NSG 210 Test 3 Study Guide with complete solutions.
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Course
NSG 210
Institution
NSG 210
clots
made up of platelets, RBC, and fibrin
-formation mediated by 30 proteins (clotting factors) - made by liver
intrinsic pathway
less protective and more reactive; internal problem
-impaired blood flow, excessive substances that promote clotting
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NSG 210 Test 3 Study Guide with
complete solutions
clots - ANSWER- made up of platelets, RBC, and fibrin
-formation mediated by 30 proteins (clotting factors) - made by liver
intrinsic pathway - ANSWER- less protective and more reactive; internal problem
-impaired blood flow, excessive substances that promote clotting
extrinsic pathway - ANSWER- outside the bloodstream
-happens with trauma
what is a nursing consideration for those at risk for bleeding? - ANSWER- 2 IVs at
least 20 G
temporary platelet seal - ANSWER- platelets are activated when injury exposes
collagen and VonWillebrand factor to the blood
-these 2 factors draw platelets to injury site --> platelets activated
-releasing prothrombotic molecules which cause platelet aggregation --> clot
grows rapidly
-activated platelets trigger the cascade and form thrombin and fibrin
tissue factor - ANSWER- exposed with injury to vessels and also triggers the
coagulation cascade
-leading to fibrin and clot formation
coagulation panel - ANSWER- -prothrombin time (PT)
-international normalized ratio (INR)
-platelets
-activated partial prothrombin time (aPTT)
-D-Dimer
-H/H
,prothrombin time (PT) - ANSWER- time it takes for blood to clot
-11 - 15 seconds
-increase for someone on anticoagulants
international normalized ration (INR) - ANSWER- ratio of clotting time
-0.8 - 1.5 is normal
-2.5 - 3.5 is the therapeutic level (someone on anticoagulants)
- >3 means blood is not clotting fast enough (stop/decrease anticoagulants)
-increase heparin to increase levels
platelets - ANSWER- come from bone marrow
-clump together at bleeding site to form a clot
-150,000 - 400,000
- <25,000 is critical - primary hemostasis
-activated by *collagen*
activated partial prothrombin time (aPTT) - ANSWER- time it takes for blood to
clot
-20 - 40 seconds
-increase for someone on anticoagulants
-used to monitor effect of heparin
D-Dimer - ANSWER- <0.5
-high level means could be a clot
-pregnancy can cause increased levels
Hgb - ANSWER- 12-15
Hct - ANSWER- 35-45
clotting cascade - ANSWER- I - fibrin
II - thrombin
III - tissue factor: comes from injured endothelial cells
clotting assessment - ANSWER- -age and sex
-description of bleeding episode (epistaxis, menorrhagia, or hematomas)
-nutritional info, alcohol use, liver/kidney disease, recent illness or infection
-family history: hemophilias, von Willebrand disease
what drugs cause coagulation inhibition? - ANSWER- lovenox, heparin, Eliquis
, what drugs cause collagen degradation? - ANSWER- corticosteroids
what drugs cause platelet function inhibition? - ANSWER- aspirin, Plavix, fish oil,
SSRIs
what drugs cause thrombocytopenia? - ANSWER- alcohol, antibiotics, Tegretol
deep vein thrombophlebitis signs and symptoms - ANSWER- -cramping calf pain
(may be painless)
-edema
-tenderness to the touch
superficial vein thrombophlebitis signs and symptoms - ANSWER- -redness
along the vein
-warmth and tenderness along the vein
DVT at risk - ANSWER- -sedentary
-obese
-post-op
-smoking
-pregnancy
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