Exam 1 Advanced Medical Surgical Nursing
Study online at https://quizlet.com/_7xslgs
1. Pulmonary Em- - Obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid,
boli or septic thrombus
- Obstructed area has diminished of absent blood flow (although are is ventilated,
no gas exchange occurs)
2. Most thrombus leg veins especially the lower leg in the calf
are blood clots
from:
3. Pulmonary Em- - Inflammatory process causes regional blood vessels, bronchioles to constrict,
bolism (PE) further increasing pulmonary vascular resistance, pulmonary arterial pressure,
Pathophysiology right ventricular workload
- Ventilation-perfusion imbalance, right ventricular failure, shock occur
4. Risk Factors for - Venous stasis - immobility
Pulmonary Em- - Hypercoagulabity
boli - Venous edothelial disease
- Certain disease states: heart disease, trauma, postoperative/postpartum, dia-
betes mellitus, COPD
- Other conditions: pregnancy, obesity, oral contraceptive use, constrictive cloth-
ing
- Previous history of thrombophlebitis
- Long bone fxs
5. S/S of pulmonary - restless, anxiety, agitation
embolism (PE) - tachycardia, tachypnea, hypotension, fever
- chest pain
- hemoptysis (Hemoptysis *huh-maap-tuh-suhs* is the coughing up of blood or
blood-stained mucus from the bronchi, larynx, trachea, or lungs)
- Mental Status change
- decreased LOC (level of consciousness)
- cyanosis
, Exam 1 Advanced Medical Surgical Nursing
Study online at https://quizlet.com/_7xslgs
- Hx of thromboembolism
- Crackles
6. What are some - exercises to avoid venous stasis
was to prevent - early ambulation
pulmonary em- - Sequential compression devices (SCDs)
bolism (PE)? - Anticoagulant Therapy:
- LMWH low molecular weight heparin subQ (1st line of prevention)
- enoxaparin (lovenox), Sub Q (spring loaded, has a bubble, leave the bubble in
there, it helps push the medication into the tissues) (first line of prevention)
7. What are some - Measures to improve respiratory, CV status
methods of treat- - Anticoagulation, thrombolytic therapy
ment for pul-
monary em-
bolism?
8. Management of - O2
Pulmonary Em- - Anticoagulants
bolism includes: - Embolectomy
- Thrombolytic Therapy
- Intracaval Filter
9. Extra Info about - General Use - Prevention and treatment of thromboembolic disorders including
Anticoagulants deep vein thrombosis (DVT), pulmonary embolism (PE), and a fib. Also used in
the management of myocardial infarction (MI) sequentially or in combination with
thrombolytics and/or and/or antiplatelet agents
- General Action and Information - Anticoagulats are used to prevent clot extension
and formation, they do NOT dissolve clots
, Exam 1 Advanced Medical Surgical Nursing
Study online at https://quizlet.com/_7xslgs
- Contraindications - Underlying coagulation disorders, ulcer disease, malignancy,
recent surgery, or active bleeding
- Precautions - Anticoagulation should be undertaken cautiously in any patient with
a potential site for bleeding. Pregnant or lactating pts should not receive warfarin.
Heparin does not cross the placenta. All anticoagulants should be used cautiously
in pts receiving epidural analgesia.
- Assessment - Assess pt taking anticoagulants for signs of bleeding and hemor-
rhage (bleeding gums, nosebleed, unusual bruising, tarry, black stools, hematuria,
fall in hematocrit or BP
- Lab test Considerations - Monitor prothrombin time (PT) or international normal-
ized ratio (INR) with warfarin therapy, activated partial thromboplastin time (aPTT)
with full dose heparin therapy and hematocrit, and other clotting factors frequently
during therapy
- Toxicity and Overdose - If overdose occurs or anticoagulation needs to be
immediately reversed, the antidote
for heparin is vitamin K (phytonadione)
- Pt/Family Teaching - Caution pt to avoid activities leading to injury, to use a soft
toothbrush and electric razor, and to report any symptoms of unusual bleeding
or bruising to health care professional immediately. Instruct pt not to take OTC
medications, expecially those containing aspirin, NSAIDs, or alcohol, without advice
of health care professional
- S/S - Heparin Induced thrombocytopenia (HIT) (with or without thrombosis) and
bleeding
10. Name 4 anticoag- Heparin, enoxaprin, dalteparin, fondaparinux
ulants, name the
generic brand
first
11. What is the pur- When oral intake is not adequate
pose of IV Fluid
Maintenance?
Study online at https://quizlet.com/_7xslgs
1. Pulmonary Em- - Obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid,
boli or septic thrombus
- Obstructed area has diminished of absent blood flow (although are is ventilated,
no gas exchange occurs)
2. Most thrombus leg veins especially the lower leg in the calf
are blood clots
from:
3. Pulmonary Em- - Inflammatory process causes regional blood vessels, bronchioles to constrict,
bolism (PE) further increasing pulmonary vascular resistance, pulmonary arterial pressure,
Pathophysiology right ventricular workload
- Ventilation-perfusion imbalance, right ventricular failure, shock occur
4. Risk Factors for - Venous stasis - immobility
Pulmonary Em- - Hypercoagulabity
boli - Venous edothelial disease
- Certain disease states: heart disease, trauma, postoperative/postpartum, dia-
betes mellitus, COPD
- Other conditions: pregnancy, obesity, oral contraceptive use, constrictive cloth-
ing
- Previous history of thrombophlebitis
- Long bone fxs
5. S/S of pulmonary - restless, anxiety, agitation
embolism (PE) - tachycardia, tachypnea, hypotension, fever
- chest pain
- hemoptysis (Hemoptysis *huh-maap-tuh-suhs* is the coughing up of blood or
blood-stained mucus from the bronchi, larynx, trachea, or lungs)
- Mental Status change
- decreased LOC (level of consciousness)
- cyanosis
, Exam 1 Advanced Medical Surgical Nursing
Study online at https://quizlet.com/_7xslgs
- Hx of thromboembolism
- Crackles
6. What are some - exercises to avoid venous stasis
was to prevent - early ambulation
pulmonary em- - Sequential compression devices (SCDs)
bolism (PE)? - Anticoagulant Therapy:
- LMWH low molecular weight heparin subQ (1st line of prevention)
- enoxaparin (lovenox), Sub Q (spring loaded, has a bubble, leave the bubble in
there, it helps push the medication into the tissues) (first line of prevention)
7. What are some - Measures to improve respiratory, CV status
methods of treat- - Anticoagulation, thrombolytic therapy
ment for pul-
monary em-
bolism?
8. Management of - O2
Pulmonary Em- - Anticoagulants
bolism includes: - Embolectomy
- Thrombolytic Therapy
- Intracaval Filter
9. Extra Info about - General Use - Prevention and treatment of thromboembolic disorders including
Anticoagulants deep vein thrombosis (DVT), pulmonary embolism (PE), and a fib. Also used in
the management of myocardial infarction (MI) sequentially or in combination with
thrombolytics and/or and/or antiplatelet agents
- General Action and Information - Anticoagulats are used to prevent clot extension
and formation, they do NOT dissolve clots
, Exam 1 Advanced Medical Surgical Nursing
Study online at https://quizlet.com/_7xslgs
- Contraindications - Underlying coagulation disorders, ulcer disease, malignancy,
recent surgery, or active bleeding
- Precautions - Anticoagulation should be undertaken cautiously in any patient with
a potential site for bleeding. Pregnant or lactating pts should not receive warfarin.
Heparin does not cross the placenta. All anticoagulants should be used cautiously
in pts receiving epidural analgesia.
- Assessment - Assess pt taking anticoagulants for signs of bleeding and hemor-
rhage (bleeding gums, nosebleed, unusual bruising, tarry, black stools, hematuria,
fall in hematocrit or BP
- Lab test Considerations - Monitor prothrombin time (PT) or international normal-
ized ratio (INR) with warfarin therapy, activated partial thromboplastin time (aPTT)
with full dose heparin therapy and hematocrit, and other clotting factors frequently
during therapy
- Toxicity and Overdose - If overdose occurs or anticoagulation needs to be
immediately reversed, the antidote
for heparin is vitamin K (phytonadione)
- Pt/Family Teaching - Caution pt to avoid activities leading to injury, to use a soft
toothbrush and electric razor, and to report any symptoms of unusual bleeding
or bruising to health care professional immediately. Instruct pt not to take OTC
medications, expecially those containing aspirin, NSAIDs, or alcohol, without advice
of health care professional
- S/S - Heparin Induced thrombocytopenia (HIT) (with or without thrombosis) and
bleeding
10. Name 4 anticoag- Heparin, enoxaprin, dalteparin, fondaparinux
ulants, name the
generic brand
first
11. What is the pur- When oral intake is not adequate
pose of IV Fluid
Maintenance?
