severe headache - speech difficulties - loss of coordination - facial droop
33
Risk factors for stroke
- HTN - diabetes - sleep apnea - smoking - cholesterol levels - drug use
34
Dx Tests
1 - CT Scan - Stroke Scale - MRI - neurologic exam
35
Pharmacologic prevention
-antiplatelet agents: aspirin, plavix, etc
36
Pharmacologic for acute stroke
- Anticoagulants (not for hemorrhagic) - Fibrinolytic (clot buster) drugs: 3 hour window - Antithrombotic drugs: inhibit platelet phase of clot form.
37
If a CVA happens on the right side of brain, which side of body is affected
Left
38
Hemianopia
loss of half of visual field
39
Agnosia
inability to recognize one or more subjects that were previously familiar
40
Apraxia
inability to carry out some motor pattern
41
Neglect syndrome
person cannot integrate & use perceptions from affected side of body.
42
Aphasia
inability to use or understand language
43
Hemiplegia
paralysis of left OR right half of body
44
Hemiparesis
weakness of left OR right half of body
45
Flaccidity
abscence of muscle tone
46
spasticity
increased muscle tone, but with a degree of weakness
47
Possible Nursing Dx for Stroke patients
- Ineffective tissue perfusion - Impaired physical mobility - Self-care deficit - Impaired verbal communication - Impaired swallowing - Impaired urinary elimination
48
What physical assessments would a nurse perform on someone suspected of a stroke?
- PMSC (pulses, motor, sensation, circulation) - LOC - speech - neuro (cranial nerves)
49
What is stenosis?
narrowing.

Nursing 163 Exam 1 (4 decks)

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