Study

NSG223 Mod 4

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  • What is the antidote to warfarin?
    Vit K
  • List 3 risk factors for PE.
    Recent surgery, pregnancy, HF, over 50yo, hypercoagulable state, prolonged immobility, OCPs, smoking
  • You are going to be giving a patient midazolam. Which reversal agent do you need available?
    Flumazenil
  • How does warfarin work?
    Acts in liver to prevent synthesis of vit-K dependent clotting factors. Similar to vit-K in structure, it acts as a competitive antagonist to hepatic use of K
  • What does an IVC filter do?
    Provides a screen in the IVC- allows blood through while blocking or fragmenting emboli from pelvis or lower extremities
  • Garlic can increase the effects of heparin. True or False?
    True (garlic supplement or excessive garlic intake)
  • How long should a patient expect to be on anticoagulation therapy after a PE?
    10 days-3 months; Forever if high risk
  • Why would a patient start both enoxaparin and warfarin at the same time?
    enoxaparin acts right away. warfarin takes time to become therapeutic. Enoxaparin bridges until warfarin is therapeutic
  • What is V/Q mismatch?
    happens when part of your lung receives oxygen without blood flow or blood flow without oxygen.
  • What is the specific test to diagnose PE?
    CT angiogram- Multidetector-row computed tomography angiography (MDCTA)
  • What is a normal PTT? Therapeutic PTT?
    25-35 seconds; 45-70 seconds (2-2.5 times normal)
  • What is the "classic" sign of pulmonary edema?
    Frothy pink sputum
  • Positioning is important for the patient with ARDS. Oxygenation is sometimes improved in patients with ARDS when in which position?
    Prone
  • Vecuronium may be used to facilitate easy tracheal intubation and mechanical ventilation by relaxing the vocal cords, jaw, and associated respiratory muscles. True or False
    True
  • Dabigatran is safe to use in older adults. True or False
    Both... alert: Beer Criteria: potentially inappropriate; Check Creatinine clearance. No dose adjustment if renal function ok.
  • Heparin is safe to use during pregnancy. True or False?
    True- does not cross placental barrier and not secreted in breast milk
  • What is the "train of four" test?
    4 consecutive stimuli delivered along path of a nerve and response of muscle is measured. 4 equal muscle contractions = no neuromuscular blockade. absence=block
  • Rivaroxaban is safe to use for those with renal disease. True or False
    False- avoid if creatinine clearance of less than 15mL/min
  • Idarucizumab is the antidote for ______.
    Dabigatran (Pradaxa)
  • Your patient is diagnosed with a PE and a urinary catheter is ordered. Why?
    Need to monitor I&O very closely. PE can lead to shock, etc.
  • When the left ventricle begins to fail, blood backs up into the pulmonary circulation, causing pulmonary ______.
    edema
  • What is a VTE?
    Venous Thromboembolism; DVT, PE