prolonged elevation of systolic and diastolic blood pressure.

What is HYPERTENSION and Risk factors- race (African-American), aging, obesity, stress,
what are the risk factors?
elevated cholesterol levels, sodium intake, tobacco, oral
contraceptives.
What are the signs &
symptoms of
HYPERTENSION?

usually none, asymptomatic. Hypertension strains the heart

and lungs and may result in left ventricular hypertrophy,
failure, CHF or pulmonary edema

What are dx for

HYPERTENSION?

is made by serial blood pressure readings with a systolic

greater than 140 and a diastolic greater than 90. Take two or
more blood pressure readings rather than relying on one
single abnormal reading

What drugs are used to treat

HYPERTENSION

diuretics, antihypertensives , Vasodilators, Calcium blockers

Beta-adrengergic blockers and ACE inhibitors

Provide two examples of

diuretics meds

Lasix, diazide

Provide two examples of

antihypertensive meds

Aldomet, Minipress

Provide one example of a

Vasodilator

Nipride

Provide two examples of

Calcium blockers

Procardia, Cardizem

What is PERIPHERAL
VASCULAR DISEASE?

chronic inadequate blood flow in the lower extremities

What are signs and symptoms

moderate edema, burning, itching, prominent superficial
of PERIPHERAL VASCULAR
veins, ulcers and skin changes
DISEASE
Explain the treament of
PERIPHERAL VASCULAR
DISEASE

aimed at vasodilation, pain relief, and maintaining skin

integrity. Do NOT use a heating pad to keep extremities warm

What are complications of

PERIPHERAL VASCULAR
DISEASE

Complications include gangrene, and pressure sores

What should be encouraged

and avoided as it relates to
PERIPHERAL VASCULAR
DISEASE? What instructions
should be given?

Encourage walking and other leg exercise, watch for signs of

decreased peripheral circulation. Avoid temperature
extremes, prolonged standing, constrictive clothing or
crossing the legs at the knee when seated. Provide instruction
about foot care and exercise programs

What type of drugs are used to antiplatelet vasodilators anticoagulants Lipid reducers

treat PERIPHERAL
VASCULAR DISEASE
Questran is an example of
what type of medication

Lipid reducer

Trenta is what type of

medication

vasodilators

Mevacor is an example of what

Lipid reducer
type of medication
Buergers Disease

vascular disease linked to cigarette smoking and jewish

ancestry between the ages of 20-40

What is the most common

Intermittent claudication of the instep
symptom of buerger's disease
What is Raynauds disease?

episodic vasospasms precipitated by stress and exposure to

cold. Common in women between puberty and age 40.
Affects both hands and sometimes both feet

What are signs and symptoms tingling and numbness, blanching that is relieved with
of Raynauds disease
warming
What is GANGRENE

lack of oxygen supply that leads to thrombosis and tissue

necrosis and localized edema.

severe localized pain, discoloration and swelling that usually

What are signs and symptoms occurs within 72 hours of surgery or trauma. Tachycardia,
of GANGRENE
tachypnea and hypotension related to toxemia and
hypovolemia.
What is another name for
ARTERIOSCLEROTIC HEART CORONARY ARTERY DISEASE
DISEASE
What is CORONARY ARTERY common disorder caused by a buildup of fatty, fibrous plaques
DISEASE?
that narrow the coronary artery lumen.

What are non-modifiable risk

factors for CORONARY
ARTERY DISEASE

Non-modifiable risk factors include age (over 50), gender

(male) with increased incidence of disease in postmenopausal
women (loss of the protective effects of estrogen) and family
history

CORONARY ARTERY
DISEASE

Other risk factors include stress, sedentary life-style,

hypertension, obesity, cigarette smoking, diabetes mellitus,
increased cholesterol, alcohol intake

What are treatments for

- reduce lipid levels , reduce hypertension, modify diet to limit

CORONARY ARTERY
DISEASE

meat, dairy and high-fat foods, and quit smoking. Limit alcohol
intake to 2 ounces

clofibrate is an example of type

Lipid lowering agents
of medication
cholestyramine is an example
Lipid lowering agents
of type of medication
Questranis an example of type
Lipid lowering agents
of medication
What are complications of
CORONARY ARTERY
DISEASE

angina, MI, CHF, and

What is ANGINA?

dull squeezing or crushing pressure resulting from decreased

blood flow to the heart. May radiate to the arms, usually lasts
3-5 minutes

sweating, pallor, nausea, vomiting, cool extremities and

What are signs and symptoms
fainting. Associated with physical exertion, emotional
of ANGINA
excitement and exposure to cold.
What are dx for ANGINA

EKG: ST depression, T wave inversion during acute pain

What are tx for ANGINA

include beta-adrenergic blockers ( propranolol, Lopressor),

and calcium channel blocers (Verapamil, Cardizem,
Procardia). The aim is to decrease oxygen demand or
increase myocardial oxygen supply.

What should be noted about

the storage of nitroglycerine?

store in dark, glass, securely capped vial, kept fresh enough

that it tingles when you place it under your tongue

When nitroglycerine is given in

paste form what should be
When using paste do not rub it in and rotate sites
noted?
include keeping nitro available at all times, use at the first sign
What patient teachings should
of pain and stop and rest until pain subsides. Seek medical
be given as it relates to
attention if pain lasts more than 20 minutes. Instruct the
nitrolycerine?
patient about risk factors for MI
are exposure to cold, emotional upset or excitement, exertion,
Which activities commonly lead
smoking, heavy meals, and rushing about as well as
to aginal pain?
decongestants, diet pills, caffeine and nicotine.
Prevention is the best treatment and includes reducing risk
Explain prevention as it relates
factors, reducing calories, fats, salt and getting regular
to anginal pain?
exercise.

What are complications of

angina?

Complications include arrhythmias, CHF, and MI.

What is ABDOMINAL AORTIC

widening of the aorta. There are three types type
ANEURYSM
What are the three types of
abdominal aortic aneurysm?
Ascending (most common and deadly), Descending or
Which one is the most common Transverse
and deadly?
What are signs and symptoms severe ripping, boring pain of the shoulder, neck, lower back
of ABDOMINAL AORTIC
or abdomen. Bradycardia, pericardial friction rub, pulse
ANEURYSM
intensity disparit
What is the dx test for
ABDOMINAL AORTIC
ANEURYSM

Dx confirmed by x-ray

Explain Life-threatening
emergency as it relates to
ABDOMINAL AORTIC
ANEURYSM

includes decreasing hypertension, myocardial contractility,

pain control and relief of respiratory distress while preparing
for surgical intervention. Abdominal aneurysm resectionsurgical removal of a portion of weakened arterial wall with an
end-to-end anastomosis to a prosthetic graft.

What is CARDIAC FAILURE ? heart cant pump enough blood to meet the bodys metabolic
Which side usually fails
needs. Left-sided heart failure caused mostly pulmonary
What are general signs of
cardiac failure?

SOB, dyspnea, and a moist cough. Also crackles, and gallop

rhythm: S3 and S4

Explain signs and symptoms of edema, swelling, dependent edema, jugular vein distention,
right-side of the heart failure
hepatomegaly and weight gain

What causes cardiac failure

atherosclerosis, conduction defects, COPD, fluid overload,

hypertension, MI, pulmonary hypertension, valvular
insufficiency or stenosis

How is heart failure dx as it

relates to the left side of the
heart

by chest x-ray that shows increased pulmonary congestion

and L ventricular hypertrophy

How is heartfailure dx for the

right side of the heart?

R sided failure shows pulmonary congestion, cardiomegaly

and pleural effusions on chest x-ray

What are the interventions for

cardiac heart failure?

low-sodium diet, fluid restriction, IABP, O2 therapy, ACE

inhibitors

What are the nursing

keeping the patient in semi-fowlers position to increase chest

interventions for cardiac

failure?

expansion and improve ventilation. Administer O2 to enhance

arterial oxygenation. Monitor patient for fluid gain. Plan
periods of relaxation for patients with cardiac failure. Restrict
fluid intake after two consecutive days of weight gain.

What is DYSRHYTHMIA ?
What are the the 4 most
common types?

- abnormal electrical conduction or automaticity changes the

heart rate and rhythm. The most common arrhythmias include
atrial fibrillation, asystole, ventricular fibrillation, and
ventricular tachycardia

What are the signs and

symptoms for atrial fibrillation

Asymptomatic, Irregular pulse

What are the signs and

symptoms of Asystole
arrhythmias

Apnea

What are the signs and

symptoms of ventricular fib
arrhythmias

Apnea

Cyanosis
No palpable blood pressure Pulselessness
Pulselessness
No Palpable blood pressure
Chest Pain
Diaphoresis

What are the signs and

symptoms of ventricular
tachycardia arrhythmia

Hypotension
Weak pulse
Dizziness
LOC Possible
Irregular atrial rhythm

What 5 EKG changes are

noted with Atrial fibrillation
arrhythmias

Rate> 400/minute
Uniform QRS complex
Indiscernible PR interval
No P waves
No rate or rhythm

What 4 EKG changes are with No P waves

Asystole arrhythmias
No QRS complex
No T waves
What 3 EKG changes are
noted with Ventricular fib
arrhythmias

Rapid/chaotic ventricular rhythm

No discernible Ps
Wide/irregular QRS complex
Ventricular rate 140-220
What EKG changes are noted No discernible Ps
with Ventricular tachy
arrhythmias
Wide/bizarre QRS complex
Starts/stops suddenly
What are the treaments for
Atrial fibrillation arrhythmias

Cardioversion
Pacemaker
Atropine, epi

What are the treaments for

Asystole arrhythmias

Resuscitation
Defibrillation

What are the treaments for

Ventricular tachy arrhythmias

Antiarrhythmics
Antiarrhythmics

What are the treaments for

Ventricular fib arrhythmias

Resuscitation
Defibrillation
Antiarrhythmics

What are Ventricular tachy

arrhythmias treatments?

Resuscitation
Cardioversion
Defib implant

What are arrhythmias

treatments?

identifying and treating life-threatening arrhythmias (duh!)

What is MI (MYOCARDIAL
INFARCTION)?

death to myocardial muscle related to lack of oxygen from

inadequate perfusion

What are the signs and

symptoms of MI
(MYOCARDIAL
INFARCTION)?

crushing substernal pain that may radiate to the jaw, back,

and arms. It last longer than anginal pain and is unrelieved by
rest or nitroglycerin. May also be asymptomatic. diaphoresis,
pallor, arrhythmias

What are are the ekg

readinging to confirm an MI
(Myocardial infration)

EKG: enlarged Q wave, elevated ST segment, T wave

inversion.

What dx are used to confirm MI

CK, LDH, AST, and positive CK-MB fraction
(Myocardial Infraction)
beta-adrenergic blockers (propranolol-Inderal, Lopressor) .
What may be used used to
Thrombolytic therapy includes the use of Streptase, and
treat MI (Myocardial Infraction)
Eminase
When would beta-adrengeric
blocker be contraindicatedfor
MI (Myocardial infraction)
treatment

contraindicated if patient also has CHF, hypotension or

bronchospasm

When would Thrombolytic

therapy be contraindicated for the patient has had recent surgery, or experienced a fall or
MI (Myocardial infraction)
head wound concurrent with the MI
treatment
What would the plan of care for discussion of the resumption of patients sexual activities
MI (Myocardial Infraction)
(based on endurance- ability to climb 2 flights of stairs without
include?
pain, sob).
What is VALVULAR HEART
DISEASE

mechanical disruption of blood flow through the heart.

What are the three types of

Three main types: stenosis-narrowing, incomplete closure of
VALVULAR HEART DISEASE the valve, and prolapse of the valve.
What does Aortic insufficiency blood flowing back into the left ventricle during diastole (rest),
result from?
creating fluid overload in the left atrium and pulmonary system
What causes Aortic
insufficiency

enocarditis, hypertension, rheumatic fever, and syphilis.

What test are commonly used Echocardiography shows L ventricular enlargement,

to dx aortic insufficency and

what would they reveal?

x-ray shows L ventricular enlargement and pulmonary vein

congestion

in blood flowing back into the L atrium during systole

What does Mitral insufficiency
(squeeze), the atrium enlarges and the ventricle dilates to
result from?
accommodate the increased volume of blood
What may cause Mitral
insufficiency result from?

include L ventricular failure, mitral valve prolapse, and

rheumatic fever

Cardiac catheterization shows mitral regurgitation and

What test are used to confirm elevated atrial and pulmonary artery wedge pressures.
Mitral insufficiency and what do
they show?
X-ray shows L atrial and ventricular enlargement.
What does Mitral stenosis do? obstructs blood flow from the L atrium to the L ventricle
What may cause Mitral
stenosis

rheumatic fever
cardiac catheterization shows diastolic pressure gradient
across the valve and elevated L atrial and pulmonary artery
wedge pressures.

What test are performed to

confirm Mitral stenosis and
what would the test show?

Echocardiography shows thickened mitral valve leaflets.

ECG shows L atrial hypertrophy and x-ray shows L atrial and
ventricular enlargement.

What is Mitral valve prolapse

etiology & the etiology

one or both valve leaflets protruding into the L atriumIt has an

unknown etiology

What is a test that confirms

Mitral valve prolapse

ECG shows prolapse of the mitral valve into the L atrium

What does Tricuspid

insufficiency result in

results in blood flowing back into the R atrium during systole

(squeeze). Blood flow to the lungs and L side of the heart is
decreased. Fluid overloads in the R side of the heart

What causes Tricuspid

insufficiency

Causes include endocarditis, rheumatic fever and trauma

Which test are used to confirm Echocardiography shows systolic prolapse of the tricuspid
Tricuspid insufficiency and
valve.
what would they show?

ECG shows R atrial or ventricular hypertrophy.

X-ray shows R atrial dilation and R ventricular enlargement.
Echocardiography shows systolic prolapse of the tricuspid
valve.

What test are performed to

confirm Tricuspid insufficiency
and what would the test show? ECG shows R atrial or ventricular hypertrophy. X-ray shows R
atrial dilation and R ventricular enlargement.
Aortic Insufficiency

Angina, Cough, Dysnpea,Fatigue, Palpitations

What are the signs and

sympotoms of Tricuspid
Angina, Dysnpea, Fatigue, Orthopnea, peripheral edema
insufficiency Mitral Insufficiency
dyspnea on exert
fatigue
What are the signs and
sympotoms of Tricuspid
insufficiency Mitral stenosis

orthopnea
palpitations
peripheral edema
weakness
Asymptomatic

What are the signs and

sympotoms of Tricuspid
insufficiency Mitral valve
prolapse

Palpitations
Chest Pain
Fatigue
Headache

What are the signs and

sympotoms of Tricuspid
insufficiency

Dysnpea, Fatigue, Peripheral edema,

What are the Tx for all valvular surgical replacement of the valves
diseases
sodium restriction in cases of heart failure
anticoagulant therapy (Coumadin) to prevent thrombus
formation around diseased

replace valves
what are the nursing
interventions for patients with
valvular diseases?

placing the patient in an upright position to relieve dyspnea,

maintain bed rest ect. to decrease oxygen demands on the
heart

What is Endocarditis?

infection of the endocardium, heart valves or cardiac

prosthesis caused by bacterial or fungal invasion. Vegetative
growths form on the heart valves, endocardial lining of the
heart chamber, or endothelium of a blood vessel

What are risk factors for

Endocarditis?

include coarctation of the aorta, marfans syndrome,

pulmonary stnosis, tetralogy of fallot and ventricular septal
defect

What are the signs and

symptoms of Endocarditis

chills, fatigue, loud, regurgitant murmur, malaise, night

sweats, weakness, weight loss.

What are test are run to

confirm Endocarditis?
What are the treaments for
Endocarditis

EKG may show atrial fibrillation.

Three or more blood cultures identify the causative organism
Antibiotics, aspirin and maintaining sufficient fluid intake
prevent anaphlaxis ( history of drug allergies before
implementing antibiotic), watch for signs of embolization

What are the nursing

interventions for Endocarditis

(hematuria, pleuritic chest pain, LUQ pain and paresis,

monitor renal status (BUN, creatinine clearance and output),
educate patient in need for prophylactic antibiotics before,
during and after any invasive procedures (dental work etc.).

What is Myocarditis

focal or diffuse inflammation of the cardiac muscle (middle

muscular layer). Can be acute or chronic and occur at any
age. Recovery is usually spontaneous, without residual
defects

What are the signs and

symptoms of Myocarditis

arrhythmias (S3 and S4 gallops, faint S1), dyspnea, fatigue,

fever.

What test are done to confirm

Myocarditis

EKG shows diffuse ST-segment and T-wave abnormalities,

Prolonged PR interval and supraventricular arrhythmias.

Biopsy confirms the diagnosis

includes bed rest,
restricted sodium diet,
antiarrhythmics (Pronestyl),
What are six treaments for
Myocarditis

antibiotics,
anticoagulants (Coumadin),
Lanoxin to increase myocardial contractility and diuretics
(lasix).

What are the nursing

interventions for Myocarditis

watching for signs of Lanoxin toxicity( anorexia, n/v, blurred,

vision) and stress the importance of bed rest to decrease
oxygen demands on the heart.

Pericarditis

inflammation of the fibroserous sac that envelops, supports

and protects the heart

Many varied causes include, bacteria, fungus, virus, radiation,

What causes Pericarditis name hypersensitivity or autoimmune disease (lupus, rheumatic
at least 5
arthritis), neoplasms, injury, trauma and uremia or none of
these at all
Friction rub (grating sound heard as the heart moves)
What are the signs and
symptoms of Pericarditis

Sharp sudden pain in the sternum that radiates to the neck,

shoulders, back and arms (increasing with deep inspiration
and decreasing when the patient sits up and leans forward).

echo confirms free space between the ventricular wall and

what test confirm and what do
pericardium. EKG- elevated ST segments without significant
they show Pericarditis
changes in the QRS.
what is the tx for Pericarditis?

bed rest and possibly surgery depending on symptoms. Drug

therapy includes antibiotics, corticosteroids, and NSAIDs

what are the nsg interventions bed rest to decrease oxygen demands on the heart, relieve
for Pericarditis?
dyspnea and chest pain by placing the patient in an upright

position, reassurance to promote patient comfort and allay

anxiety.
What is CARDIOMYOPATHY

increased muscle mass to compensate for flabby L. ventricle,

altering cardiac function and resulting in decreased cardiac
output

what are the causes of

CARDIOMYOPATHY

alcoholism, infection, metabolic and immunologic disorders,

pregnancy and postpartum disorders, hypertension,
amyloidosis and cancer or other infiltrative disease

what are the signs & symptoms -murmur (S3, S4), dyspnea, cough, crackles, jugular vein
CARDIOMYOPATHY
distention, dependent pitting edema, fatigue.
what may indicate
CARDIOMYOPATHY

echo indicates L ventricular hypertrophy and nonspecific

changes

what are the tx for

CARDIOMYOPATHY

beta-adrenergic blockers, calcium channel blockers, diuretics,

inotropic drugs (dopamine), anticoagulants

monitoring for arrhythmias and ischemia, monitor for

what are nursing interventions hypokalemia (s/e of diuretics), monitor respiratory and
for CARDIOMYOPATHY
cardiovascular status for signs of heart failure, administer O2
and meds to improve oxygenation and cardiac output.
heart fails to adequately pump reducing cardiac output and
compromising tissue perfusion.
Decreased stroke volume increases back volume in the L
ventricle.

what is CARDIOGENIC
SHOCK?

Blood from the L ventricle backs up into the lungs creating

pulmonary edema.
Compensation for decreased CO is increased heart rate and
contractility, increasing the need for O2.
An imbalance between supply of O2 and demand for O2
increase myocardial ischemia further impairing the hearts
pumping action. Causes include MI, heart failure, myocarditis,
cardiomyopathy and advanced heart block

What are signs and symptoms cold, clammy skin, hypotension with a narrow pulse pressure,
of CARDIOGENIC SHOCK
oliguria (less than 30 ml/hr), S3 and S4 heart sounds,

tachycardia, tachypnea, and weak, thready pulse

what would an ekg show for a
CARDIOGENIC SHOCK
shows enlarged Q wave, elevated ST segment (MI
patient?
Drug treatment for
CARDIOGENIC SHOCK
includes

adrenergics (epinephrine_, digoxin, dopamine, diuretics,

vasodilators (Nitro-press) and vasopressors (norepinephrine

CARDIOGENIC SHOCK

NPO status to reduce risk of aspiration, admminister meds,

fluids, oxygen to maximize cardiac, pulmonary and renal fx.
Use of IABP

Explain IABP (intra-aortic

balloon pump) as it relates to
CARDIOGENIC SHOCK

an inflatable balloon is inserted through the femoral artery into

the descending aorta. Coronary artery perfusion increases
when the aortic valve closes and the balloon inflates during
diastole (rest). It deflates during systole (squeeze) to reduce
cardiac workload by reducing resistance to ejection.

reduced blood volume causes circulatory dysfunction and

HYPOVOLEMIC SHOCK is ? inadequate tissue perfusion. Without reversal, it can lead to
cerebral and renal damage, cardiac arrest and death
include blood loss (didnt we already go over this?), acute
What causes HYPOVOLEMIC pancreatitis, dehydration from excessive perspiration,
SHOCK
intestinal obstruction, severe diarrhea, protracted vomiting,
inadequate fluid intake and diuresis
HYPOVOLEMIC SHOCK s/s
are

- cold, pale, clammy skin, decreased sensorium, hypotension

with narrowing pulse pressure, reduce urine output,
tachycardia, rapid, shallow respirations

what are used to confirm

HYPOVOLEMIC SHOCK

Blood tests (elevated K, serum lactate, BUN , urine specific

gravity (greater than 1.020), ABG reveals metabolic acidosis
(decreased pH) decreased PO2 and increased PCO2

HYPOVOLEMIC SHOCK tx
are

blood and fluid replacement, control of bleeding

spiritual/religious beliefs of Jehovahs witness to refuse blood

what are nsg interventions and transfusions. Interventions include correcting fluid volume
special considerations
deficit, monitoring for adequate urine output, provide emotional
HYPOVOLEMIC SHOCK
support to the patient and his family to help them cope and
relieve anxiety.
IRON DEFICIENCY ANEMIA diet high in iron, fiber, and protein with increased fluids. Avoid
tx is
teas and coffee which reduce absorption of iron
IRON DEFICIENCY ANEMIA pallor, sensitivity to cold, weakness and fatigue. Dx- decreased

s/s are

Hb, HCT, iron

Increase the intake of vitamin C.

IRON DEFICIENCY ANEMIA

nsg interventions are
iron injection deep into the muscle using Z-track technique to
avoid subQ irritation and discoloration from leaking drug.

PERNICIOUS ANEMIA is

chronic, progressive, macrocytic anemia caused by a

deficiency of intrinsic factor which prevents the absorption of
dietary vitamin B12. Without intrinsic factor RBCs are defective
as they mature

PERNICIOUS ANEMIA s/s are

tingling and paresthesia of hands and feet, weight loss,

anorexia, dyspepsia

PERNICIOUS ANEMIA is
confirmed by , what do these
test reveal

bone marrow aspiration shows increased megaloblasts, few

maturing erythrocytes and defective leukocyte matureation.
Peripheral blood smear reveals oval, macrocytic,
hyperchromic erythroctyes

PERNICIOUS ANEMIA tx is

diet high in iron and protein and restricting highly seasoned or

extremely hot foods. Vitamins especially B12 and B6, Vitamin
C and folic acid

congenital hematologic disease that causes impaired

circulation, chronic ill health and premature death. Exists in
African populations and people from Puerto Rico, Turkey,
Provide sn overview of SICLE
India, the Middle East and the Mediterranean. The RBc are
CELL ANEMIA excluding the
rigid and rough, forming an elongated sickle shape and
dx, tx, s/s and nsg
impairing circulation by clumping together. This happens
interventions
during periods of hypoxia which can be provoked by strenuous
exercise, high altitude, unpressurized aircraft, cold and
vasoconstrictive drugs
aching bones, jaundice, pallor, tachycardia, family history,
SICLE CELL ANEMIA s/s are frequent infections, joint swelling and leg ulcers, especially on
the ankles. Sickle cell crisis is very painful
SICLE CELL ANEMIA may be decreased RBC, elevated WBC and platelet counts,
confirmed vy
decreased ESR. Hb electrophoresis shows HbS.
SICLE CELL ANEMIA tx is

iron and folic acid supplements, prevent dehydration and

analgesics for pain

SICLE CELL ANEMIA nsg

interventions are

during crisis include warm compresses to painful areas, (cold

aggravates the condition) maintain bed rest to reduce
workload on the heart and to reduce pain, encourages fluid
intake to prevent dehydration, which can precipitate a crisis.

DISSEMINATED
INTRAVASCULAR
COAGULATION (DIC) is

)- complication of diseases and conditions that accelerate

clotting. Accelerated clotting process caused depletion of
circulating clotting factors and platelets which can provoke
severe hemorrhage

DISSEMINATED INTRAVASCULAR
COAGULATION (DIC) s/s are

abnormal bleeding without history of serious

hemorrhagic disorder, oliguria, shock, sever muscle,
back and abdominal pain

DISSEMINATED INTRAVASCULAR
COAGULATION (DIC) is confirmed by

prolonged PT greater than 15 seconds, prolonged

PTT greater than 60-80 seconds, fibrinogen levels
less than 150 mg/dl, platelets less than 100,000/ul,
and a positive D-dimer test specific for DIC

bedrest and transfusion with fresh frozen plasma,

platelets, and packed RBCs. Interventions- complete
bed rest protects the patient from injury. Apply
DISSEMINATED INTRAVASCULAR
pressure to injection sites for at least 10 minutes to
COAGULATION nsg interventions and tx
prevent hemorrhage. Weight the patient daily to
are
monitor for fluid volume excess. Measure abdominal
girth every 4 hours to detect intra-abdominal
bleeding.
HEMOPHILIA is

hereditary bleeding disorder affecting only males.

Inherited as x-linked recessive traits

HEMOPHILIA s/s are

spontaneous or severe bleeding after minor trauma

(excessive bleeding at circumcision), subcutaneous
and intramuscular hematomas, prolonged bleeding
after major trauma/surgery (up to 8 days),
hematuria, joint tenderness, pain and swelling in a
weight-bearing joint (hip, knee or ankle), tarry stools

HEMOPHILIA is confirmed by

Factor VIII assay reveals 0-25% of normal factor VIII

HEMOPHILIA tx is

administer cryoprecipitate antihemophilic fact to

encourage normal hemostasis. Analgesics to control
joint pain.

ALTERNATIVE/COMPLEMENTARY TX interventions could include vitamin E, soy products,

for ALTERATION IN COAGULATION
oat bran, relaxation therapy, guided imagery, music
THROMBOCYTOPENIC PURPURA are therapy, garlic and parsley for hypertension.
Briefly explain POLYCYTHEMIA

chronic myeloproliferative disorder characterized by

increased RBC mass, leukocytosis, thrombocytosis
and increased Hb concentration. Occurs between
the ages of 40-60 to male of Jewish ancestry.

Mortality is high if untreated

POLYCYTHEMIA s/s are

clubbing of the digits (cystic fibrosis), dizziness,

headache, hypertension, ruddy cyanosis of the
nose, thrombosis of smaller vessels, visual
disturbances (blurring, diplopia, engorged veins of
fundus and retina.)

POLYCYTHEMIA tx is

phlebotomy (350-500ml removed every other day

until the patients HCT is reduced to low-normal),
plasmapheresis. Drug tx includes chemotherapy and
myelosuppressive drugs and anitgout agents
(allopurinol).

POLYCYTHEMIA nsg interventions are

Interventions include administering juice or water to

replace fluid volume lost during procedure.

Briefly explain Positive Homans sign

The sign is positive (indicative of a problem) if, when

the examiner flexes your foot, you feel pain in the
calf. A positive Homan's sign helps diagnose deep
vein thrombosis.

Buerger-allen exercises

Exercises used to empty engorged vessels,

stimulate circulation, and at least partially relieve
swelling (oedema) in patients with arterial
insufficiency of the lower limbs and feet

What is buerger's Disease

A chronic inflammatory disease of the peripheral

vessels forming blood clots that results in reduced
blood flow, possible ulceration, and gangrene.

Exercise or walking will bring on rapid fatigue, pain,

Explain Buerger's Disease as it relates to and leg cramps. The feet or hands may turn pale or
exercise
feel cold. The pain may be increased by exposure to
cold, and painful ulcers or gangrene may develop
Shave With An Electric Razor instead of a
disposable.
When Anticoagulant therapy is given
what activties should be avoided

Use a Toothbrush With Soft Bristles

Any activities that could cause injuries

What foods are high in vitamin K?

green leafy vegetables (spinach, kale), liver