Jen Shared "MS3 Exam 1" - 49 Picmonics

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MS3 Exam 1

Complications of Cirrhosis
Portal Hypertension
Ascites
Esophageal Varices
Coagulation Defects
Portal-Systemic Encephalopathy
Hepatorenal Syndrome
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1 min
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
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2 mins
Cirrhosis Interventions
Interventions
Maintain Nutrition
Paracentesis
Esophageal and Gastric Varices
Drug Therapy
Endoscopic Band Ligation or Sclerotherapy
Balloon Tamponade
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Hepatic Encephalopathy
Lactulose
Antibiotics
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2 mins
Hepatitis A (HAV) Assessment
Transmission
Fecal-Oral
Ingestion of Contaminated Food or Water
Incubation
4 Weeks
Assessment
Fever
General Malaise
Hepatomegaly
Considerations
Self-Limiting
Proper Hand Washing
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
IV Drug Abusers
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Abusers
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
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2 mins
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 10-30 U/L
ALT: 10-40 U/L
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1 min
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
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2 mins
Enoxaparin (Lovenox)
Mechanism of Action
Inhibits Clotting Factors
Factor Xa
Indications
Clot Formation Prevention
Side Effects
Heparin Induced Thrombocytopenia (HIT)
Bleeding
Considerations
Medication Education
Subcutaneous Injection
2 Inches from Umbilicus or Incisions
Antidote
Protamine Sulfate
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2 mins
Coagulation Cascade
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
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2 mins
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
Sickle Cell Anemia Assessment
Cause/Mechanism
Hemoglobin S (Genetic Defect)
Sickle Shaped RBCs
Assessment
Jaundice
Vaso Occlusive Crisis
Fever
Priapism
Severe Pain
Considerations
Prominent in African Americans
May be Asymptomatic
Increased Risk of Infection
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2 mins
Sickle Cell Anemia Interventions
Interventions
Increase Hydration
Analgesics
Oxygen
Warm Compress
Bone Marrow Transplant
Hydroxyurea
Considerations
Avoid High Altitudes
Prophylactic Antibiotics
Avoid Strenuous Exercise
Vaccines
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3 mins
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
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2 mins
Cobalamin (Vitamin B12)
Mechanism
Vitamin B12
Indications
Vitamin Deficiency
Pernicious Anemia
Side Effects
Hypokalemia
Arthralgia
Dizziness
Considerations
IM Injection for Pernicious Anemia
Never Give IV
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2 mins
Bleeding Precautions
Things to Avoid
Hard Foods
Aspirin Products
Blowing Nose Forcefully
Straining During BMs
Enemas or Rectal Suppositories
Tampons and Monitor Menstruation
Guidelines to Follow
Soft-bristled Toothbrush
Electric Razor
Limit Needle Sticks
Smaller Needle Size
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3 mins
Heparin Induced Thrombocytopenia (HIT)
Pathophysiology
5-10 Days After Heparin Exposure
Heparin-Platelet Factor 4 Complex
Autoantibodies Form Against Complex
Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
Platelet Aggregation
Procoagulant Release
Symptoms
Thrombocytopenia
Diagnosis
Serotonin Release Assay (SRA)
Treatment
Stop Heparin, Start Direct Thrombin Inhibitor
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2 mins
Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
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2 mins
Clotting Overview
Characteristics
Endothelial Cells are Damaged
Platelets Respond to Exposed Collagen and Stick
Platelets Release Recruiting Factors
More Platelets are Attracted
Soluble Fibrinogen Turns to Insoluble Fibrin
Fibrin Seals the Clot
Clot Dissolves
Liver Produces Clotting Factors
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2 mins

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