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Med Surg 1 > week 4 > Flashcards

week 4 Flashcards

1
Q

peripheral artery disease

A

NARROWING of lower extremity arteries for atherosclerosis = inadequate blood flow

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2
Q

peripheral artery disease manifestations

A

pain at rest (aka intermittent clausication)
parethesia
bruit of femoral & aortic arteries
pallor
dependent rubor
cool extremities
nonpalpable peripheral pulses
calf muscle atrophy
shiny skin w hair loss & thick toenails

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3
Q

6P’s manifestations of acute occlusion from thrombosis

A

Pain
Pallor
Paralysis
Parethesia
Pulselessness
Poikilothermia (cant regulate temp)

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4
Q

lab values indicating risk for peripheral arterial disease

A

elevated:
*c-reactive protein
*homocysteine level
* lipids— hyperlipidemia

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5
Q

PAD manifestations commonly occur

A

**aggravated by limb elevation
occurs @ night
@ rest

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6
Q

diagnostic studies for PAD

A
  1. Ankle-Brachial Index <0.9
  2. 6min walk test
  3. doppler ultrasound
  4. Segmental systolic BP measurements
  5. Peripheral vascular angiography
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7
Q

meds for intermittent claudication

A

**pain @ rest w PAD

  1. Cilostazol
  2. Pentoxifylline
  3. Statins
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8
Q

med to increase blood flow

A

*PAD = ramipril

*risk for hyperkalemia –muscle weakness, paralysis, abdominal cramps

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9
Q

PAD complications

A
  1. ulcers
  2. wounds
  3. compartment syndrome
  4. infection
  5. amputation
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10
Q

Buerger’s disease

A

*THROMBOANGIITIS OBLITERANS

recurring inflammation of the arteries & veins resulting in THROMBOSIS w OCCLUSION

** men 20 - 35yrs old **

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11
Q

Buerger’s disease risk factors

A

genetics
smoking
tobacco
men: 20 to 35yrs old

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12
Q

Buerger’s manifestations

A

painful open sores
ulcers w gangrene
claudication
cold sensitivity

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13
Q

nursing care for buerger’s

A
  1. smoking cessation
  2. avoid cold & constrictive clothing
  3. pain meds
  4. antibiotics
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14
Q

Raynaud’s Syndrome

A

EPISODIC vasospastic disorder of arteries/arterioles cold & stress

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15
Q

manifestations of Raynaud’s Syndrome

A

2 phases

  1. Vasoconstrictive phase = cold/white extremities w pain
  2. Hyperemic phase = blood flow to extremities (red & swelling)
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16
Q

nursing care for Raynaud’s

A
  1. avoid cold & keep warm
  2. stop smoking
  3. limit caffeine
  4. manage stress
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17
Q

Virchow’s triad

A

presence of 3 factors predisposes a person to develop vascular thrombosis

(1) hypercoagulability
(2) venous stasis
(3) endothelial damage

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18
Q

Risk factors for venous thromboembolisms

A

surgery / immobility
oral contraceptives
65+
pregnancy
obesity
catheters

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19
Q

clinical manifestations of venous thromboembolisms

A

asymptomatic
calf/groin tenderness
warm, erythematous skin
change in circumference of extremity

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20
Q

diagnostic studies for VTE

A

D-dimer
ultrasound
CT / MRI
CT pulmonary angiography
V/Q scan

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21
Q

antidote for heparin

A

protamine sulfate

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22
Q

white clot syndrome

A

antibody development to a heparin-platelet membrane complex
*arterial thrombi

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23
Q

enoxaparin

A

SubQ low-molecular weight heparin

1mg/kg of body weight not to exceeed 90mg BID

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24
Q

antidote for warfarin

A

Vitamin K

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25
Q

3 IV thrombolytics & monitoring for…

A

Reteplase
tenecteplase
activase (tPA)

*neuro status
bleeding
anaphylaxis
Intracranial bleeding

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26
Q

Dabigatran

A

PO direct thrombin inhibitor

antidote= idarucizumab

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27
Q

venous vs arterial ulcer

A
  1. location (A) =
28
Q

anemia manifestations

A

increased HR
orthostatic hypotension
fatigue
decreased O2
SOB / dyspnea
cold sensitivity

29
Q

irony deficiency anemia manifestations

A

glossitis (beefy red tongue)
chelitis (swollen lips)
asymptomatic
decreased iron
increased total iron binding capacity

30
Q

Thalassemia manifestations

A

**inherited blood disorder– abnormal hgb resulting in RBC destruction

facial bone deformities
growth failure
jaundice

31
Q

Thalassemia collaborative care

A

blood transfusion
folic acid
bone marrow transplant
splenectomy

32
Q

B12 deficiency anemia manifestations

A

parethesia
ataxia
glossitis
jaundice

33
Q

tests for vitamin B12 deficiency anemia

A

labs
Shilling test *swallowing radio-labeled tablet

34
Q

Aplastic Anemia

A

result of bone marrow suppression

INCREASED
iron
total iron binding capacity

DECREASED
hgb
wbc
platelets
reticulocytes

35
Q

risk factors for hemolytic anemia

A

trauma
lead poisoning
infection
transfusion reaction

36
Q

clinical manifestations of hemolytic anemia

A

chills
jaundice
hepato/spleno-megaly
dark urine

37
Q

medication for patient with anemia AND kidney disease

A

epoetin alfa

38
Q

sickle cell anemia

A

abnormal hgb = sickled red cells that clump together *african-american or Mediterranean origin

39
Q

sickle cell anemia manifestations

A

*hypoxia
fever
jaundice
swelling
pain
hematuria
priapism

40
Q

med for sickle cell anemia

A

hydroxyurea & O2 therapy

pain = morphine or hydromorphone

41
Q

thrombocytopenia manifestations

A

petechiae
purpura
ecchymoses

if bleeding
increased HR
decreased BP
LOC change
abdominal pain
dizziness
weakness

42
Q

meds for heparin induced thrombocytopenia

A

protamine sulfate
alternative anticoagulant (warfarin or argatroban)

43
Q

pulse pressure in PAD

A

is lower in the thigh, calf, & ankle than in upper extremities

44
Q

ankle brachial index range

A

0.9 to 1.3

*less than 0.9 = PAD

45
Q

PAD is treated w/ (2)

A

(1) = antiplatelets : aspirin, clopidogel, pentoxifylline

(2) = statins : simvastatin, atorvastatin

46
Q

a nurse should expect to see a client with PAD

A

have pallor on elevation of limbs & rubor when limbs are dependent

sleep with both legs in dependent position

47
Q

test to determine PVD

A

d-dimer test

48
Q

teaching to client w PVD

A

apply stockings in the morning upon awakening & before getting out of bed

keep legs elevated for at least 20 min 4 to 5x a day

49
Q

folate diet

A

spinach
lentils
bananas

50
Q

iron dextran

A

parenteral iron
Z-track methos
*SEVERE anemia only

51
Q

Vitamin C w/ anemia

A

increases oral iron absorption

52
Q

total iron binding capacity test

A

diagnoses anemia

is an indirect measurement of transferring (indicates total iron stores)

53
Q

medication for client with DIC

A

heparin– decreases microclots

54
Q

aPTT range

A

30 to 40 sec

*measures clotting factors

*1.5 to 2x baseline range when taking heparin

55
Q

pTT range

A

*how long it takes blood to clot
60 to 70 seconds

56
Q

fibrinogen range

A

200 to 400 mg/dL

57
Q

prothrombin time range

A

11.0 to 12.5 seconds

58
Q

3 anticoagulants with direct thrombin inhibitor

A
  1. argatroban
  2. lepirudin
  3. bivalrudin
59
Q

disseminated intravascular coagulation

A

clotting and anti-clotting mechanisms occur at the same time

*internal and external bleeding

60
Q

immune thrombocytopenic purpura (ITP)

A

autoimmune disorder that results in the body producing antibodies that decreases platelet lifespan with normal platelet production

females 20 - 50

61
Q

epoetin alfa considerations

A

increases erythrocytes (rbc’s)

treats anemia

monitor hgb & Hct 2x a week (increased = effective)
monitor iron levels

DO NOT SHAKE VIAL

adv effects = HEADACHE &
HYPERTENSION

62
Q

iron dextran

A

IM & IV form of iron for iron deficiency anemia

63
Q

adverse effect of vitamin b12 meds

A

hypertension
hypokalemia
erythema

64
Q

s/s of hypokalemia

A

muscle weakness
nausea
palpitations
paresthesia

65
Q

Alteplase

A

thrombolytic drug that can dissolve thrombi

*taken within 3 hours

66
Q

adverse effects of alteplase

A

*thrombolytic drug that dissolves thrombi

intracranial bleeding
headache
bronchospasm
bleeding
hypotension

67
Q

antidote for alteplase

A

alteplase= thrombolytic drug that dissolves thrombi

***AMINOCAPROIC ACID = coagulator

Med Surg 1 (8 decks)

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