University:
York University
Course:
NURSING 2534 | Pathophysiology
Academic year:

2023
Views:

247

Pages:

2
Author:

Niklas

Drug Therapy Anticoagulation Therapy Warfarin (Coumadin) PO - Vitamin K antagonist Long term Monitor INR Range: 2-3 Therapeutic: 2-3 Takes 3 days to start working Antidote: Vitamin K Heparin SQ/IV Works immediately Monitor aPTT Normal: 25-40 Therapeutic: 2x normal Antidote: protamine sulfate Low molecular: given SQ abdomen Used for prevention of DVT Platelet Aggregation Inhibitors Effects reversed by PPIs (Proton Pump Inhibitors) Aspirin Thrombolytic/Fibrinolysis Lyse clots Signs of Bleeding Petechiae Ecchymosis Epistaxis Dark, tarry stools Coffee ground emesis Acute Decompensated HF Drug Therapy Loop Diuretics Furosemide Volume overload (preload) Vasodilators Nitro Morphine Preload + coronary artery perfusion Chronic Heart Failure Diuretics Monitor I/O, electrolytes Check apical pulse Toxicity: vision issues Positive inotropes Digoxin ACE inhibitors (ACEI) "pril" Cough VASCULAR DISORDERS Conceptual Focus: Clotting Perfusion Tissue integrity Management: Modify risk factors: stress, caffeine, nicotine Promote tissue repair Exercise: 30-60 minutes daily, ≥3x/week Peripheral Arterial Disease (PAD) Thickening of the artery walls (atherosclerosis) → progressive narrowing & degeneration of arteries → intermittent claudication & tissue necrosis Risk Factors: Tobacco Atherosclerosis Diabetes (Age > 47) Hypertension Cholesterol Manifestations: Diminished/latent pulses Intermittent claudication: leg pain, cramps caused by a constant level of walking → lactic acid build-up Clinical Manifestations: Lack of arterial blood flow (ischemia) Paresthesia (numbness & tingling) Dependent rubor, elevation pallor Skin shiny & taut Ulceration Evaluation: ABI: lower extremity Ankle-brachial index GPS: paresthesia, paralysis, pain, poikilothermia (coldness) Critical Limb Ischemia Arterial leg ulcers → gangrene Management: need to restore blood flow Arterial Bypass Graft Artery Bypass Graft: Femoro-popliteal: removes atherosclerotic plaque, restores perfusion Complications: No healing arterial ulcers → gangrene Amputation