Medical-Surgical Nursing, 9th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid
Peripheral Artery Disease (PAD)
- Atherosclerosis
- Intermittent Claudication
- Pain with Exercise
- Paresthesias
- Arterial Ulcers
- Critical Limb Ischemia
- Amputation
- Ankle-Brachial Index (ABI)
Arterial Ulcer Assessment
- Absent or Decreased Pulses
- Intermittent Claudication
- Sharp Pain
- Dependent Rubor
- Well Defined Edges
- Over Bony Areas
- Smooth, Shiny Skin
- Toes, Heels, Lateral Lower Legs
- Cool
Arterial Ulcer Interventions
- Saline Dressing
- Structured Exercise Programs
- Fibrinolytics
- Antiplatelet Medication
- No Caffeine, Nicotine
- Surgery
Venous Thromboembolism (DVT) Assessment
- Venous Wall Inflammation caused by Thrombus
- Tenderness
- Edema
- Warmth
- Asymmetry
- Could be Asymptomatic
- Monitor for Pulmonary Embolism
Venous Thromboembolism (DVT) Interventions
- Anticoagulants
- Prevention Education
- Frequent Ambulation
- Leg Exercises
- Compression Stockings or SCD's
- Avoid Nicotine and Oral Contraceptives
- Surgery
Warfarin Antidotes
- Vitamin K
- Fresh Frozen Plasma
Heparin (Unfractionated)
- Suppresses Coagulation
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Protamine Sulfate
Heparin Induced Thrombocytopenia (HIT)
- 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
- Thrombocytopenia
- Serotonin Release Assay (SRA)
- Stop Heparin, Start Direct Thrombin Inhibitor
Enoxaparin (Lovenox)
- Inhibits Clotting Factors
- Factor Xa
- Clot Formation Prevention
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Protamine Sulfate
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
Bleeding Precautions
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
Varicose Veins Assessment
- Increased Venous Pressure
- Incompetent Valves
- Telangiectasias
- Small Reticular Veins
- Dilated and Tortuous Veins
Varicose Veins Interventions
- Laser Therapy
- Sclerotherapy
- Removal of Saphenous Vein
- Avoid Prolonged Standing
- Elastic Compression Stockings
Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment
- Venous Stasis Ulcer
- Uneven Edges
- Dull Persistent Pain
- Medial Malleolus
- Necrotic
- Normal Pulses
- Lower Leg Edema
- Bronze-Brown Pigmentation
- Warm
- Pruritus
Chronic Venous Insufficiency (Venous Stasis Ulcer) Interventions
- Frequently Elevate Legs
- Avoid Standing/Sitting for Long Periods of Time
- Elastic Compression Stockings
- Bilayer Artificial Skin
- Daflon
- Wound Dressings
- Proper Foot and Leg Care