AHN 447 Exam 3 with Verified Solutions
What is used to determine risk for a DVT? Correct Ans-Padua prediction scale; 4 or more
points indicated high risk
What diagnostic procedure is used fro a DVT? Correct Ans-venous ultrasound
What is the medical management for a DVT? Correct Ans-- extremity elevation
- anticoagulation therapy (heparin, warfarin)
What is the goal for PTT levels in a pt with a DVT? How often should it be moniotred? Correct
Ans-1.5-2x the normal level; q6hrs
How log does IV heparin need to be off before lovenox is started? Correct Ans-at least 30 min
What is used to measure warfarin values and what is the normal value? Correct Ans-INR -
0.9-1.1
PT - 10-13 seconds
What is used to measure heparin values and what is the normal value? Correct Ans-PTT - 11-
13.5 seconds
What are the clinical manifestations of PVD? Correct Ans-- bilateral edema
- varicose veins
- stasis dermatitis (reddish brown discoloration extending up form the ankles, chronic ulcers)
What the management for PVD? Correct Ans-compression stockings, leg exercises, elevation
above the heart
,What should you teach your patient with PVD? Correct Ans-- avoid standing for long periods
of time
- avoid crossing legs
- avoid restrictive clothing
- unna boot (zinc oxide dressing) for ulcer care
insufficient oxygen Correct Ans-ischemia
tissue death Correct Ans-infarction
chest discomfort with exertion that is relived by rest and/or nitroglycerin; frequency/duration is
predictable and pts usually know their limits Correct Ans-stable angina (chronic)
What is stable angina managed with? Correct Ans-nitrates, beta blockers, rest
used to describe pts with either unstable angina or an acute MI Correct Ans-acute coronary
system
chest pain that occurs at rest or with exertion; not rleived by rest or nitroglycerin Correct
Ans-unstable angina
thickening or hardening of the arterial wall associated with aging (naturally) Correct Ans-
arteriosclerosis
formation of plaque within the arterial wall itself Correct Ans-atherosclerosis
, occurs at the same time of day secondary to spasm (variant angina) Correct Ans-prinzmetal's
angina
What kind of MI is characterized by ST elevation and thrombus formation? Correct Ans-
STEMI (worse kind)
What kind of MI is characterized by ST depression, T wave inversion, the initial troponin is
normal (but can creep up in the second set of vitals)? Correct Ans-NSTEMI
What should you teach your patient about diet modifications to prevent MI? Correct Ans--
limit sodium intake 1500 mg/day
- limit cholesterol intake 200 mg/day
- avoid trans fatty acids
What should you teach your patient about lifestyle modifications to prevent MI? Correct Ans-
- stop/avoid smoking
- moderate exercise 3-4x a week or 30 min walk a day
- importance of diabetes/HTN management
- importance of weight loss
What are the similarities between angina and an MI? Correct Ans-both have substernal chest
pain/pressure radiating to the left arm
What are the differencesbetween angina and an MI? Correct Ans-- angina is precipitated by
exertion or stress, MI occurs without cause usually in the morning
- angina is relived by nitroglycerin and/or rest, MI is only relived by opioids
- angina usually lasts less than 15 minutes, MI lasts 30 min or more
- angina has no other symptoms, MI frequently has associated symptoms
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