The Blood Line
This component makes up the largest part of blood and is responsible for transporting nutrients, hormones, and waste products.
What is plasma?
A patient on warfarin should have this lab value monitored regularly to ensure therapeutic levels.
What is INR?
This GI condition presents with hematemesis or melena and is a common cause of upper gastrointestinal bleeding. Prophylaxis often includes the use of H2 blockers and proton pump inhibitors (PPIs) to reduce gastric acid and prevent bleeding.
What is a peptic ulcer?
A clot that forms in a deep vein, often in the leg, is known as this.
What is a deep vein thrombosis (DVT)?
This inherited blood disorder leads to chronic hemolytic anemia due to abnormally shaped red blood cells.
What is sickle cell disease?
A person with a hemoglobin level of 6.5 g/dL may need this intervention.
What is a red blood cell transfusion?
You’re educating a patient on antiplatelet therapy. This is side effect they should report immediately.
What is unusual bleeding or bruising?
Uterine atony is the most common cause of this leading contributor to maternal morbidity and mortality in the US and worldwide.
What is postpartum hemorrhage?
This condition results from blocked coronary arteries, leading to chest pain and potential heart damage.
What is a myocardial infarction (MI)?
Hydration is critical in managing sickle cell disease because it helps prevent this type of painful event.
What is a vaso-occlusive crisis?
This lab value, when elevated, suggests possible clot formation and breakdown in the body.
What is D-dimer?
This medication is used as an antidote to reverse the effects of heparin overdose.
What is protamine sulfate?
This common over-the-counter medication can increase bleeding risk by inhibiting platelet aggregation.
What is aspirin?
Identify at least three modifiable risk factors for developing venous thromboembolism (VTE).
What are immobility, smoking, obesity, prolonged travel or bed rest (immobility), hormone replacement therapy, oral contraceptive use, dehydration
3 Key aspects of a plan of care for a person with sickle cell crisis
What are adequate hydration, pain management, & oxygen therapy?
A patient has a platelet count of 45,000/µL. Identify 3 precautions the nurse should implement to reduce the risk of bleeding.
-Promote a safe environment to avoid injury (e.g. implement fall precautions; wear non-slip footwear; keep pathways clear; manage wires and cords)
-Be aware of prolonged times to achieve hemostasis.
-Notify Practitioner if unable to achieve hemostasis
-Avoid IM injections & Venipuncture
-Delay invasive procedures as able
-Monitor stool and urine for occult (i.e. hidden / unseen) blood if concerned for bleeding
-Avoid rectal trauma: Do not use enema. Exercise caution with suppositories
-Use an electric razor instead of a razor
-Use a soft bristle toothbrush.
-Do not use water-pressure gum cleaners (e.g. Water Pick).
-A platelet transfusion may be necessary - particularly for critically low levels and/or active bleeding.
Explain why a patient might be prescribed both heparin and warfarin simultaneously.
What is a heparin bridge to maintain anticoagulation until warfarin reaches therapeutic levels?
Identify four assessment findings that may indicate a client is experiencing abnormal bleeding.
petechiae, ecchymosis, prolonged bleeding from minor cuts, and hypotension, tachycardia, fatigue, dizziness, pallor, hematoma formation, hematuria, melena, and bleeding gums, frequent epistaxis
Recognize at least 2 of these priority reperfusion interventions for a client experiencing critical limb ischemia.
What are thrombolytic therapy, angioplasty, or surgical revascularization?
Explain why patients with sickle cell disease are at increased risk for stroke
What is due to the sickled cells causing blockages in cerebral blood vessels, leading to ischemia?
Compare and contrast the manifestations of arterial vs. venous clotting.
What are cool, pale, pulseless extremities for arterial clots, and warm, swollen, tender extremities for venous clots?
Differentiate between anticoagulants, thrombolytics, and antiplatelet agents.
What are anticoagulants to prevent clot formation, thrombolytics to dissolve existing clots, and antiplatelets to prevent platelets from aggregating?
This life-threatening condition occurs when the body's clotting mechanisms are overactivated, leading to widespread clot formation and subsequent bleeding due to depletion of clotting factors.
What is disseminated intravascular coagulation (DIC)?
Name all six P's of assessing for acute limb ischemia in a client with peripheral artery occlusion.
What are Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia (coolness or coldness)?
Name the lab test used to diagnose sickle cell disease.
What is hemoglobin electrophoresis?