Week 7: Vascular Perfusion textbook

Question 1

what is a thrombus without inflammation?

Answer 1

Phlebothrombosis

Question 2

what is a Thrombophlebitis?

Answer 2

thrombus that is associated with inflammation - can occur in superficial veins, most common deep veins of lower extremities

Question 3

what is the most common type of thrombophlebitis?

Answer 3

DVT or deep vein thrombosis - most serious greater risk of PE

Question 4

what condition is a medical emergency when it comes to clots?

Answer 4

Pulmonary Embolism!!!

Question 5

where in the body does DVT most often occur?

Answer 5

in the legs BUT can also occur in the upper arms

Question 6

what is the Virchow Triad?

Answer 6

this is the thrombus formation - associated with stasis of blood flow, endothelial injury and/or hyper coagulability

Question 7

what is a pre disposing factor of thrombus formation?

Answer 7

patients that underwent hip surgery, total knee replacement, open prostate surgery also heart failure cancer immobility etc.

Question 8

are people who sit for long periods of time (airplane and computer) are also at risk

Answer 8

yes

Question 9

is Phlebitis (vein inflammation) associated with invasive procedures ex. IV therapy be at risk for thrombosis? (predisposing)

Answer 9

YES

Question 10

What would you assess recognize cues for Thrombosis?

Answer 10

history of any type of VTE
assess risks for developing VTE - prolonged sitting/bedrest, recent surgical procedures or factors that may affect coagulation

Question 11

What is Padua Prediction Score (PPS) used for?

Answer 11

to assess risk for VTE

Question 12

what are some physical assessments of S&S of VTE?

Answer 12

may be asymptomatic

S&S of DVT: calf or groin tenderness, pain and sudden unilateral swelling of leg

palpate site observe for induration (hardening), warmth and edema, redness

Question 13

what is the preferred diagnostic test for DVT?

Answer 13

venous duplex ultrasonography

Question 14

what are you analyzing/ prioritizing hypothesis of VTE

Answer 14

priority problem for most patients with VTE is potential for injury due to complications of VTE and anticoagulation therapy

Question 15

Planning and Implementation: Generate Solutions and Take Action - VTE

Answer 15

expected no injury from VTE

Interventions:
how to prevent pulmonary emboli - use of drugs

Question 16

nonsurgical management of VTE:

Answer 16

Patient education
* Leg exercises
* Early ambulation
* Adequate hydration
* Graduated compression stockings
* Intermi ent pneumatic compression, such as sequential
compression devices (SCDs) * Venous plexus foot pump
* Anticoagulant therapy - drug of choice

Question 17

what is hemostasis?

Answer 17

multistep process of controlled blood clo tting, resulting in localized blood clo tting in damaged blood vessels to prevent excessive
blood loss while continuing perfusion of liquid blood and individual cells to all other areas.

Question 18

what is platelet aggregation?

Answer 18

begins forming a platelet plug by having platelets clump together, a process essential for blood clo tting

Question 19

when collagen is exposed what happens due to damaging of blood vessels what happens (extrinsic factors)

Answer 19

collagen activates platelets to form platelet plug within seconds -starts the protective healing process

Question 20

true or false about clotting factors: they are inactive enzymes that become activated in sequence. At each step, the activated enzyme from the previous step activates the next enzyme.

Answer 20

TRUE

Question 21

what is the last phase of blood clotting?

Answer 21

fibrin clot formation

Question 22

true or false: Thus whenever the clo ing cascade is started, anticlo ing forces are also started to limit clot formation only to damaged areas so normal perfusion is maintained everywhere else.

Answer 22

true

Question 23

true of false: When blood procloting and anticloting actions are balanced, cloting occurs only where it is needed, and normal perfusion is maintained.

Answer 23

true

Question 24

what is fibrinolysis mean? ** remember lysis means disintegration

Answer 24

is the process that dissolves fibrin clot edges with special enzymes

Question 25

true or false: Deficiency of any anticloting factor decreases the risk for venous thromboembolism (VTE) such as pulmonary embolism, myocardial infarction (MI), and strokes.

Answer 25

false, increase

Question 26

what does Prothrombin time (PT) measure

Answer 26

how long blood takes to clot - reflects clotting factors II, V, VII and X and how they function

Question 27

what does International normalized ratio (INR) measure?

Answer 27

same as PT , established normal mean or standard for PT

Question 28

anti-factor Xa

Answer 28

measures the amount of anti-activated factor X (anti-Xa) in blood, which is affected by heparin. - used to monitor heparin in patients

Question 30

true or false: Platelet aggregation, or the ability to clump, is tested by mixing the patient’s plasma with an agonist substance that should cause clumping.

Answer 30

true

Question 31

what are anticoagulants?

Answer 31

Drugs that activate antithrombin heparin and enoxaparin warfarin

Question 32

whats another word for Vitamin K agonist?

Answer 32

NOTHING! if ur thinking warfarin its a vitamin k Antagonist

Question 33

what is the action of anticoagulants?

Answer 33

decreases the formation of fibrin - used to prevent thrombosis in veins and atria of heart

Question 34

what is oral anticoagulants and parental anticoagulants?

Answer 34

oral is PO, for example warfarin parental is IV or subQ ex Heparin and Enoxaparin

Question 35

can enoxaparin be administered via IV?

Answer 35

no, its SubQ - longer half life then heparin

Question 36

what is a low molecular weight heparin? what does it do in MOA?

Answer 36

Enoxaparin, reduces the activity of Xa more than they reduce the activity of thrombin

Question 37

true or false: Heparin suppresses coagulation by helping antithrombin inactivate clotting factors, primarily thrombin and factor Xa.

Answer 37

true

Question 38

does heparin only bind to antithrombin when inactivating Xa ?

Answer 38

YES

Question 39

true or false: By activating antithrombin, and thereby promoting the inactivation of thrombin and factor Xa, heparin ultimately suppresses the formation of fibrin.

Answer 39

true

Question 40

can heparin be absorbed and cross membranes?

Answer 40

no thats why it is admin via IV and SubQ, Because it cannot cross membranes, heparin does not traverse the placenta and does not enter breast milk.

Question 41

half life in heparin is short unless renal impairment is present

Answer 41

yes

Question 42

what are some adverse effects for heparin?

Answer 42

hemorrhage, Spinal/Epidural Hematoma, Heparin-Induced Thrombocytopenia, Hpersensitivity

Question 43

why does it take days for results to be seen with warfarin?

Answer 43

only works once the clots are decaying, have no effect on clotting factors in circulation (though it acts quickly to inhibit synthesis)

Question 44

what are some adverse effects of Warfarin?

Answer 44

Hemmorhage, Fetal hemorrhage, use when breast feeding (oral so enters milk)

Question 45

what is the adverse effects of clopidogrel?

Answer 45

risk of bleeding, thrombotic thrombocytopenic Purpura

Question 46

what is an antifibrinolytic agent?

Answer 46

Aminocaproic Acid - given IV and tablet