Campus Collusion
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Vascular DisordersMedical Surgical Nursing

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________ exert 18 mm Hg of pressure on the legs to promote venous blood flow, prevent venous dilation, and stimulate fibrinolytic activity in patients at risk for developing DVTs.
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Ted hose/antiembolism stockings
What changes in D-dimer would you expect to see in a patient with a DVT?
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An elevation (suggests fibrin degradation and clot lysis)
For a patient that has an ICD, when should they NOT wear it?
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When showering/bathing, walking or during a skin assessment. If the patient has a DVT, they shouldn't wear it
What are the normal non-pharmacologic therapies to treat a DVT?
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Bed rest, elevate the extremity, apply warm compresses to the area for 2-4 days
Patients who have had a DVT should be fitted for a Jobst stocking that applies 30-40 mm Hg of pressure at the ankle (or arm) to support the vein walls and valves and to decrease pain and swelling during ambulation. These should be used for ________.
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3-6 months
Hyperhomocysteinemia is a risk factor for DVTs. What is the recommendation for lowering it?
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B-complex vitamins: B12, B6, and Folic acid
What are the 5 different types of anticoagulation therapies used to treat DVTs?
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Vitamin K antagonists, Unfractionated Heparin, Low Molecular Weight Heparin, Direct thrombin inhibitors and Factor Xa inhibitors
What is the therapeutic level for an INR if a patient is on Warfarin/Coumadin?
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2-3 (normal is 0.75-1.25)
What is the therapeutic level for an Activated Clotting Time (ACT) if a patient is on Warfarin/Coumadin?
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3 minutes (normal is 80-135 seconds)
What is the therapeutic level for an aPtt if a patient is on Warfarin/Coumadin?
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46-70 seconds (normal is 24-36 seconds)
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Which types of drugs interact with warfarin?
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NSAIDS, phenytoin, barbiturates and many herbal supplements
What type of drug is Warfarin/Coumadin?
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Vitamin K antagonist
What type of drug is heparin?
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Indirect Thrombin Inhibitor
What drug is used to treat DVTs in patients who are allergic or contraindicated for Heparin?
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Argatroban
What is the antidote for Low Molecular Weight Heparin (LMWH) and Unfractionated Heparin (UH)?
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Protamine sulfate
What is the antidote for warfarin/Coumadin?
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Vitamin K
How long should pressure be applied to a venipuncture site for a patient on anticoagulants?
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10 minutes
What teaching points should be covered for a patient who is being discharged on anticoagulant therapy?
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How to monitor PT/INR, s/s of a PE, administration of the drug, active/younger people need to avoid contact or high risk sports (like skiing), older patients should be taught to prevent falls. Apply pressure to injuries for 10-15 minutes and go to ER if bleeding doesn't stop. Eat Calcium, C, and K. Avoid K supplements, excessive vitamin E and alcohol. Stay hydrated. Exercise: walking, swimming.
What is the preferable time of day to take anticoagulant medication?
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Afternoon/early evening
What are reticular veins?
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Small varicose veins that appear flat, and are blue-green in color
________ are usually referred to as spider veins and are very small, visible vessels that appear bluish-black, red or purple.
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Telangiectasias
  
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