p.76
Management of Deep Vein Thrombosis (DVT)
What is the role of aldosterone receptor antagonists in hypertension?
Block aldosterone receptors.
p.104
Peripheral Vascular Disease: Assessment and Interventions
How is the laser probe advanced in Laser-Assisted Angioplasty?
Through a cannula similar to that used for PTA.
p.110
Peripheral Vascular Disease: Assessment and Interventions
At what age does Raynaud's Disease usually occur?
Usually in people older than 30 years of age.
p.121
Management of Deep Vein Thrombosis (DVT)
What supportive therapy is recommended for DVT management?
Bed rest and elevation of the extremity.
p.128
Peripheral Vascular Disease: Assessment and Interventions
What relieves the discomfort caused by varicose veins?
Activity or elevation of the legs.
p.117
Management of Deep Vein Thrombosis (DVT)
What is the highest incidence of clot formation associated with?
Deep Vein Thrombophlebitis/Thrombosis (DVT).
p.127
Peripheral Vascular Disease: Assessment and Interventions
What factors can constrict or interfere with venous return?
Prolonged standing, obesity, pregnancy, and abdominal tumors.
p.127
Peripheral Vascular Disease: Assessment and Interventions
What is the impact of thrombophlebitis on veins?
It may damage the valves.
p.9
Types and Causes of Anemia
How does the destruction of RBCs result in anemia?
It decreases the overall RBC count.
p.44
Hemolytic Anemia: Types and Management
When is a blood transfusion used in hemolytic anemia?
As part of medical management.
p.61
Blood Clotting Mechanisms and Disorders
What is Disseminated Intravascular Coagulation (DIC)?
Diffuse fibrin deposition within arterioles and capillaries with widespread coagulation and depletion of clotting factors.
p.83
Peripheral Vascular Disease: Assessment and Interventions
What condition is indicated by an 'eggshell' appearance on an X-ray?
AAA (Abdominal Aortic Aneurysm).
p.63
Blood Clotting Mechanisms and Disorders
What is the underlying cause of Disseminated Intravascular Coagulation (DIC)?
Underlying disease (e.g., toxemia of pregnancy, cancer).
p.63
Blood Clotting Mechanisms and Disorders
What happens to RBCs in DIC?
They are trapped in fibrin strands and are hemolyzed.
p.73
Types and Causes of Anemia
What does an ECG determine in hypertension assessment?
The degree of cardiac involvement.
p.72
Types and Causes of Anemia
What is orthostatic hypotension?
A decrease in BP of 20mmHg systolic and/or 10mmHg diastolic when changing position from lying to sitting within 2 minutes.
p.79
Peripheral Vascular Disease: Assessment and Interventions
How does a normal aorta compare to one with an aneurysm?
A normal aorta has a uniform diameter, while an aorta with an aneurysm is enlarged and bulging.
p.66
Blood Clotting Mechanisms and Disorders
Why is heparin administration in DIC considered controversial?
Its use is debated due to varying outcomes.
p.87
Peripheral Vascular Disease: Assessment and Interventions
What is Peripheral Vascular Disease?
Disorders that alter the natural flow of blood through the arteries and veins of the peripheral circulation.
p.64
Blood Clotting Mechanisms and Disorders
What renal condition can occur in DIC?
Oliguria and acute renal failure.
p.67
Blood Clotting Mechanisms and Disorders
What should be observed for in patients with DIC?
Signs of additional bleeding or thrombus formation.
p.71
Types and Causes of Anemia
What are some causes of secondary hypertension?
Specific disease states and some medications.
p.71
Types and Causes of Anemia
What diseases can lead to secondary hypertension?
Renal vascular & renal parenchymal disease, primary aldosteronism, pheochromocytoma, Cushing’s syndrome, coarctation of aorta, brain tumors, encephalitis, psychiatric disturbances, pregnancy.
p.79
Peripheral Vascular Disease: Assessment and Interventions
What is the primary visual difference between a normal aorta and one with a large abdominal aneurysm?
The aorta with a large abdominal aneurysm is significantly enlarged and bulging.
p.87
Peripheral Vascular Disease: Assessment and Interventions
What does Peripheral Arterial Disease lead to?
Deprivation of oxygen and nutrients.
p.90
Peripheral Vascular Disease: Assessment and Interventions
Why is atherosclerosis significant in Peripheral Arterial Disease?
It is the most common cause.
p.105
Peripheral Vascular Disease: Assessment and Interventions
What is the most commonly performed procedure to increase arterial blood flow in an affected limb for Peripheral Arterial Disease?
Arterial revascularization.
p.111
Peripheral Vascular Disease: Assessment and Interventions
Why might ulcers form in Raynaud's Phenomenon?
Due to prolonged vasospasm and reduced blood flow.
p.9
Types and Causes of Anemia
What are the main causes of anemia?
Blood loss, inadequate or abnormal RBC production, destruction of RBCs.
p.5
Hematopoiesis and Normal Blood Values
What is the normal platelet count?
150,000-400,000/mm^3 or 150-400 x 10^9/L
p.2
Hematopoiesis and Normal Blood Values
What is hematopoiesis?
The process of blood cell formation.
p.15
Iron Deficiency Anemia: Assessment and Management
What injection technique is recommended to prevent leakage of iron into tissues?
The Z-track injection technique.
p.13
Iron Deficiency Anemia: Assessment and Management
What should be monitored for in patients with iron deficiency anemia?
Signs and symptoms of abnormal bleeding, especially from the GIT.
p.15
Iron Deficiency Anemia: Assessment and Management
When is parenteral iron used in iron deficiency anemia management?
In clients intolerant to oral preparations, noncompliant with therapy, or with severe iron deficiency anemia.
p.5
Hematopoiesis and Normal Blood Values
What is the normal RBC count for males?
4.7 – 6.1 million/uL or 4.7-6.1 x 10^12 cells/L
p.15
Iron Deficiency Anemia: Assessment and Management
Why should one needle be used to withdraw and another to administer iron preparations?
To prevent tissue staining and irritation.
p.2
Hematopoiesis and Normal Blood Values
What types of cells are produced during hematopoiesis?
White blood cells, red blood cells, and platelets.
p.14
Iron Deficiency Anemia: Assessment and Management
What is the therapeutic dose of oral iron supplements for iron deficiency anemia?
600-1200 mg daily in divided doses.
p.9
Types and Causes of Anemia
What is anemia?
Deficiency of RBCs, Hgb, Hct.
p.13
Iron Deficiency Anemia: Assessment and Management
How should activities be planned for patients with iron deficiency anemia?
Plan activities to provide adequate rest and avoid overtiring.
p.9
Types and Causes of Anemia
What does Hct stand for?
Percentage of PRBCs per dl of blood.
p.13
Iron Deficiency Anemia: Assessment and Management
Why is it important to explain diagnostic tests to patients with iron deficiency anemia?
To allay anxiety and ensure cooperation.
p.5
Hematopoiesis and Normal Blood Values
What is the normal Hgb range for females?
12-16 g/dL or 120-160 g/L
p.5
Hematopoiesis and Normal Blood Values
What is the normal Hgb range for males?
14-18 g/dL or 140-180 g/L
p.5
Hematopoiesis and Normal Blood Values
What is the normal RBC count for females?
4.2 – 5.4 million/uL or 4.2-5.4 x 10^12 cells/L
p.11
Iron Deficiency Anemia: Assessment and Management
How can decreased absorption of iron in the GIT cause anemia?
It prevents sufficient iron from entering the bloodstream.
p.17
Iron Deficiency Anemia: Assessment and Management
What should be avoided after a parenteral iron injection?
Massaging the injection site.
p.14
Iron Deficiency Anemia: Assessment and Management
When should iron be taken to avoid GI upset?
With or immediately after a meal.
p.5
Hematopoiesis and Normal Blood Values
What is the normal Hct range for females?
37 – 47% or 0.37 – 0.47 fraction
p.14
Iron Deficiency Anemia: Assessment and Management
Why should a straw be used for elixir iron preparations?
To prevent staining of teeth.
p.5
Hematopoiesis and Normal Blood Values
What is the normal WBC count?
5,000-10,000/uL or 5.0-10 x 10^9 cells/L
p.11
Iron Deficiency Anemia: Assessment and Management
What causes Iron Deficiency Anemia?
Inadequate intake of iron, decreased absorption of iron in GIT, excessive loss of iron.
p.11
Iron Deficiency Anemia: Assessment and Management
What are common causes of excessive loss of iron?
Excessive bleeding or blood loss.
p.17
Iron Deficiency Anemia: Assessment and Management
Why should vigorous exercise be avoided after a parenteral iron injection?
It can interfere with absorption.
p.11
Iron Deficiency Anemia: Assessment and Management
What type of anemia is Iron Deficiency Anemia?
Microcytic, Hypochromic anemia.
p.14
Iron Deficiency Anemia: Assessment and Management
What can be taken with iron to enhance absorption?
Orange juice or a vitamin C source.
p.11
Iron Deficiency Anemia: Assessment and Management
What can lead to inadequate intake of iron?
Poor diet or nutritional deficiencies.
p.12
Iron Deficiency Anemia: Assessment and Management
What does a blood smear reveal in iron deficiency anemia?
Microcytic & hypochromic RBCs.
p.5
Hematopoiesis and Normal Blood Values
What is the normal Hct range for males?
42 – 52% or 0.42 – 0.52 fraction
p.25
Pernicious Anemia: Causes and Treatment
What is the medical management for pernicious anemia?
Administration of Vitamin B12 (IM) weekly & monthly for maintenance.
p.12
Iron Deficiency Anemia: Assessment and Management
What are common assessment findings in iron deficiency anemia?
Reduced energy, cold sensitivity, fatigue, DOE, decreased HR even at rest, decreased CBC, Hgb, Hct, serum Fe, microcytic & hypochromic RBCs.
p.12
Iron Deficiency Anemia: Assessment and Management
What are the key components of medical management for iron deficiency anemia?
Treat & eliminate the cause, correct faulty diet, prescribe oral supplements or parenteral iron, and blood transfusion in severe cases.
p.39
Aplastic Anemia: Causes and Nursing Care
What procedures should be implemented to minimize infection risk in aplastic anemia patients?
Special isolation procedures.
p.23
Pernicious Anemia: Causes and Treatment
What does a microscopic exam reveal in pernicious anemia?
Large and immature erythrocytes.
p.24
Pernicious Anemia: Causes and Treatment
How is vitamin B12 normally absorbed in the body?
By combining with intrinsic factor produced by stomach cells.
p.18
Iron Deficiency Anemia: Assessment and Management
What types of bread and cereals are high in iron?
Whole-wheat breads and cereals.
p.30
Folic Acid Deficiency Anemia: Symptoms and Management
What are the three main causes of Folic Acid Deficiency Anemia (FADA)?
Poor nutrition, malabsorption, and drugs.
p.10
Pernicious Anemia: Causes and Treatment
What is the intrinsic factor and where is it produced?
A substance produced by the gastric mucosa needed for absorption of Vitamin B12.
p.36
Aplastic Anemia: Causes and Nursing Care
What is a potential treatment option for severe cases of aplastic anemia?
Bone marrow transplantation.
p.27
Pernicious Anemia: Causes and Treatment
What should be provided for safety when ambulating in patients with pernicious anemia?
Ensure safety, especially when carrying hot items.
p.16
Iron Deficiency Anemia: Assessment and Management
How is iron typically administered in cases of iron deficiency anemia?
Orally or via intramuscular injection.
p.36
Aplastic Anemia: Causes and Nursing Care
When is blood transfusion discontinued in aplastic anemia treatment?
If the client's own marrow begins to produce blood cells.
p.10
Iron Deficiency Anemia: Assessment and Management
What is iron needed for in RBC production?
Hemoglobin synthesis and giving color to the blood.
p.12
Iron Deficiency Anemia: Assessment and Management
What is the significance of decreased HR even at rest in iron deficiency anemia?
It is a symptom indicating reduced oxygen-carrying capacity.
p.9
Types and Causes of Anemia
How does blood loss contribute to anemia?
It reduces the number of RBCs.
p.16
Iron Deficiency Anemia: Assessment and Management
What is the primary focus of nursing management for iron deficiency anemia?
Administering iron supplements.
p.24
Pernicious Anemia: Causes and Treatment
What can result from inadequate absorption of vitamin B12?
Diseases such as pernicious anemia.
p.23
Pernicious Anemia: Causes and Treatment
What does the Schilling test depend on?
Normal renal and bladder function.
p.30
Folic Acid Deficiency Anemia: Symptoms and Management
What diseases can cause malabsorption leading to FADA?
Crohn's disease and chronic alcohol abuse.
p.36
Aplastic Anemia: Causes and Nursing Care
What should be identified and withdrawn in the management of aplastic anemia?
The offending agent or drug.
p.10
Folic Acid Deficiency Anemia: Symptoms and Management
What condition results from a lack of folic acid?
Folic acid-deficiency anemia.
p.9
Types and Causes of Anemia
Why does inadequate or abnormal RBC production cause anemia?
It leads to insufficient RBCs in the blood.
p.23
Pernicious Anemia: Causes and Treatment
How is the Schilling test performed?
By administering 58Co-labeled cobalamin and collecting urine for 24 hours.
p.25
Pernicious Anemia: Causes and Treatment
What mouth care should be provided for a client with pernicious anemia?
Mouth care before and after meals using a soft toothbrush and nonirritating rinses.
p.36
Aplastic Anemia: Causes and Nursing Care
What type of blood is used in transfusions for aplastic anemia?
Fresh whole blood containing all blood components and plasma, less than 24 hours old.
p.21
Pernicious Anemia: Causes and Treatment
What are common oral symptoms of pernicious anemia?
Stomatitis and glossitis (a smooth, beefy-red tongue).
p.12
Iron Deficiency Anemia: Assessment and Management
What symptoms might a patient with iron deficiency anemia experience?
Reduced energy, cold sensitivity, fatigue, DOE.
p.20
Pernicious Anemia: Causes and Treatment
Why is Vitamin B12 important for erythrocytes?
Needed for their maturation.
p.21
Pernicious Anemia: Causes and Treatment
What neurologic symptoms are associated with pernicious anemia?
Numbness and tingling in the arms and legs, and difficulty with gait or balance.
p.42
Hemolytic Anemia: Types and Management
What factors influence the clinical manifestations of hemolytic anemia?
Severity of anemia and the rate of onset (acute vs chronic).
p.23
Pernicious Anemia: Causes and Treatment
What diagnostic methods are used for pernicious anemia?
Client’s history, symptoms, blood and bone marrow studies.
p.24
Pernicious Anemia: Causes and Treatment
What role does vitamin B12 play in the body?
Formation of red blood cells, maintenance of the central nervous system, and metabolism.
p.16
Iron Deficiency Anemia: Assessment and Management
Why is it important to monitor hemoglobin and hematocrit levels in iron deficiency anemia?
To assess the effectiveness of treatment.
p.18
Iron Deficiency Anemia: Assessment and Management
Which vegetables are high in iron?
Leafy green vegetables and carrots.
p.16
Iron Deficiency Anemia: Assessment and Management
What is a common side effect of oral iron supplements?
Gastrointestinal discomfort.
p.20
Pernicious Anemia: Causes and Treatment
What causes pernicious anemia?
Deficiency of intrinsic factor.
p.39
Aplastic Anemia: Causes and Nursing Care
What type of diet should be encouraged to help reduce the incidence of infection in aplastic anemia patients?
High-protein, high-vitamin diet.
p.23
Pernicious Anemia: Causes and Treatment
What is the Schilling test used for?
To measure absorption of radioactive Vitamin B12 and detect lack of intrinsic factor.
p.30
Folic Acid Deficiency Anemia: Symptoms and Management
What foods are rich in folic acid?
Beef liver, organ meats, eggs, green leafy vegetables, cabbage, broccoli, yeast, citrus fruits, peanut butter, oatmeal, asparagus.
p.12
Iron Deficiency Anemia: Assessment and Management
How is iron deficiency anemia diagnosed through blood tests?
Decreased CBC, Hgb, Hct, and serum Fe.
p.30
Folic Acid Deficiency Anemia: Symptoms and Management
How does chronic alcohol abuse contribute to FADA?
It leads to malnutrition.
p.47
Blood Clotting Mechanisms and Disorders
What is the first step in the blood clotting mechanism?
Platelet aggregation with formation of a platelet plug.
p.20
Pernicious Anemia: Causes and Treatment
What is the role of intrinsic factor in the body?
Necessary for absorption of Vitamin B12.
p.10
Folic Acid Deficiency Anemia: Symptoms and Management
Why is folic acid important for RBC production?
It is needed for the maturation of RBCs.
p.20
Pernicious Anemia: Causes and Treatment
What type of cells are formed due to Vitamin B12 deficiency?
Megaloblastic or macrocytic cells.
p.33
Aplastic Anemia: Causes and Nursing Care
What causes aplastic anemia?
Failure of the bone marrow to produce cells (pluripotent stem cell injury).
p.39
Aplastic Anemia: Causes and Nursing Care
What should be administered as ordered for a patient with aplastic anemia?
Blood transfusions and medications.
p.43
Hemolytic Anemia: Types and Management
What laboratory tests are used to assess Hemolytic Anemia?
Hgb/Hct, Reticulocyte count, Coombs' test, Bilirubin (indirect).
p.21
Pernicious Anemia: Causes and Treatment
Why does pernicious anemia commonly occur in the elderly?
Due to decreased production of intrinsic factor with age and gastric mucosal atrophy.
p.20
Pernicious Anemia: Causes and Treatment
What is paresthesia and how is it related to Vitamin B12?
Paresthesia is abnormal nerve function; Vitamin B12 is needed for normal nerve function.
p.18
Iron Deficiency Anemia: Assessment and Management
What types of meat are high in iron?
Red meat and organ meats.
p.16
Iron Deficiency Anemia: Assessment and Management
What dietary advice should be given to patients with iron deficiency anemia?
Increase intake of iron-rich foods like red meat, beans, and leafy greens.
p.25
Pernicious Anemia: Causes and Treatment
What foods should be avoided if a client with pernicious anemia has stomatitis and glossitis?
Highly seasoned, coarse, or very hot foods.
p.16
Iron Deficiency Anemia: Assessment and Management
Why might vitamin C be recommended alongside iron supplements?
It enhances iron absorption.
p.21
Pernicious Anemia: Causes and Treatment
What are general symptoms of pernicious anemia?
Pallor, fatigue, and DOE (dyspnea on exertion).
p.43
Hemolytic Anemia: Types and Management
What does a positive Coombs' test indicate in Hemolytic Anemia?
Presence of autoimmune features.
p.41
Hemolytic Anemia: Types and Management
What are some acquired causes of hemolytic anemia?
Cardiopulmonary bypass surgery, arsenic or lead poisoning, malarial infection, toxins & hazardous chemicals, transfusion reactions.
p.42
Hemolytic Anemia: Types and Management
What gastrointestinal symptoms are associated with hemolytic anemia?
Abdominal pain, nausea and vomiting (N&V), diarrhea, melena, hematuria.
p.16
Iron Deficiency Anemia: Assessment and Management
What is the purpose of the Z-track method in intramuscular injections?
To prevent medication from leaking into subcutaneous tissue.
p.25
Pernicious Anemia: Causes and Treatment
What type of diet should be provided for nursing management of pernicious anemia?
A Vitamin B12-rich diet including liver, organ meats, dried beans, nuts, green leafy vegetables, citrus fruit, and brewer’s yeast.
p.47
Blood Clotting Mechanisms and Disorders
What are the three sequential processes involved in blood clotting?
Platelet aggregation, blood clotting cascade, formation of a fibrin clot.
p.21
Pernicious Anemia: Causes and Treatment
What symptoms are seen in severe cases of pernicious anemia?
Jaundice, irritability, and confusion.
p.47
Blood Clotting Mechanisms and Disorders
What is the final step in the blood clotting mechanism?
Formation of a complete fibrin clot.
p.12
Iron Deficiency Anemia: Assessment and Management
How can iron deficiency anemia be managed through diet?
Correction of faulty diet and oral iron supplements.
p.27
Pernicious Anemia: Causes and Treatment
What should client teaching and discharge planning for pernicious anemia include?
Dietary instruction, lifelong Vitamin B12 therapy, and safety instructions.
p.31
Folic Acid Deficiency Anemia: Symptoms and Management
What nursing management strategies are recommended for folic acid deficiency anemia?
Encourage good oral hygiene and adequate rest periods.
p.10
Pernicious Anemia: Causes and Treatment
What condition results from a lack of Vitamin B12?
Vitamin B12-deficiency anemia.
p.24
Pernicious Anemia: Causes and Treatment
What is intrinsic factor and why is it important?
A protein produced by stomach cells necessary for vitamin B12 absorption in the small intestine.
p.23
Pernicious Anemia: Causes and Treatment
Why might cobalamin absorption be abnormal in pernicious anemia?
Due to lack of intrinsic factor.
p.21
Pernicious Anemia: Causes and Treatment
Who is usually affected by pernicious anemia?
Elderly and clients with a history of surgical removal of the stomach or bowel resection.
p.45
Hemolytic Anemia: Types and Management
Why is frequent turning and meticulous skin care important in hemolytic anemia patients?
Because skin friability is increased.
p.31
Folic Acid Deficiency Anemia: Symptoms and Management
What are common assessment findings in folic acid deficiency anemia?
Severe fatigue, sore & beefy red tongue, dyspnea, nausea, anorexia, headaches, weakness, lightheadedness.
p.29
Folic Acid Deficiency Anemia: Symptoms and Management
How do the manifestations of folic acid deficiency anemia compare to those of Vitamin B12 deficiency?
They are similar except for the nervous system involvement.
p.33
Aplastic Anemia: Causes and Nursing Care
What is aplastic anemia?
A deficiency of circulating RBCs usually accompanied by leukopenia and thrombocytopenia.
p.42
Hemolytic Anemia: Types and Management
What are common symptoms of chronic hemolytic anemia?
Dyspnea, pallor, fatigue, jaundice.
p.41
Hemolytic Anemia: Types and Management
What are some hereditary causes of hemolytic anemia?
Hereditary spherocytosis, G6PD deficiency, sickle cell anemia, thalassemia.
p.10
Pernicious Anemia: Causes and Treatment
Why is Vitamin B12 important for RBC production?
It is needed for the maturation of RBCs.
p.30
Folic Acid Deficiency Anemia: Symptoms and Management
Which drugs can prevent the absorption and conversion of folic acid?
Anticonvulsants and oral contraceptives.
p.30
Folic Acid Deficiency Anemia: Symptoms and Management
Why do anticonvulsants and oral contraceptives cause FADA?
They prevent absorption and conversion of folic acid to its active form.
p.31
Folic Acid Deficiency Anemia: Symptoms and Management
What lab findings are associated with folic acid deficiency anemia?
Decreased Hgb/Hct and serum folate.
p.20
Pernicious Anemia: Causes and Treatment
What happens to precursor cells without Vitamin B12?
Undergo improper DNA synthesis.
p.31
Folic Acid Deficiency Anemia: Symptoms and Management
What dietary advice is given to patients with folic acid deficiency anemia?
Eat soft, bland, and high in folic acid foods.
p.41
Hemolytic Anemia: Types and Management
How can cardiopulmonary bypass surgery lead to hemolytic anemia?
By causing increased destruction of RBCs.
p.40
Aplastic Anemia: Causes and Nursing Care
What should be checked for occult blood in patients with aplastic anemia?
Urine and stool (Hematest).
p.40
Aplastic Anemia: Causes and Nursing Care
What signs of bleeding should be observed in patients with aplastic anemia?
Oozing from gums, petechiae, or ecchymoses.
p.51
Blood Clotting Mechanisms and Disorders
How do intrinsic factors affect blood clotting?
They make platelets clump and activate the blood-clotting cascade.
p.41
Hemolytic Anemia: Types and Management
What causes hemolytic anemia?
Increased destruction of RBCs.
p.29
Folic Acid Deficiency Anemia: Symptoms and Management
What role does folic acid play in the body?
Proper DNA synthesis and cell division.
p.27
Pernicious Anemia: Causes and Treatment
Why is lifelong Vitamin B12 therapy important for patients with pernicious anemia?
To manage the condition effectively.
p.27
Pernicious Anemia: Causes and Treatment
What rehabilitation and physical therapy are recommended for patients with pernicious anemia?
Therapy for neurologic deficits and safety instructions.
p.41
Hemolytic Anemia: Types and Management
What is a common feature of conditions causing hemolytic anemia?
Increased destruction of RBCs.
p.55
Blood Clotting Mechanisms and Disorders
What are common assessment findings in Idiopathic Thrombocytopenic Purpura?
Ecchymoses, petechial rashes, mucosal bleeding.
p.10
Aplastic Anemia: Causes and Nursing Care
What role does bone marrow play in RBC production?
It is the site where RBCs are produced.
p.33
Aplastic Anemia: Causes and Nursing Care
What are some long-term exposures that can cause aplastic anemia?
Toxic agents (drugs, chemicals).
p.34
Aplastic Anemia: Causes and Nursing Care
What coagulation abnormalities are seen in aplastic anemia?
Unusual bleeding, petechiae, and ecchymoses (bruises).
p.41
Hemolytic Anemia: Types and Management
Why can lead poisoning cause hemolytic anemia?
It leads to increased destruction of RBCs.
p.49
Blood Clotting Mechanisms and Disorders
Why is the platelet release reaction important?
It is crucial for initiating the blood clotting process to prevent excessive bleeding.
p.34
Aplastic Anemia: Causes and Nursing Care
What is the definitive test for diagnosing aplastic anemia?
Bone marrow aspiration/biopsy.
p.31
Folic Acid Deficiency Anemia: Symptoms and Management
How is folic acid deficiency anemia medically managed?
Oral or parenteral folic acid supplements and a well-balanced diet.
p.34
Aplastic Anemia: Causes and Nursing Care
What type of infections are frequent in aplastic anemia?
Opportunistic infections.
p.42
Hemolytic Anemia: Types and Management
What symptoms might indicate an acute onset of hemolytic anemia?
Chills, fever, irritability, precordial pain.
p.46
Pernicious Anemia: Causes and Treatment
What condition is indicated by a beefy-red tongue?
Pernicious anemia and Folic Acid Deficiency anemia.
p.49
Blood Clotting Mechanisms and Disorders
What role does calcium play in the platelet release reaction?
Calcium is essential for the activation and aggregation of platelets.
p.10
Types and Causes of Anemia
What type of anemia can result from secondary causes?
Anemia secondary in origin.
p.58
Blood Clotting Mechanisms and Disorders
What is the primary goal in the medical management of Idiopathic Thrombocytopenic Purpura?
Treatment of underlying condition and protection from trauma-induced bleeding episodes.
p.55
Blood Clotting Mechanisms and Disorders
What rare but serious complication can occur in Idiopathic Thrombocytopenic Purpura?
Intracranial bleed-induced stroke.
p.44
Hemolytic Anemia: Types and Management
What is the first step in the medical management of hemolytic anemia?
Identify and eliminate the cause.
p.49
Blood Clotting Mechanisms and Disorders
What is the function of collagen in the platelet release reaction?
Collagen triggers platelet adhesion and activation at the site of vascular injury.
p.49
Blood Clotting Mechanisms and Disorders
What substances are liberated during the platelet release reaction?
ADP, serotonin, and thromboxane A2.
p.49
Blood Clotting Mechanisms and Disorders
How do platelets respond to vascular injury?
They adhere to the exposed collagen and release substances to promote clotting.
p.55
Blood Clotting Mechanisms and Disorders
Where do petechial rashes commonly appear in Idiopathic Thrombocytopenic Purpura?
Arms, legs, upper chest, and neck.
p.55
Blood Clotting Mechanisms and Disorders
What should be assessed in patients with Idiopathic Thrombocytopenic Purpura to monitor for serious complications?
Neurologic function and mental status.
p.10
Hematopoiesis and Normal Blood Values
What is erythropoietin and what is its role in RBC production?
A hormone that stimulates RBC production.
p.51
Blood Clotting Mechanisms and Disorders
What is the extrinsic pathway in blood clotting?
Factors outside the blood, such as trauma.
p.55
Blood Clotting Mechanisms and Disorders
What happens to platelets in Idiopathic Thrombocytopenic Purpura?
They are destroyed, causing slow blood clotting.
p.58
Blood Clotting Mechanisms and Disorders
Why are platelet transfusions not routinely performed in Idiopathic Thrombocytopenic Purpura?
Because the platelets will be destroyed.
p.42
Hemolytic Anemia: Types and Management
What organ enlargements are associated with hemolytic anemia?
Splenomegaly and hepatomegaly.
p.34
Aplastic Anemia: Causes and Nursing Care
What does a CBC typically show in aplastic anemia?
Macrocytic anemia, leukopenia, thrombocytopenia.
p.44
Hemolytic Anemia: Types and Management
What signs and symptoms of hypoxia should be monitored in hemolytic anemia patients?
Confusion, cyanosis, shortness of breath, tachycardia, and palpitations.
p.51
Blood Clotting Mechanisms and Disorders
What is the intrinsic pathway in blood clotting?
Problems or substances directly in the blood that make platelets clump and activate the blood-clotting cascade.
p.34
Aplastic Anemia: Causes and Nursing Care
Why does splenomegaly occur in aplastic anemia?
Accumulation of blood cells destroyed by lymphocytes.
p.59
Blood Clotting Mechanisms and Disorders
How should support be provided to a client with Idiopathic Thrombocytopenic Purpura?
Be sensitive to change in body image.
p.51
Blood Clotting Mechanisms and Disorders
What are some examples of intrinsic factors in blood clotting?
Antigen-antibody reaction, circulating debris, prolonged venous stasis, bacterial toxins.
p.58
Blood Clotting Mechanisms and Disorders
What medications are used to suppress immune function in Idiopathic Thrombocytopenic Purpura?
Corticosteroids and Azathioprine (Imuran).
p.44
Hemolytic Anemia: Types and Management
Why might jaundice make the assessment of skin color in hypoxia unreliable?
Because jaundice affects skin color.
p.58
Blood Clotting Mechanisms and Disorders
How can the environment be managed to protect clients with Idiopathic Thrombocytopenic Purpura?
Maintain a safe environment and protect from conditions that can lead to bleeding.
p.60
Blood Clotting Mechanisms and Disorders
What should be measured for baseline in patients with Idiopathic Thrombocytopenic Purpura?
Normal circumference of extremities.
p.60
Blood Clotting Mechanisms and Disorders
How should medications be administered to patients with Idiopathic Thrombocytopenic Purpura?
Orally, rectally, or IV, rather than IM.
p.59
Blood Clotting Mechanisms and Disorders
What is a key nursing intervention for controlling bleeding in Idiopathic Thrombocytopenic Purpura?
Administer platelet transfusions as ordered.
p.46
Pernicious Anemia: Causes and Treatment
What deficiency causes pernicious anemia?
Deficient intrinsic factor.
p.61
Blood Clotting Mechanisms and Disorders
What organs are commonly affected by hemorrhage in DIC?
Kidneys, brain, adrenals, heart, and other organs.
p.59
Blood Clotting Mechanisms and Disorders
How should a bleeding part be positioned in Idiopathic Thrombocytopenic Purpura?
Above heart level if possible.
p.60
Blood Clotting Mechanisms and Disorders
How should immunizations be administered to patients with Idiopathic Thrombocytopenic Purpura?
Subcutaneously (SC) with pressure held on the site for 5 minutes.
p.65
Blood Clotting Mechanisms and Disorders
What happens to fibrinogen levels and platelet count in DIC?
They are usually depressed.
p.61
Blood Clotting Mechanisms and Disorders
What types of diseases are clients with DIC usually critically ill with?
Obstetric, surgical, hemolytic, or neoplastic diseases.
p.61
Blood Clotting Mechanisms and Disorders
Why is the mortality rate high in DIC?
Because the underlying disease cannot be corrected.
p.69
Peripheral Vascular Disease: Assessment and Interventions
What is arteriosclerosis?
Thickening or hardening of the arterial wall.
p.77
Peripheral Vascular Disease: Assessment and Interventions
What is an aneurysm?
A permanent localized dilation of an artery, enlarging it to at least 2 times its normal diameter.
p.69
Peripheral Vascular Disease: Assessment and Interventions
What is the first step in the pathophysiology of atherosclerosis?
Vascular damage and inflammation.
p.72
Types and Causes of Anemia
What should be reviewed in a client's history for hypertension assessment?
Client’s risk factors for hypertension.
p.63
Blood Clotting Mechanisms and Disorders
What are the consequences of microthrombi formation in DIC?
Microinfarcts and tissue necrosis.
p.72
Types and Causes of Anemia
What symptoms suggest a pheochromocytoma or adrenal medulla tumor?
Tachycardia, sweating, and pallor.
p.61
Blood Clotting Mechanisms and Disorders
What may DIC be linked with?
Entry of thromboplastic substances into the blood.
p.64
Blood Clotting Mechanisms and Disorders
Where can petechiae and ecchymoses appear in DIC?
On the skin, mucous membranes, heart, lungs, and other organs.
p.79
Peripheral Vascular Disease: Assessment and Interventions
What is an aneurysm?
A bulging or ballooning in the wall of an artery.
p.64
Blood Clotting Mechanisms and Disorders
What type of bleeding is prolonged in DIC?
Bleeding from breaks in the skin (e.g., IV or venipuncture sites).
p.64
Blood Clotting Mechanisms and Disorders
When can severe and uncontrollable hemorrhage occur in DIC?
During childbirth or surgical procedures.
p.64
Blood Clotting Mechanisms and Disorders
What severe neurological symptoms can occur in DIC?
Convulsions, coma, and death.
p.63
Blood Clotting Mechanisms and Disorders
What promotes clot deposition throughout the microcirculation in DIC?
Release of thromboplastic substances.
p.72
Types and Causes of Anemia
What should be assessed in a psychosocial assessment for hypertension?
Psychosocial stressors such as job-related, economic, and other life stressors.
p.82
Peripheral Vascular Disease: Assessment and Interventions
How are most aneurysms discovered?
By routine examination or radiographic study performed for another reason.
p.72
Types and Causes of Anemia
What are common symptoms of hypertension?
Headaches, dizziness, fainting.
p.80
Peripheral Vascular Disease: Assessment and Interventions
What increases as an aneurysm grows?
The risk of arterial rupture.
p.64
Blood Clotting Mechanisms and Disorders
What are the skin-related assessment findings in Disseminated Intravascular Coagulation (DIC)?
Petechiae and ecchymoses on the skin.
p.69
Peripheral Vascular Disease: Assessment and Interventions
What is atherosclerosis?
A type of arteriosclerosis involving plaque formation within the arterial wall.
p.80
Peripheral Vascular Disease: Assessment and Interventions
What is an aneurysm?
A weakening of the artery's middle layer (T. media) causing stretching in the inner (T. intima) and outer layers (T. adventitia).
p.73
Types and Causes of Anemia
What can laboratory tests assess in relation to hypertension?
Possible causes of secondary hypertension.
p.81
Peripheral Vascular Disease: Assessment and Interventions
What are the contributing factors to aneurysms besides atherosclerosis?
Hypertension and cigarette smoking.
p.66
Blood Clotting Mechanisms and Disorders
What is key in the medical management of Disseminated Intravascular Coagulation (DIC)?
Identification and control of the underlying disease.
p.87
Peripheral Vascular Disease: Assessment and Interventions
What causes Peripheral Arterial Disease?
Systemic atherosclerosis.
p.75
Management of Deep Vein Thrombosis (DVT)
How do thiazide diuretics work?
They prevent Na+ and water reabsorption in the distal tubules while promoting K+ excretion.
p.85
Peripheral Vascular Disease: Assessment and Interventions
What type of aneurysm is specifically mentioned in the diagnostic assessment?
Abdominal Aortic Aneurysm (AAA).
p.78
Peripheral Vascular Disease: Assessment and Interventions
At which specific anatomic sites do aneurysms tend to occur?
Various specific anatomic sites, most commonly the abdominal aorta.
p.77
Peripheral Vascular Disease: Assessment and Interventions
What characterizes a fusiform aneurysm?
Diffuse dilation affecting the entire circumference of the artery.
p.70
Peripheral Vascular Disease: Assessment and Interventions
What is considered normal adult blood pressure according to the 2003 classification?
<120mmHg systolic and <80mmHg diastolic.
p.63
Blood Clotting Mechanisms and Disorders
What happens to platelets, prothrombin, and other clotting factors in DIC?
They are destroyed, leading to bleeding.
p.63
Blood Clotting Mechanisms and Disorders
What is the effect of the activated fibrinolytic system in DIC?
It inhibits platelet function, causing further bleeding.
p.71
Types and Causes of Anemia
What are some risk factors associated with essential hypertension?
Age >60 years, family history, excessive calorie consumption, physical inactivity, excessive alcohol intake, hyperlipidemia, African-American ethnicity, high intake of salt or caffeine, reduced intake of K+, Ca++, Mg++, obesity, smoking, stress.
p.75
Management of Deep Vein Thrombosis (DVT)
How do loop diuretics work?
They depress Na+ reabsorption in the ascending loop of Henle and promote K+ excretion.
p.74
Peripheral Vascular Disease: Assessment and Interventions
What are the equivalents of 1 ounce of ethanol in different alcoholic beverages?
2 ounces of liquor, 8 ounces of wine, or 24 ounces of beer.
p.80
Peripheral Vascular Disease: Assessment and Interventions
What effect does the weakening of the middle layer of an artery have?
It produces a stretching effect in the inner (T. intima) and outer layers (T. adventitia).
p.66
Blood Clotting Mechanisms and Disorders
What is the role of heparin in the management of DIC?
Inhibits thrombin to prevent further clot formation and allows coagulation factors to accumulate.
p.82
Peripheral Vascular Disease: Assessment and Interventions
What type of pain is associated with an abdominal aortic aneurysm (AAA)?
Steady with a gnawing quality abdominal, flank, or back pain.
p.77
Peripheral Vascular Disease: Assessment and Interventions
What characterizes a saccular aneurysm?
An outpouching affecting only a distinct portion of the artery.
p.71
Types and Causes of Anemia
What medications can cause secondary hypertension?
Estrogen (oral contraceptives), glucocorticoids, mineralocorticoids, sympathomimetics.
p.87
Peripheral Vascular Disease: Assessment and Interventions
What is another name for PAD of the lower extremities?
Lower Extremity Arterial Disease (LEAD).
p.89
Peripheral Vascular Disease: Assessment and Interventions
What does inflow obstruction in Peripheral Arterial Disease involve?
The distal end of the aorta and the common, internal, external iliac arteries.
p.100
Peripheral Vascular Disease: Assessment and Interventions
Why should clients with PAD refrain from raising their legs above heart level?
Extreme elevation slows arterial blood flow to the feet.
p.80
Peripheral Vascular Disease: Assessment and Interventions
Which layer of the artery is weakened in an aneurysm?
The middle layer (T. media).
p.66
Blood Clotting Mechanisms and Disorders
What types of blood transfusions are used in the management of DIC?
WB, PRBC, platelets, plasma, cryoprecipitates, and volume expanders.
p.79
Peripheral Vascular Disease: Assessment and Interventions
Why is an aneurysm dangerous?
It can rupture, leading to life-threatening internal bleeding.
p.82
Peripheral Vascular Disease: Assessment and Interventions
What are the signs of a rupturing AAA?
Hypotension, diaphoresis, mental obtundation, oliguria, and dysrhythmias.
p.74
Peripheral Vascular Disease: Assessment and Interventions
How much alcohol should be limited to manage hypertension?
No more than 1 ounce of ethanol daily.
p.89
Peripheral Vascular Disease: Assessment and Interventions
What does outflow obstruction in Peripheral Arterial Disease involve?
Femoral, popliteal, and tibial arteries.
p.67
Blood Clotting Mechanisms and Disorders
What type of data should be monitored in patients with DIC?
Appropriate laboratory data.
p.85
Peripheral Vascular Disease: Assessment and Interventions
What is an aneurysm?
An abnormal bulge in the wall of a blood vessel.
p.102
Peripheral Vascular Disease: Assessment and Interventions
How does Pentoxifylline (Trental) improve blood flow to the extremities?
By inhibiting platelet aggregation and decreasing fibrinogen.
p.96
Peripheral Vascular Disease: Assessment and Interventions
What happens to BP readings in the thigh and calf in the presence of arterial disease?
They are lower than the brachial pressure.
p.87
Peripheral Vascular Disease: Assessment and Interventions
What is Peripheral Arterial Disease (PAD)?
Chronic partial or total arterial occlusion resulting from systemic atherosclerosis.
p.76
Management of Deep Vein Thrombosis (DVT)
What do calcium channel blocking agents do to blood pressure?
Lower BP by causing vasodilation.
p.75
Management of Deep Vein Thrombosis (DVT)
What is an example of a K+-sparing diuretic?
Spironolactone (Aldactone).
p.86
Peripheral Vascular Disease: Assessment and Interventions
How is hypertension managed in patients with an aneurysm?
With anti-hypertensive agents.
p.76
Management of Deep Vein Thrombosis (DVT)
Why are beta blockers recommended for hypertensive clients with ischemic heart disease?
They protect the heart from end-organ damage.
p.92
Peripheral Vascular Disease: Assessment and Interventions
What happens to the extremities in Peripheral Arterial Disease?
They become cold and cyanotic; pallor occurs when elevated.
p.101
Peripheral Vascular Disease: Assessment and Interventions
Why should direct heat never be applied to the limb in Peripheral Arterial Disease?
Sensitivity might be decreased, leading to burn injury.
p.92
Peripheral Vascular Disease: Assessment and Interventions
What is the most sensitive and specific indicator of arterial function in Peripheral Arterial Disease?
The quality of the posterior tibial pulse.
p.101
Peripheral Vascular Disease: Assessment and Interventions
What causes vasoconstriction in Peripheral Arterial Disease?
Emotional stress, caffeine, and nicotine.
p.75
Management of Deep Vein Thrombosis (DVT)
What should be monitored when a patient is on diuretics?
K+ level, irregular pulse, and muscle weakness.
p.67
Blood Clotting Mechanisms and Disorders
What should be administered to patients with DIC as ordered?
Blood transfusions and medications.
p.96
Peripheral Vascular Disease: Assessment and Interventions
What is an inexpensive, noninvasive method of assessing PAD?
Segmental Systolic BP measurements using a Doppler probe.
p.92
Peripheral Vascular Disease: Assessment and Interventions
What are the skin characteristics associated with Peripheral Arterial Disease?
Dry, scaly, dusky, pale or mottled skin; thickened toenails.
p.98
Peripheral Vascular Disease: Assessment and Interventions
What is Peripheral Arterial Disease?
A condition where arteries in the limbs are narrowed, reducing blood flow.
p.98
Peripheral Vascular Disease: Assessment and Interventions
How is Exercise Tolerance Testing performed?
By stress test or treadmill.
p.89
Peripheral Vascular Disease: Assessment and Interventions
What is Peripheral Arterial Disease?
A condition involving obstruction of arteries outside the heart.
p.67
Blood Clotting Mechanisms and Disorders
What type of mouth care should be provided to patients with DIC?
Frequent nontraumatic mouth care using a soft toothbrush or gauze sponge.
p.89
Peripheral Vascular Disease: Assessment and Interventions
Where are the arteries involved in inflow obstruction located?
Above the inguinal ligament.
p.90
Peripheral Vascular Disease: Assessment and Interventions
What are the risk factors for Peripheral Arterial Disease?
Hypertension, hyperlipidemia, diabetes mellitus (DM), cigarette smoking, obesity, and familial predisposition.
p.100
Peripheral Vascular Disease: Assessment and Interventions
What is a controversial aspect of positioning clients with Peripheral Arterial Disease (PAD)?
Positioning to promote circulation.
p.89
Peripheral Vascular Disease: Assessment and Interventions
Where are the arteries involved in outflow obstruction located?
Below the superficial femoral artery.
p.100
Peripheral Vascular Disease: Assessment and Interventions
What should clients with PAD avoid to prevent interference with blood flow?
Crossing the legs and wearing restrictive clothing.
p.76
Management of Deep Vein Thrombosis (DVT)
Which drugs are examples of calcium channel blocking agents?
Verapamil, Amlodipine, Diltiazem.
p.86
Peripheral Vascular Disease: Assessment and Interventions
What does an Abdominal Aortic Aneurysm Resection involve?
Excision of the aneurysm from the abdominal aorta to prevent or repair rupture.
p.96
Peripheral Vascular Disease: Assessment and Interventions
How do BP readings in the thigh and calf normally compare to those in the upper extremities?
They are normally higher.
p.91
Peripheral Vascular Disease: Assessment and Interventions
What is the characteristic leg pain called in Peripheral Arterial Disease?
Intermittent claudication.
p.85
Peripheral Vascular Disease: Assessment and Interventions
What information does ultrasonography provide about an aneurysm?
Size and location of the aneurysm.
p.74
Peripheral Vascular Disease: Assessment and Interventions
How should one start an exercise program for hypertension management?
Start slowly and gradually work up to more rigorous activities.
p.76
Management of Deep Vein Thrombosis (DVT)
How do ACE inhibitors help in hypertension?
Inhibit conversion of angiotensin I to II.
p.76
Management of Deep Vein Thrombosis (DVT)
What is the function of angiotensin II receptor blockers?
Block angiotensin II receptors.
p.86
Peripheral Vascular Disease: Assessment and Interventions
What is the goal of nonsurgical management for an aneurysm?
To monitor the growth of the aneurysm and maintain BP at a normal level to reduce the risk of rupture.
p.76
Management of Deep Vein Thrombosis (DVT)
Which drugs are examples of ACE inhibitors?
Captopril, Enalapril, Lisinopril.
p.110
Peripheral Vascular Disease: Assessment and Interventions
What causes Raynaud's Disease?
Vasospasm of the arterioles and arteries of the upper and lower extremities.
p.91
Peripheral Vascular Disease: Assessment and Interventions
What symptom forces clients with intermittent claudication to stop walking?
Cramping, burning muscle discomfort or pain.
p.75
Management of Deep Vein Thrombosis (DVT)
How do K+-sparing diuretics work?
They inhibit Na+ reabsorption in the DCT in exchange for K+, thereby retaining K+.
p.86
Peripheral Vascular Disease: Assessment and Interventions
What is the purpose of frequent CT scanning in nonsurgical management of an aneurysm?
To monitor the growth of the aneurysm.
p.104
Peripheral Vascular Disease: Assessment and Interventions
For which clients is Laser-Assisted Angioplasty reserved?
Clients with smaller occlusions in the distal superficial femoral, proximal popliteal, and common iliac arteries.
p.104
Peripheral Vascular Disease: Assessment and Interventions
What is the purpose of Laser-Assisted Angioplasty?
To open occluded or stenosed arteries.
p.101
Peripheral Vascular Disease: Assessment and Interventions
How can increased blood viscosity be prevented in Peripheral Arterial Disease?
By drinking adequate fluids.
p.111
Peripheral Vascular Disease: Assessment and Interventions
What happens to the extremities during a vasospasm in Raynaud's Phenomenon?
Blanching followed by cyanosis.
p.100
Peripheral Vascular Disease: Assessment and Interventions
How might clients with severe PAD and swelling sleep for comfort?
With the affected limb hanging from the bed or sitting upright in a chair.
p.96
Peripheral Vascular Disease: Assessment and Interventions
What is arteriography and why is it not commonly performed today?
It involves injecting contrast medium into the arterial system and has risks like hemorrhage, thrombosis, embolus, and death.
p.104
Peripheral Vascular Disease: Assessment and Interventions
What does the heat from the laser do in Laser-Assisted Angioplasty?
Vaporizes the arteriosclerotic plaque.
p.110
Peripheral Vascular Disease: Assessment and Interventions
Can Raynaud's Disease occur in younger individuals?
Yes, it can occur between the ages of 17 and 50 years.
p.96
Peripheral Vascular Disease: Assessment and Interventions
How is the Ankle-Brachial Index (ABI) calculated?
By dividing the ankle BP by the brachial BP.
p.108
Peripheral Vascular Disease: Assessment and Interventions
What is another name for Buerger's Disease?
Thromboangiitis Obliterans.
p.91
Peripheral Vascular Disease: Assessment and Interventions
What is rest pain in Peripheral Arterial Disease?
Numbness or burning sensation severe enough to awaken clients at night.
p.91
Peripheral Vascular Disease: Assessment and Interventions
Where is rest pain typically located in Peripheral Arterial Disease?
In the distal portion of the extremities (heel, toes).
p.91
Peripheral Vascular Disease: Assessment and Interventions
What symptoms are associated with outflow disease in Peripheral Arterial Disease?
Burning or cramping in the calves, ankles, feet, and toes.
p.109
Peripheral Vascular Disease: Assessment and Interventions
What physical finding is commonly used to diagnose Buerger’s Disease?
Peripheral ischemia leading to ulceration and gangrene.
p.102
Peripheral Vascular Disease: Assessment and Interventions
What is the purpose of Pentoxifylline (Trental) in treating Peripheral Arterial Disease?
To increase flexibility of RBCs and decrease blood viscosity.
p.105
Peripheral Vascular Disease: Assessment and Interventions
What are the preferred grafts for bypass procedures in Peripheral Arterial Disease?
Saphenous vein, cephalic or basilic arm veins, synthetic materials like polytetrafluoroethylene, Gore-Tex, and Dacron.
p.101
Peripheral Vascular Disease: Assessment and Interventions
What is one intervention to promote vasodilation in Peripheral Arterial Disease?
Provide warmth to the affected extremity.
p.112
Peripheral Vascular Disease: Assessment and Interventions
How does vessel constriction affect blood supply in Raynaud's Phenomenon?
It decreases the blood supply to the fingers.
p.106
Peripheral Vascular Disease: Assessment and Interventions
What is the purpose of a graft bypass in treating Peripheral Arterial Disease?
To restore blood flow to the affected limb.
p.104
Peripheral Vascular Disease: Assessment and Interventions
What is Laser-Assisted Angioplasty?
An invasive procedure using a laser probe to open occluded or stenosed arteries.
p.76
Management of Deep Vein Thrombosis (DVT)
Which drugs are examples of angiotensin II receptor blockers?
Candesartan, Losartan, Telmisartan.
p.102
Peripheral Vascular Disease: Assessment and Interventions
What is the main goal of drug therapy in Peripheral Arterial Disease?
To improve blood flow to the extremities.
p.105
Peripheral Vascular Disease: Assessment and Interventions
What is the purpose of arterial revascularization in Peripheral Arterial Disease?
To increase arterial blood flow in an affected limb.
p.86
Peripheral Vascular Disease: Assessment and Interventions
What is the goal of surgical management for an aneurysm?
To secure stable aortic integrity and tissue perfusion throughout the body.
p.98
Peripheral Vascular Disease: Assessment and Interventions
What valuable information does Exercise Tolerance Testing provide?
Information about claudication (muscle pain) without rest pain.
p.103
Peripheral Vascular Disease: Assessment and Interventions
What is Percutaneous Transluminal Angioplasty (PTA)?
An invasive procedure where arteries are dilated with a balloon catheter.
p.106
Peripheral Vascular Disease: Assessment and Interventions
What does a graft bypass do in Peripheral Arterial Disease?
It reroutes blood flow around a blocked artery.
p.105
Peripheral Vascular Disease: Assessment and Interventions
What synthetic materials are used for grafts in bypass procedures for Peripheral Arterial Disease?
Polytetrafluoroethylene, Gore-Tex, and Dacron.
p.102
Peripheral Vascular Disease: Assessment and Interventions
What is the role of antiplatelet agents like ASA in Peripheral Arterial Disease?
To prevent platelet aggregation.
p.98
Peripheral Vascular Disease: Assessment and Interventions
What is Exercise Tolerance Testing used for in Peripheral Arterial Disease?
To assess claudication (muscle pain) without rest pain.
p.112
Peripheral Vascular Disease: Assessment and Interventions
What is Raynaud's Phenomenon?
A condition where constriction of vessels decreases blood supply to fingers, causing them to turn pale.
p.112
Peripheral Vascular Disease: Assessment and Interventions
What causes the fingers to turn pale in Raynaud's Phenomenon?
Decreased blood supply due to constriction of vessels.
p.103
Peripheral Vascular Disease: Assessment and Interventions
Where is the cannula inserted in PTA?
Into or above an occluded or stenosed artery.
p.114
Blood Clotting Mechanisms and Disorders
What are the components of Virchow's triad?
Endothelial injury, venous stasis, and hypercoagulability.
p.91
Peripheral Vascular Disease: Assessment and Interventions
What discomfort is associated with inflow disease in Peripheral Arterial Disease?
Discomfort in the lower back, buttocks, or thighs.
p.103
Peripheral Vascular Disease: Assessment and Interventions
What may be used along with PTA to help keep the vessel open?
Stents (wirelike devices).
p.116
Management of Deep Vein Thrombosis (DVT)
What risk is increased by Deep Vein Thrombosis (DVT)?
Risk for pulmonary embolism.
p.109
Peripheral Vascular Disease: Assessment and Interventions
What is the first clinical manifestation of Buerger’s Disease?
Claudication of the arch of the foot.
p.106
Peripheral Vascular Disease: Assessment and Interventions
Why is a graft bypass necessary in Peripheral Arterial Disease?
To bypass the blocked artery and improve circulation.
p.109
Peripheral Vascular Disease: Assessment and Interventions
What is a key intervention for managing Buerger’s Disease?
Complete abstinence from tobacco in all forms.
p.113
Peripheral Vascular Disease: Assessment and Interventions
What are some side effects of drug therapy for Raynaud's Disease?
Facial flushing, headaches, hypotension, and dizziness.
p.99
Peripheral Vascular Disease: Assessment and Interventions
How does exercise help in Peripheral Arterial Disease?
Improves arterial blood flow through buildup of collateral circulation.
p.121
Management of Deep Vein Thrombosis (DVT)
What is the focus of treatment for Deep Vein Thrombosis (DVT)?
Prevent complications like pulmonary emboli, prevent further thrombus formation, and prevent an increase in thrombus size.
p.111
Peripheral Vascular Disease: Assessment and Interventions
What symptoms may be present in Raynaud's Phenomenon besides blanching and cyanosis?
Numbness, coldness, pain, swelling, ulcers.
p.109
Peripheral Vascular Disease: Assessment and Interventions
What is the treatment for Buerger’s Disease similar to?
Treatment for Peripheral Artery Disease (PAD).
p.114
Blood Clotting Mechanisms and Disorders
What is phlebothrombosis?
A thrombus without inflammation.
p.99
Peripheral Vascular Disease: Assessment and Interventions
Who should not participate in exercise for Peripheral Arterial Disease?
People with severe rest pain, venous ulcers, or gangrene.
p.103
Peripheral Vascular Disease: Assessment and Interventions
How are arteries dilated in PTA?
With a balloon catheter advanced through a cannula.
p.106
Peripheral Vascular Disease: Assessment and Interventions
Where is the graft placed in a graft bypass procedure?
Around the blocked artery.
p.109
Peripheral Vascular Disease: Assessment and Interventions
Why should patients with Buerger’s Disease avoid extreme cold?
To prevent vasoconstriction.
p.114
Blood Clotting Mechanisms and Disorders
What is an embolus?
A blood clot, air, or fat that has moved from its place of origin and can obstruct circulation in a blood vessel.
p.113
Peripheral Vascular Disease: Assessment and Interventions
What is the primary goal of treatment for Raynaud's Disease?
Relieving or preventing vasoconstriction.
p.118
Management of Deep Vein Thrombosis (DVT)
What are the classic signs and symptoms of Deep Vein Thrombosis (DVT)?
Calf or groin tenderness and pain, sudden onset of unilateral swelling of the leg.
p.123
Management of Deep Vein Thrombosis (DVT)
How does Warfarin work in the body?
It inhibits the synthesis of four vitamin K-dependent clotting factors in the liver.
p.116
Management of Deep Vein Thrombosis (DVT)
What does Deep Vein Thrombophlebitis/Thrombosis (DVT) affect?
The deep vein of the lower extremities.
p.114
Blood Clotting Mechanisms and Disorders
What is thrombophlebitis?
A thrombus associated with inflammation.
p.127
Peripheral Vascular Disease: Assessment and Interventions
What is a familial tendency in the context of varicose veins?
A genetic predisposition to developing varicose veins.
p.118
Management of Deep Vein Thrombosis (DVT)
Why is checking Homan’s sign not advised for DVT?
Only 10% of clients appear to be positive from this test.
p.117
Management of Deep Vein Thrombosis (DVT)
What conditions increase the risk of DVT during pregnancy?
Pregnancy itself increases the risk of DVT.
p.130
Peripheral Vascular Disease: Assessment and Interventions
What other diagnostic methods are used for varicose veins?
Ultrasonography and venography.
p.114
Blood Clotting Mechanisms and Disorders
What is a thrombus?
A blood clot usually as a result of endothelial injury, venous stasis, or hypercoagulability.
p.123
Management of Deep Vein Thrombosis (DVT)
What is the mechanism of action of Warfarin in DVT management?
Inhibits synthesis of vitamin K-dependent clotting factors.
p.127
Peripheral Vascular Disease: Assessment and Interventions
How can prolonged standing contribute to varicose veins?
It can cause venous congestion or pooling.
p.113
Peripheral Vascular Disease: Assessment and Interventions
What additional measures are important in managing Raynaud's Disease?
Health teaching and education.
p.121
Management of Deep Vein Thrombosis (DVT)
What should you avoid doing to the affected extremity in DVT?
Do not massage the affected extremity.
p.130
Peripheral Vascular Disease: Assessment and Interventions
What is the Brodie-Trendelenburg test used for?
Diagnosing varicose veins.
p.125
Management of Deep Vein Thrombosis (DVT)
What signs and symptoms should clients with DVT watch out for?
Signs and symptoms of bleeding.
p.128
Peripheral Vascular Disease: Assessment and Interventions
How do varicose veins appear under the skin?
Distended and tortuous, seen as dark blue or purple, snakelike elevations.
p.126
Peripheral Vascular Disease: Assessment and Interventions
What are esophageal varices?
Varicose veins in the esophagus.
p.124
Management of Deep Vein Thrombosis (DVT)
What is the main function of thrombolytic therapy in DVT management?
Dissolving clots or preventing new clots.
p.134
Peripheral Vascular Disease: Assessment and Interventions
What should the nurse remind the client to do in the immediate postoperative period for varicose veins?
Alternately contract and relax the lower leg muscles.
p.99
Peripheral Vascular Disease: Assessment and Interventions
Why is exercise individualized for each client with Peripheral Arterial Disease?
To accommodate their specific condition and limitations.
p.122
Management of Deep Vein Thrombosis (DVT)
What is the purpose of Unfractionated Heparin Therapy in DVT management?
To prevent formation of other clots and prevent enlargement of the existing clot.
p.125
Management of Deep Vein Thrombosis (DVT)
Why should clients with DVT avoid contact sports?
To prevent traumatic situations while on warfarin or heparin.
p.130
Peripheral Vascular Disease: Assessment and Interventions
How is the Brodie-Trendelenburg test performed?
Client lies flat, elevates the leg, tourniquet is applied to the upper thigh, and the client stands.
p.125
Management of Deep Vein Thrombosis (DVT)
What should individuals with DVT avoid to reduce the risk of recurrence?
Smoking and oral contraceptives.
p.131
Peripheral Vascular Disease: Assessment and Interventions
What type of clothing is recommended for managing mild varicose veins?
Elastic support stockings.
p.132
Peripheral Vascular Disease: Assessment and Interventions
What happens during vein stripping?
Ligated veins are severed and removed.
p.118
Management of Deep Vein Thrombosis (DVT)
What imaging techniques are used to diagnose DVT?
Duplex ultrasonography, Doppler flow studies, impedance plethysmography, MRI.
p.127
Peripheral Vascular Disease: Assessment and Interventions
What are incompetent valves and when do they typically occur?
Valves that do not function properly, often occurring in early adulthood.
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Peripheral Vascular Disease: Assessment and Interventions
What indicates incompetent valves in the Brodie-Trendelenburg test?
Blood flows from the upper part of the leg into the superficial veins.
p.117
Management of Deep Vein Thrombosis (DVT)
What types of trauma are associated with a higher risk of DVT?
Trauma in general increases the risk of DVT.
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Peripheral Vascular Disease: Assessment and Interventions
What are common symptoms of varicose veins?
Legs feel heavy and tired, particularly after prolonged standing.
p.117
Management of Deep Vein Thrombosis (DVT)
Who are at high risk of developing DVT?
Clients who have undergone hip surgery, total knee replacement, or open prostate surgery.
p.126
Peripheral Vascular Disease: Assessment and Interventions
What are hemorrhoids?
Varicose veins in the rectum.
p.122
Management of Deep Vein Thrombosis (DVT)
When should Unfractionated Heparin Therapy be discontinued?
If there is severe heparin-induced thrombocytopenia and thrombosis.
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Management of Deep Vein Thrombosis (DVT)
Why might Unfractionated Heparin Therapy cause thrombocytopenia and thrombosis?
Due to platelet aggregation.
p.117
Management of Deep Vein Thrombosis (DVT)
Which type of cancer is linked to an increased risk of DVT?
Adenocarcinoma of the visceral organs.
p.117
Management of Deep Vein Thrombosis (DVT)
How does heart failure contribute to DVT risk?
Heart failure increases the risk of clot formation.
p.117
Management of Deep Vein Thrombosis (DVT)
What autoimmune disease is associated with an increased risk of DVT?
Systemic Lupus Erythematosus (SLE).
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Peripheral Vascular Disease: Assessment and Interventions
What should be assessed in patients with varicose veins?
Skin, distal circulation, peripheral edema.
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Peripheral Vascular Disease: Assessment and Interventions
How should the nurse position the bed in the immediate postoperative period for varicose vein patients?
Elevate the foot of the bed.
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Peripheral Vascular Disease: Assessment and Interventions
What does the nurse monitor postoperatively in patients with varicose veins?
Swelling in the operative leg(s) and its effect on circulation.
p.117
Management of Deep Vein Thrombosis (DVT)
What role does immobility play in DVT?
Immobility increases the risk of clot formation.
p.126
Peripheral Vascular Disease: Assessment and Interventions
Why are saphenous leg veins commonly affected by varicose veins?
They lack support from surrounding muscles.
p.117
Management of Deep Vein Thrombosis (DVT)
How do oral contraceptives affect DVT risk?
They increase the risk of clot formation.
p.124
Management of Deep Vein Thrombosis (DVT)
What are some examples of thrombolytic agents used in DVT management?
Recombinant tissue plasminogen activator, Alteplase, Reteplase.
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Peripheral Vascular Disease: Assessment and Interventions
What should be avoided to help manage mild varicose veins?
Prolonged sitting and standing.
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Peripheral Vascular Disease: Assessment and Interventions
Where else can varicose veins occur besides the legs?
Rectum (Hemorrhoids) and Esophagus (Esophageal varices).
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Peripheral Vascular Disease: Assessment and Interventions
What is vein ligation?
Veins are tied off above and below the area of incompetent valves, but the dysfunctional vein remains.
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Peripheral Vascular Disease: Assessment and Interventions
How can a nurse facilitate blood flow postoperatively in varicose vein patients?
By removing and rewrapping the roller bandage.
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Peripheral Vascular Disease: Assessment and Interventions
What should the nurse inspect the dressing for in varicose vein patients?
Signs of active bleeding.
