Nursing 125 Exam 4 Questions with
Verified Solutions
Thrombus - ANSWER-stationary blood clot
Phlebitis - ANSWER-inflammation of a vein
Thrombophlebitis - ANSWER-inflammation of a vein associated with a clot formation
Superficial thrombophlebitis - ANSWER-inflammation of a vein near the surface due to
the presence of a blood clot
Deep venous thrombosis (DVT) - ANSWER-a blood clot in the deep venous system of
the arms or legs which can break off and cause a PE
Pulmonary embolism (PE) - ANSWER-Blocking of a pulmonary artery due to a blood
clot
What causes a clot to form? - ANSWER-1. circulatory stasis: develops from immobility
2. vascular damage: clotting cascade of platelets and fibrin
3. hypercoagulability: injury itself or surgery can modify coagulability of the blood
Virchow's triad - ANSWER-stasis of blood flow, endothelial injury, hypercoagulability
Etiology of clots - ANSWER-- venous clots: occurs where blood flow is low
- arterial clots: occur at sites of arterial plaque rupture
- as complication of hospitalization, surgery, immobilization
- cancer (pancreatic, lung, ovary, testes, urinary tract, breast, stomach)
- pregnancy and delivery
- hormone therapy (contraceptives, hormone replacement)
- clotting disorders, obesity, family history of DVT
smoking
Risk factors of DVT - ANSWER-- orthopedic procedures (highest risk)
- A-fib
- acute myocardial infarction
- ischemic stroke
- contraception and estrogen therapy
Clinical presentation of DVT - ANSWER-- dull, aching pain in calf (especially when
walking)
,- possible tenderness, swelling, warmth, and erythema along affected vein
- cyanotic extremity
- cramping
- unilateral edema
Diagnostic tests for DVT's - ANSWER-- venous ultrasonography
- MRI
- contrast venography (inject contrast dye)
- labs: Plasma Dimer (not for children), PT/INR, PTT, platelet count
Anticoagulants in treatment for DVT - ANSWER-- DO NOT DISSOLVE EXISTING
CLOTS
- used to prevent clots from forming/growing larger
- increases normal clotting time
Adverse effects of anticoagulants - ANSWER-- *Bleeding*
- GI upset
Heparin IV - ANSWER-- used in higher doses to treat conditions of DVT and PE
- prolongs the clotting time and aPTT
- a few days for therapeutic affect
- safe for pregnant women (acute situation)
Heparin Antagonist - ANSWER-Protamine sulfate
PTT (partial thromboplastin time) - ANSWER-A partial thromboplastin time (PTT) test
measures the time it takes for a blood clot to form.
PTT range for heparin - ANSWER-normal: 20-30 sec
on heparin: 60-100 seconds
Warfarin (coumadin) - ANSWER-- takes several days to achieve therapeutic PT/INR
value
- requires frequent blood work to check INR
- given together with heparin
- inhibits action if vitamin K
- contraindicated in pregnant women
Warfarin antagonist - ANSWER-vitamin K
- takes about 6 hours
Cautious use of Warfarin - ANSWER-pt taking warfarin can still eat leafy greens as long
as diet is regular
PT/INR - ANSWER-prothrombin time/international normalized ratio
, PT/INR ranges - ANSWER-ONLY FOR PT USING WARFARIN
- on med 2-3
- off med 1
Lovenox (enoxaparin) - ANSWER-- low molecular weight heparin
- no INR monitoring
- no dietary restrictions
- preferred for pregnant women (at home subcutaneous)
Factor Xa inhibitor anticoagulants - ANSWER-Xarelto (rivaroxaban)
eliquis (apixaban)
savaysa (edoxaban)
- new oral anticoagulants
- inhibits factor Xa in clotting cascade
- given together w heparin
Factor Xa benefits - ANSWER-- immediate therapeutic action
- no dietary restrictions
- no INR monitoring
Factor Xa negatives - ANSWER-- antagonist administered in hospital (no immediate
reversal otherwise)
- expensive
Antiplatelet medication - ANSWER-- PO med used to prevent clot formation in arteries
- interferes w platelet aggregation
- ASA (NSAID)
- clopidogrel (plavix)
- brillinta
- pletal, trental for intermittent claudication
Thrombolytics - ANSWER-- IV med used to dissolve fibrin clot
- goal is to quickly restore blood flow to the blocked vessel
- used to treat embolic stroke (must be given w/in three hours of stroke)
Surgery for DVT - ANSWER-- venous thrombectomy: when necessary to prevent PE or
gangrene
- if anticoag therapy contraindicated: inferior vena cava filter inserted to trap emboli
Lifespan considerations for DVT - ANSWER-- infants: rare
- adolescents: 8x more likely than infants
- pregnant women: 4-5x greater risk than non-pregnant people
- older adults: increases w age
Verified Solutions
Thrombus - ANSWER-stationary blood clot
Phlebitis - ANSWER-inflammation of a vein
Thrombophlebitis - ANSWER-inflammation of a vein associated with a clot formation
Superficial thrombophlebitis - ANSWER-inflammation of a vein near the surface due to
the presence of a blood clot
Deep venous thrombosis (DVT) - ANSWER-a blood clot in the deep venous system of
the arms or legs which can break off and cause a PE
Pulmonary embolism (PE) - ANSWER-Blocking of a pulmonary artery due to a blood
clot
What causes a clot to form? - ANSWER-1. circulatory stasis: develops from immobility
2. vascular damage: clotting cascade of platelets and fibrin
3. hypercoagulability: injury itself or surgery can modify coagulability of the blood
Virchow's triad - ANSWER-stasis of blood flow, endothelial injury, hypercoagulability
Etiology of clots - ANSWER-- venous clots: occurs where blood flow is low
- arterial clots: occur at sites of arterial plaque rupture
- as complication of hospitalization, surgery, immobilization
- cancer (pancreatic, lung, ovary, testes, urinary tract, breast, stomach)
- pregnancy and delivery
- hormone therapy (contraceptives, hormone replacement)
- clotting disorders, obesity, family history of DVT
smoking
Risk factors of DVT - ANSWER-- orthopedic procedures (highest risk)
- A-fib
- acute myocardial infarction
- ischemic stroke
- contraception and estrogen therapy
Clinical presentation of DVT - ANSWER-- dull, aching pain in calf (especially when
walking)
,- possible tenderness, swelling, warmth, and erythema along affected vein
- cyanotic extremity
- cramping
- unilateral edema
Diagnostic tests for DVT's - ANSWER-- venous ultrasonography
- MRI
- contrast venography (inject contrast dye)
- labs: Plasma Dimer (not for children), PT/INR, PTT, platelet count
Anticoagulants in treatment for DVT - ANSWER-- DO NOT DISSOLVE EXISTING
CLOTS
- used to prevent clots from forming/growing larger
- increases normal clotting time
Adverse effects of anticoagulants - ANSWER-- *Bleeding*
- GI upset
Heparin IV - ANSWER-- used in higher doses to treat conditions of DVT and PE
- prolongs the clotting time and aPTT
- a few days for therapeutic affect
- safe for pregnant women (acute situation)
Heparin Antagonist - ANSWER-Protamine sulfate
PTT (partial thromboplastin time) - ANSWER-A partial thromboplastin time (PTT) test
measures the time it takes for a blood clot to form.
PTT range for heparin - ANSWER-normal: 20-30 sec
on heparin: 60-100 seconds
Warfarin (coumadin) - ANSWER-- takes several days to achieve therapeutic PT/INR
value
- requires frequent blood work to check INR
- given together with heparin
- inhibits action if vitamin K
- contraindicated in pregnant women
Warfarin antagonist - ANSWER-vitamin K
- takes about 6 hours
Cautious use of Warfarin - ANSWER-pt taking warfarin can still eat leafy greens as long
as diet is regular
PT/INR - ANSWER-prothrombin time/international normalized ratio
, PT/INR ranges - ANSWER-ONLY FOR PT USING WARFARIN
- on med 2-3
- off med 1
Lovenox (enoxaparin) - ANSWER-- low molecular weight heparin
- no INR monitoring
- no dietary restrictions
- preferred for pregnant women (at home subcutaneous)
Factor Xa inhibitor anticoagulants - ANSWER-Xarelto (rivaroxaban)
eliquis (apixaban)
savaysa (edoxaban)
- new oral anticoagulants
- inhibits factor Xa in clotting cascade
- given together w heparin
Factor Xa benefits - ANSWER-- immediate therapeutic action
- no dietary restrictions
- no INR monitoring
Factor Xa negatives - ANSWER-- antagonist administered in hospital (no immediate
reversal otherwise)
- expensive
Antiplatelet medication - ANSWER-- PO med used to prevent clot formation in arteries
- interferes w platelet aggregation
- ASA (NSAID)
- clopidogrel (plavix)
- brillinta
- pletal, trental for intermittent claudication
Thrombolytics - ANSWER-- IV med used to dissolve fibrin clot
- goal is to quickly restore blood flow to the blocked vessel
- used to treat embolic stroke (must be given w/in three hours of stroke)
Surgery for DVT - ANSWER-- venous thrombectomy: when necessary to prevent PE or
gangrene
- if anticoag therapy contraindicated: inferior vena cava filter inserted to trap emboli
Lifespan considerations for DVT - ANSWER-- infants: rare
- adolescents: 8x more likely than infants
- pregnant women: 4-5x greater risk than non-pregnant people
- older adults: increases w age
