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Family Nurse Practitioner Certification Intensive Review 5th Edition, Leik, 2023/
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Family Nurse Practitioner Certification Intensive Review 5th Edition, Leik, 2023 | Nurse Practitioner (NP) School Study Aid
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
1 min
Warfarin
- Mechanism of Action
- Interferes with Vitamin K-dependent Clotting Factors
- Extrinsic Pathway
- Bridge with Heparin
- Indications
- Chronic Anticoagulation
- Side Effects
- Bleeding
- Necrosis
- Cytochrome P450
- Contraindications
- Pregnancy
- Antidote
- FFP + Vitamin K
2 mins
Warfarin Antidotes
- Antidotes
- Vitamin K
- Fresh Frozen Plasma
59 secs
Vitamin K
- Sources
- Dark Green Leafy Vegetables
- Synthesized by Intestinal Flora
- Mechanism
- Activated by Epoxide Reductase
- Gamma Carboxylation of Glutamate
- Activation of Clotting Factors II, VII, IX, X, Protein C and S
- Considerations
- Deficiency with Broad Spectrum Antibiotics
- Neonatal Hemorrhage with Increased PT and aPTT
- Warfarin is a Vitamin K Antagonist
4 mins
Coagulation Cascade Overview
- Secondary Hemostasis
- Intrinsic Pathway
- Partial Thromboplastin Time (PTT)
- Heparin
- Extrinsic Pathway
- Prothrombin Time (PT)
- Warfarin
- Common Pathway
- Thrombin
- Convert Fibrinogen to Fibrin
- Stabilizes the Platelet Plug
2 mins
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
1 min
Torsades de Pointes
- Characteristics
- Polymorphic Ventricular Tachycardia
- Prolonged QT Interval
- QRS Twist Around Isoelectric Line
- Causes
- Congenital
- Antibiotics
- Antiarrhythmics
- Antipsychotics
- Antidepressants
- Electrolyte Deficiencies
- Complications
- Ventricular Fibrillation
- Treatment
- Stable: Magnesium Sulfate
- Unstable: Defibrillation
3 mins
Wolff-Parkinson-White Syndrome
- WPW Pattern vs. WPW Syndrome
- Pathophysiology
- Ventricular Pre-excitation Syndrome
- Accessory Conduction Pathway
- Signs & Symptoms
- Supraventricular Tachycardia
- Atrial Fibrillation
- Diagnosis
- Shortened PR Interval
- Delta Wave
- Widened QRS
- Treatment
- No Treatment if Asymptomatic
- Treat Arrhythmia
3 mins
Brugada Syndrome
- Defective Myocardial Sodium Channels
- Predominance in Asian Males
- Autosomal Dominant
- Pseudo-Right Bundle Branch Block Pattern
- Persistent ST Elevations in Leads V1-V2
- Risk of VTACH and Sudden Cardiac Death
- Syncope
- Management
- ICD
- Antiarrhythmics
3 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Troponin Lab Values
- Troponin T (cTnT)
- < 0.1 ng/mL Normal
- Troponin I (cTnI)
- < 0.5 ng/mL Normal
- > 2.3 ng/mL Myocardial Injury
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
Cardiac Catheterization
- Considerations
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- After Procedure
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
2 mins
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Cardiac Enzyme Evaluation: Myoglobin
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 1 - 4 Hours
- Peak: 12 Hours
- Return to Normal: 24 Hours
- Considerations
- Elevation After 24 Hours: Reinfarction
2 mins
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