TRCC NUR125 Key Revision Questions and Correct Answers 2024

Pulmonary circulation - from the right side of the heart Systemic circulation - -from the left side of the heart -responsible for moving blood to peripheral areas of the body, organs, brain coronary circulation - vessels that supply blood to the heart muscle thrombus - clot that forms in the vein or artery thrombosis - -formation of a blood clot -venous thrombosis occurs in the vein -superficial vs deep venous thrombosis (DVT) Thrombophlebitis - clot forms and blocks one or more veins Virchow's Triad - -Circulatory stasis/venous stasis (dysfunctional valves or muscle inactivity) -Vascular damage (stimulates the clotting cascade and platelet aggregation) -Hypercoagulability (predisposition to thrombus formation) Venous Stasis can occur from: - -bed rest -Immobility (r/t: bedrest, prolonged surgical procedure, prolonged travel limited mobility) -spinal cord injury -shock -venous obstruction Hypercoagulability can occur from: - -genetic factors -lower extremity trauma pregnancy and childbirth -hormonal contraceptives/menopausal hormone therapy (read: ESTROGEN) dehydration (increases blood viscosity) Vascular damage can occur from: - -surgery -massive trauma -pelvic and lower fractures -sepsis Clinical manifestations of DVT - -may be unilateral -asymptomatic at times -aching pain in effected extremity -tenderness, swelling, warmth, erythema due to inflammatory process that accompanies the thrombus -edematous extremity, may see cyanosis Labs used to diagnose DVT - -D-Dimer assay 500ng/ml (is a fibrin degradation product, lysis of fibrin clot) -PT/INR (baseline for Tx w/ Coumadin; INR 2.5-3 times is therapeutic) -aPTT or Anti-XA (per heparin protocol; 40-60 seconds) Diagnostics to diagnose DVT - -Duplex Venous Ultrasonography (Gold standard for detection, non-invasive) -Plethysmography (non-invasive, measures changes in blood flow through the vein -MRI (visual thrombosis of vena cava and pelvic veins, non-invasive) -Ascending contrast venography (invasive, expensive, uncomfortable; most accurate; injection of contrast medium done in IR) Heparin - -Prevention dosing= 5,000mg subQ daily -treatment dosing per protocol