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Emergency AssessmentMedical-Surgical Nursing-7th edition

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Which has more significant K+ deficiency, DKA or HHS?
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DKA
What are the primary causes of HHS?
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Pneumonia, UTI, stress, and trauma.
DKA: Blood sugar _______, pH _______, Bicarbonate _______, Ketones _______
Show Answer
Blood sugar: 250, pH: less than 7.3, Bicarbonate: less than 15, and Ketones: higher.
HHS: Blood sugar _______, pH _______, Bicarbonate _______, Ketones _______
Show Answer
Blood sugar: 600 - 2000, pH: normal, Bicarbonate: normal, and Ketones: none
People with HHS should get _______ liters of fluid in the 1st 6 hours.
Show Answer
6-10 hours
_______ requires less dosing for patients with renal disease and HIT-2 because it is excreted by the kidneys.
Show Answer
Lipirudin
What is the goal INR for a patient on Warfarin/ Coumadin?
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2-2.5 for 3-6 months.
Warfarin may be initiated after _______ hours of heparin as long as platelets are more than 100 x 10(9)/L.
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48 hours
For patients on Coumadin, an increase in INR isn't seen until _______ days after the 1st dose.
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2 days
When is Coumadin typically started for a patient with HIT-2?
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Once platelets are 100,000/uL
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Thrombocytopenia is a decrease of platelets below _______.
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150,000/uL
What medications should be avoided while on warfarin?
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Acetaminophen, NSAIDS, amiodarone (anti-dysrhythmic) and fluoroquinolone.
What test can be useful in diagnosing HIT-2?
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C-serotonin release assay. (+) = HIT-2
What medications are used for anticoagulation in people with a PE and HIT-2?
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Lipirudin, Argatroban, Bivalrudin/Angiomax.
Which medication is a better choice for renal patients with PE and HIT-2: Lipirudin, Argatroban or Angiomax?
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Argatroban (excreted by liver).
_______ is used for patients with unstable angina that are on aspirin therapy and who have HIT-2 that are scheduled for a coronary angioplasty.
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Bivalrudin/Angiomax
Warfarin therapy should overlap with heparin therapy for _______ days when treating a PE.
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4
_______ is an anticoagulant that helps activate prothrombin, which in turn, inhibits factor xa and thrombin.
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Heparin
What is a therapeutic PTT for a patient on Heparin?
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60 - 100 sec.
What are the major differences between Type 1 and Type 2 HIT?
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Type 1: Not autoimmune, occurs 1-3 days, P/t higher than 100,000, no increased risk for thrombi. Type 2: autoimmune, occurs within 5-10 days, P/t lower than 100,000, increased risk of clots, increased risk of bleeding (like DIC).
True or False? In low molecular weight heparin injections you don't expel the air bubble from the syringe prior to injection.
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TRUE
  
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