Podcast
Questions and Answers
What is the GFR threshold for defining Chronic Kidney Disease?
What is the GFR threshold for defining Chronic Kidney Disease?
- 60 mL/min/1.73 m2 (correct)
- 75 mL/min/1.73 m2
- 40 mL/min/1.73 m2
- 100 mL/min/1.73 m2
What serum creatinine level indicates a need for expert vascular access assessment?
What serum creatinine level indicates a need for expert vascular access assessment?
- 1.0 mg/dL
- 1.5 mg/dL
- 2.0 mg/dL (correct)
- 2.5 mg/dL
What is the normal range for platelets in adult patients?
What is the normal range for platelets in adult patients?
- 200-500 thousand per mcl
- 300-700 thousand per mcl
- 100-300 thousand per mcl
- 150-450 thousand per mcl (correct)
Which of the following describes the International Normalized Ratio (INR) range for patients on anticoagulant therapy?
Which of the following describes the International Normalized Ratio (INR) range for patients on anticoagulant therapy?
What should be considered before placing a vascular access device in thrombocytopenic patients?
What should be considered before placing a vascular access device in thrombocytopenic patients?
What is Creatinine primarily a measure of?
What is Creatinine primarily a measure of?
What is a criterion for the early identification of a person with CKD who may need a hemodialysis fistula or graft?
What is a criterion for the early identification of a person with CKD who may need a hemodialysis fistula or graft?
How should platelet transfusions be managed in relation to VAD insertion?
How should platelet transfusions be managed in relation to VAD insertion?
What is the purpose of monitoring INR in patients taking oral anticoagulants?
What is the purpose of monitoring INR in patients taking oral anticoagulants?
Which vascular access device (VAD) might be most appropriate for hypercoagulable patients?
Which vascular access device (VAD) might be most appropriate for hypercoagulable patients?
Which chronic disease primarily affects arterial circulation in aging adults?
Which chronic disease primarily affects arterial circulation in aging adults?
What is a common cause of leukocytosis in older adults?
What is a common cause of leukocytosis in older adults?
Which lifestyle factor does NOT typically affect an aging adult's circulatory system?
Which lifestyle factor does NOT typically affect an aging adult's circulatory system?
What is the normal range for White blood cell count in adults?
What is the normal range for White blood cell count in adults?
Which of the following conditions indicates a potential active infection in relation to WBC levels?
Which of the following conditions indicates a potential active infection in relation to WBC levels?
What is the normal Glomerular Filtration Rate (GFR) for adults?
What is the normal Glomerular Filtration Rate (GFR) for adults?
Which factor is primarily NOT associated with skin changes in aging adults?
Which factor is primarily NOT associated with skin changes in aging adults?
What measurement method is used to evaluate kidney function via GFR?
What measurement method is used to evaluate kidney function via GFR?
Which of these is a potential risk related to VAD devices in patients with elevated WBC?
Which of these is a potential risk related to VAD devices in patients with elevated WBC?
What lifestyle factor listed below is often correlated with an increase in chronic stress in aging adults?
What lifestyle factor listed below is often correlated with an increase in chronic stress in aging adults?
What indicates the need for a comprehensive vascular access plan in patients with CKD?
What indicates the need for a comprehensive vascular access plan in patients with CKD?
Which of the following is a criterion for identifying a person with CKD who may require a hemodialysis fistula?
Which of the following is a criterion for identifying a person with CKD who may require a hemodialysis fistula?
What is the normal range for the International Normalized Ratio (INR) for patients not on anticoagulant therapy?
What is the normal range for the International Normalized Ratio (INR) for patients not on anticoagulant therapy?
What lifestyle factor can significantly worsen vascular health in aging adults?
What lifestyle factor can significantly worsen vascular health in aging adults?
Why might a PICC be the most appropriate device for hypercoagulable patients?
Why might a PICC be the most appropriate device for hypercoagulable patients?
What should be considered when placing a vascular access device in thrombocytopenic patients?
What should be considered when placing a vascular access device in thrombocytopenic patients?
Which chronic disease is primarily associated with changes in arterial circulation due to aging?
Which chronic disease is primarily associated with changes in arterial circulation due to aging?
What does an elevated serum creatinine level commonly indicate?
What does an elevated serum creatinine level commonly indicate?
What is the primary purpose of measuring Glomerular Filtration Rate (GFR)?
What is the primary purpose of measuring Glomerular Filtration Rate (GFR)?
What skin change is commonly observed in aging adults?
What skin change is commonly observed in aging adults?
What role does serum creatinine play in assessing kidney function?
What role does serum creatinine play in assessing kidney function?
What does a platelet count below 150 thousand per mcl suggest?
What does a platelet count below 150 thousand per mcl suggest?
What impact can cigarette smoke exposure have on the vascular system of aging adults?
What impact can cigarette smoke exposure have on the vascular system of aging adults?
What is a key purpose of monitoring INR in patients taking anticoagulants?
What is a key purpose of monitoring INR in patients taking anticoagulants?
What is a potential consequence of elevated white blood cell counts in patients before vascular access device placement?
What is a potential consequence of elevated white blood cell counts in patients before vascular access device placement?
What is the minimum required GFR for diagnosing Chronic Kidney Disease?
What is the minimum required GFR for diagnosing Chronic Kidney Disease?
Which of the following is NOT a chronic condition affecting arterial circulation?
Which of the following is NOT a chronic condition affecting arterial circulation?
What might an upward trend in white blood cell counts signify in an aging adult?
What might an upward trend in white blood cell counts signify in an aging adult?
Which factor is generally associated with poorer kidney function in aging adults?
Which factor is generally associated with poorer kidney function in aging adults?
How can IV drug use affect the circulatory system of aging individuals?
How can IV drug use affect the circulatory system of aging individuals?
Flashcards
Vascular Changes in Aging
Vascular Changes in Aging
A general deterioration of the circulatory system due to the natural aging process and damage caused by various chronic ailments like diabetes, hypertension, and kidney issues. This can lead to narrowed arteries and decreased blood flow.
Leukocytosis
Leukocytosis
An increase in the number of white blood cells in the bloodstream, often indicating an infection or other health problem. This rise can be attributed to various factors such as infections, trauma, or certain types of cancer.
Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR)
A test used to measure the filtering capacity of the kidneys. It determines how much blood is filtered by the glomeruli, the tiny filters inside the kidneys, each minute.
Hypertension
Hypertension
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Diabetes Mellitus
Diabetes Mellitus
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Chronic Kidney Disease
Chronic Kidney Disease
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Lifestyle Factors Affecting Circulation
Lifestyle Factors Affecting Circulation
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Skin Changes Related to Aging
Skin Changes Related to Aging
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eGFR (Estimated Glomerular Filtration Rate)
eGFR (Estimated Glomerular Filtration Rate)
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Hyperthyroidism
Hyperthyroidism
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What is Chronic Kidney Disease (CKD)?
What is Chronic Kidney Disease (CKD)?
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What is Serum Creatinine?
What is Serum Creatinine?
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What is the significance of a GFR below 60 mL/min/1.73 m2 for 3 months?
What is the significance of a GFR below 60 mL/min/1.73 m2 for 3 months?
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What are Platelets and why are they important for vascular access?
What are Platelets and why are they important for vascular access?
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What is International Normalized Ratio (INR)?
What is International Normalized Ratio (INR)?
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What is a Comprehensive Vascular Access Plan?
What is a Comprehensive Vascular Access Plan?
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What should be considered when assessing a patient for vascular access?
What should be considered when assessing a patient for vascular access?
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What is a hemodialysis fistula?
What is a hemodialysis fistula?
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What is a Peripherally Inserted Central Catheter (PICC)?
What is a Peripherally Inserted Central Catheter (PICC)?
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Why might a PICC be preferred over other vascular access methods in certain patients?
Why might a PICC be preferred over other vascular access methods in certain patients?
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Chronic Kidney Disease (CKD)
Chronic Kidney Disease (CKD)
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Estimated Glomerular Filtration Rate (eGFR)
Estimated Glomerular Filtration Rate (eGFR)
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What defines Chronic Kidney Disease?
What defines Chronic Kidney Disease?
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Why is a GFR below 60 mL/min/1.73 m2 for 3 months significant?
Why is a GFR below 60 mL/min/1.73 m2 for 3 months significant?
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What are platelets and how do they relate to vascular access?
What are platelets and how do they relate to vascular access?
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What is the International Normalized Ratio (INR)?
What is the International Normalized Ratio (INR)?
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Study Notes
Aging Adult Population Related Vascular Changes
- Cumulative damage to blood vessels due to multiple organ systems aging
- Chronic conditions affecting arteries, including diabetes, hypertension, chronic kidney disease, hepatitis C, inflammatory bowel disease, cancer, and hypothyroidism
- Skin changes such as collagen depletion, hormone reduction, and dehydration
- Lifestyle factors affecting circulation: poor nutrition, chronic stress, alcohol use, smoking, environmental exposures (like cigarette smoke).
Laboratory Values-Device Placement
- White Blood Cells (WBC): Normal range 4,500-10,000/mcL; higher counts (leukocytosis) usually indicate an infection, which may need treatment. (Trauma, hemorrhage, coronary occlusion, malignancy, pregnancy, and VAD device use in active infections can also cause leukocytosis.)
- Other considerations: Infection in patients with vascular access devices can lead to systemic infections; consult with appropriate specialists to guide device type and appropriate insertion timing. Patients with elevated WBC or trending upwards may indicate infection not responding to antibiotics.
Kidney Function
- Glomerular Filtration Rate (GFR): Normal range is 90-120 mL/min/1.73 m². Used to evaluate kidney function; estimates the blood filtered through glomeruli each minute..
- Creatinine: Normal range 0.7-1.3 mg/dL (males) and 0.4-1.1 mg/dL (females). Indicates kidney function level and identifies kidney disease risk. Those with elevated creatinine or low GFR need a tailored vascular access plan. Low GFR or elevated creatinine in patients with CKD may necessitate prompt vascular access evaluation.
Coagulation Studies
- Platelets: Normal range 150,000-450,000 per microliter. Placement of vascular access devices in thrombocytopenic patients should be carefully guided. Consideration given to insertion sites allowing for optimal compressibility. PICC lines may be more appropriate for patients with hypercoagulability.
- International Normalized Ratio (INR): 1.0-1.2, 2.1-3.0 in treatment with anticoagulant therapy. Patients taking vitamin K antagonists need INR monitoring for appropriate dosage adjustment and risk assessment. INR is calculated from prothrombin time (PT). Be aware of possible heparin contamination from the vascular access device.
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