WAYS TO PREVENT VTE
- SQ HEPARIN OR LMWH
- LIFESTYLE CHANGES
- GRADUATED COMPRESSION STOCKINGS/SCD PUMPS TO PREVENT DVT
- LIFESTYLE CHANGES: HEALTHY WEIGHT, EXERCISE, HYDRATION, NO SMOKING, AVOID SITTING W/ LEGS CROSSED FOR LONG PERIODS OF TIME, WHEN TRAVELING, CHANGE POSITION FREQUENTLY
- MEDICATION COMPLIANCE
- EARLY AMBULATION AND LEG EXERCISES
- INT PNEUMATIC COMPRESSION DEVICES
- DON'T MASSAGE LEG W/ DVT
IF A PATIENT CURRENTLY HAS A DVT, SHOULD YOU APPLY ANTI-EMBOLIC STOCKINGS/SCD PUMPS TO AFFECT LEG
NO!
WHAT CAN UNSTABLE PE LEAD TO?
THE SUDDEN INCREASED IN PULMONARY RESISTANCE INCREASES THE WORK OF THE RIGHT VENTRICLE, WHICH CAUSES R SIDED HEART FAILURE W/ CARDIOGENIC SHOCK
NURSE INTERVENTIONS POST SURGICAL EMBOLECTOMY
- MEASURE I'S AND O'S
- PULMONARY ARTERIAL PRESSURE
- ASSESS INSERTION OF ARTERIAL CATH FOR HEMATOMA FORMATION AND INFECTION
- ELEVATE FOOT OF BED
- ENCOURAGE ISOMETRIC EXERCISES
- SCDs
- WALKING
CAUSES LYSIS OF BLOOD CLOTS
THROMBOLYTICS
- ALTEPLASE
- RETEPLASE
WHAT MEDICATIONS CAN YOU NOT TAKE WHILE TAKING ALTEPLASE
OTHER ANTICOAGULANTS
WHAT LABS ARE CHECKED BEFORE ADMN OF THROMBOLYTICS?
- aPTT
- INR
- CBC
- INR
NURSING ACTIONS WHILE ADMINISTERING THROMBOLYTICS
- MONITOR FOR BLEEDING
- BEDREST
- AVOID INVASIVE PROCEDURES
- APPLY MANUAL PRESSURE TO PUNCTURE SITE FOR 30 MINUTES
- NO IM INJECTIONS/LAB STICKS
- MONITOR VS AND NEURO CHECKS FREQUENTLY
PATIENT SHOULD NOT BE RECEIVING ANTICOAGULANTS IF THEY HAVE THIS?
WHAT IS IT?
IVC FILTER - ALLOWS BLOOD TO FLOW UNOBSTRUCTED W/ LARGE EMBOLI FROM PELVIS OR LE ARE BLOCKED OR FRAGMENTS
WHAT LAB DO YOU CHECK WITH PATIENTS TAKING HEPARIN AND ENOXAPARIN?
PLATELETS
WHAT IS THE ANTIDOTE FOR HEPARIN/ENOXAPARIN?
PROTAMINE SULFATE
CAN YOU ADMINISTER WARFARIN CONCURRENTLY W/ HEPARIN/ENOXAPARIN?
YES, UNTIL INR REACHES 2
REVIEW SLIDES 24-26
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