mathieu Shared "dvt/drugs/pe" - 22 Picmonics
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dvt/drugs/pe
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
2 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
Venous Thromboembolism (DVT) Assessment
- Mechanism
- Venous Wall Inflammation caused by Thrombus
- Assessment
- Tenderness
- Edema
- Warmth
- Asymmetry
- Considerations
- Could be Asymptomatic
- Monitor for Pulmonary Embolism
58 secs
Venous Thromboembolism (DVT) Interventions
- Anticoagulants
- Prevention Education
- Frequent Ambulation
- Leg Exercises
- Compression Stockings or SCD's
- Avoid Nicotine and Oral Contraceptives
- Surgery
1 min
Pulmonary Embolism Causes
- Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Risk Factors
- Hypercoagulable
- Central Venous Lines
- Immobilized
1 min
Pulmonary Embolism Assessment
- Assessment
- Shortness of Breath (SOB)
- Pleuritic Chest Pain
- Tachypnea
- Hemoptysis
- Hypoxemia
- Considerations
- Sudden Death
52 secs
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
2 mins
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
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
2 mins
Vitamin K1 (Phytonadione)
- Mechanism
- Synthesizes Clotting Factors II, VII, IX, X
- Indications
- Hypoprothrombinemia
- Newborn Prophylaxis
- Bleeding from Warfarin Overdose
- Side Effects
- Shock
- Kernicterus
- Cardiac Arrest
- Considerations
- Bile Salts required for Intestinal Absorption
- Increased Risks with IV Administration
2 mins
Bleeding Precautions
- Things to Avoid
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Guidelines to Follow
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
3 mins
Disseminated Intravascular Coagulation (DIC) Assessment
- Mechanism
- Improper Initiation of Clotting Cascade
- Signs and Symptoms
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
2 mins
Disseminated Intravascular Coagulation (DIC) Interventions
- Complications
- Risk for Shock
- Renal Failure
- Interventions
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
2 mins
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
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
3 mins
Aminoglycoside Side Effects
- Side Effects
- Ototoxicity
- Nephrotoxicity
- Respiratory Paralysis
- Contraindications
- Pregnancy
- Considerations
- Peak and Trough
- Never Mix with Penicillin in Same IV
2 mins
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
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
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
2 mins
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