exam 3 adult health

dvt diagnostic tests

ultrasound
MRI
venography
D dimer > 0.5 mg/L

DVT interventions

administer anticoagulants to prevent new clots

SCD

positioning

analgesics

direct oral anticoagulants examples

Factor X (xaban)
thrombin inhibitors (pradaxa)

vitamin k antagonist (warfarin)

LMWH antidote, dose, and route

protamine sulfate

SQ 40 mg

varicose vein diagnosis

doppler flow study

venography

plethysmography

varicose vein treatment

sclerotherapy chemical injection

laser ablation

surgery (vein ligation)

venous ulcers location, surrounding tissue, wet/dry, edges

lower calf or ankle

edematous, brown

wet

irregular edges

venous ulcer intervention

elevate

moist dressing

compression

intermittent claudication

ischemic pain from exercise, resolves with rest

peripheral arterial disease

PAD assessment

6 Ps

pulse, temp, cap refill, pins/needles, pain, pallor

chronic PAD assessment signs

no edema

thin, shiny skin no hair

thick brittle toenails

numbness paresthesia itch

dependent rubor (pale when elevated)

ankle brachial index

SBP ankle/SBP arm when supine

chronic PAD diagnostics

labs (cholesterol, glucose)

ABI

doppler flow

angiography

chronic PAD interventions

statins for cholesterol

antiplatelets

anticoagulants

vasodilators

BP control

exercise

smoking cessation

chronic PAD surgery interventions

angioplasty

stents

endarectomy

arterial bypass

acute arterial occlusion (critical limb ischemia) assessment, interventions

6 Ps

meds: thrombolytics, anticoagulants

surgery: remove obstruction via angioplasty, stent, bypass

other: keep warm, protect skin, keep extremity flat or slight dependent

arterial ulcers location, appearance, treatment

bony prominences on feet and toes

deep, even adges, round

pale bed

little granulation tissue, possibly gangrene

arterial ulcers interventions

relieve pressure, hyperbaric O2, diet

clean, dry dressings

surgery

aneurysm meaning

bulging or ballooning of vessels (arteries)

often cerebral, aortic, popliteal, peripheral

AAA

ascending aortic aneurysm

angina

cough, SOB, hoarse

decreased venous return

may mimc abdominal disorders

pulsatile mass left of midline in umbilical area

diagnostics for aneurysms

X ray

echocardiogram

CT

MRI

ultrasound

size threshold for monitoring vs surgery on aneurysm

<5.5 cm is monitoring

>5.5 cm is surgical

Raynaud’s manifestations

episodic

worse with cold or stress

vasospasm (blanching, cyanosis, hyperemia)

Raynaud treatments

calcium channel blockers

sympathectomy

Buerger’s disease assessment

distal extremities

same as PAD

color temp change

cold sensitivity

inflammation

possibly amputation

ventilation versus oxygenation

ventilation is movement of air in and out

gas exchange is diffusion across the alveoli

PaO2 vs SpO2

PaO2 is free O2 dissolved in plasma, not blood

SpO2 is heme sites occupied by O2 (saturation)

infectious gas exchange problems

acute bronchitis

pertussis

pneumonia

tuberculosis

restrictive issues

ARDS

atelectasis

pulmonary fibrosis

obstructive ventilation issues

COPD

emphysema

chronic bronchitis

asthma

hypoxemia vs hypoxia

hypoxemia is insufficient levels in blood

hypoxia is insufficient in body tissues

S/S of impaired respiratory function

increased HR, BP, RR

lower UO

interventions for low respiratory function

1. optimize ventilation (HOB, tripod, stop exertion)

2. oxygenate (stay w pt.)

3. notify provider

diagnostics for respiratory impairment

CBC

ABG

chest X ray

sputum culture

endoscopic bronchoscopy

biopsy

thoracentesis