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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