Atrial Fibrillation and Blood Clotting Quiz
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Questions and Answers

What is a common complication associated with atrial fibrillation?

  • Pulmonary embolism
  • Hemorrhagic stroke
  • Deep vein thrombosis
  • Embolic stroke (correct)

What measurement indicates a potential issue with blood clotting?

  • Presence of petechiae (correct)
  • Elevation in hemoglobin levels
  • Improved blood flow
  • Increased platelet count

What should patients at risk for increased clotting do to minimize their risk?

  • Drink adequate fluids (correct)
  • Cross legs frequently
  • Avoid smoking cessation programs
  • Stay sedentary for longer periods

Which condition is most likely associated with excessive red blood cell production?

<p>Polycythemia (A)</p> Signup and view all the answers

What are common sites for clots to form in venous thrombosis?

<p>Leg veins (D)</p> Signup and view all the answers

What is the most likely symptom of mesenteric artery thrombosis?

<p>Abdominal pain (D)</p> Signup and view all the answers

Which sign may indicate prolonged bleeding in patients with impaired clotting?

<p>Petechiae (D)</p> Signup and view all the answers

What is the normal lab value range for potassium in mEq/L?

<p>3.5–5.0 (A)</p> Signup and view all the answers

Which of the following is a common cause of hyperkalemia?

<p>Impaired renal excretion (B)</p> Signup and view all the answers

What is a primary health concern for patients experiencing internal bleeding?

<p>Risk of hemorrhagic stroke (B)</p> Signup and view all the answers

Which symptom is NOT typically associated with hyperkalemia?

<p>Increased intestinal motility (D)</p> Signup and view all the answers

What is a common medication that can cause hyperkalemia?

<p>Spironolactone (B)</p> Signup and view all the answers

What action should be taken if IV infusion slows or stops due to a possible thrombus?

<p>Discontinue IV access (C)</p> Signup and view all the answers

Which symptom would you use the mnemonic 'MURDER' to remember?

<p>Symptoms of hyperkalemia (A)</p> Signup and view all the answers

How often should the VAD site be checked during continuous PICC infusions?

<p>Every 4 hours (D)</p> Signup and view all the answers

Which of the following indicates a positive shift from IV fluid intake?

<p>Transition to oral fluid intake (B)</p> Signup and view all the answers

How do centrally acting adrenergic drugs like clonidine reduce sympathetic outflow?

<p>By stimulating alpha2-adrenergic receptors in the brain (D)</p> Signup and view all the answers

What is a characteristic effect of persistent pain on the sympathetic nervous system?

<p>It generally does not trigger noticeable sympathetic responses. (C)</p> Signup and view all the answers

Which of the following correctly describes the primary effect of alpha2-adrenergic receptors when stimulated?

<p>They inhibit sympathetic outflow, leading to decreased blood pressure. (B)</p> Signup and view all the answers

Which condition is indicated for the use of clonidine?

<p>Acute hypertension crisis (A)</p> Signup and view all the answers

What is a common side effect of centrally acting adrenergic drugs like clonidine?

<p>Dry mouth (B)</p> Signup and view all the answers

What distinguishes nociceptive pain from neuropathic pain?

<p>Nociceptive pain results from skin or organ damage. (D)</p> Signup and view all the answers

Which of the following patient education points should be emphasized for those taking calcium channel blockers (CCBs)?

<p>They may cause lower extremity edema. (A)</p> Signup and view all the answers

What is a critical nursing consideration when administering antihypertensives like clonidine?

<p>Monitoring for rebound hypertension upon discontinuation. (A)</p> Signup and view all the answers

What is the primary cause of hypokalemia during chronic diarrhea?

<p>Increased excretion of potassium (C)</p> Signup and view all the answers

What electrolyte imbalance can chronic diarrhea cause related to calcium levels?

<p>Hypocalcemia due to increased excretion (D)</p> Signup and view all the answers

Which substance can decrease renal excretion of potassium, exacerbating hypokalemia?

<p>Black licorice (D)</p> Signup and view all the answers

Which of the following accurately describes hypophosphatemia?

<p>Caused by decreased phosphate absorption in the GI tract (A)</p> Signup and view all the answers

What factor can lead to decreased absorption of magnesium during chronic diarrhea?

<p>Increased renal excretion (D)</p> Signup and view all the answers

What is the initial action a nurse must take if a blood transfusion reaction occurs?

<p>Stop the transfusion immediately (C)</p> Signup and view all the answers

Which gauge needle size is appropriate for a standard blood transfusion?

<p>18 to 20 gauge (A)</p> Signup and view all the answers

What is the recommended time frame for administering blood after its receipt?

<p>Immediately upon receiving blood (C)</p> Signup and view all the answers

What should be monitored and documented frequently during a blood transfusion?

<p>Patient's vital signs (C)</p> Signup and view all the answers

When managing a febrile nonhemolytic reaction, what should be administered to the patient?

<p>Antipyretics (B)</p> Signup and view all the answers

In the case of an anaphylactic reaction, what should the healthcare provider have ready for immediate use?

<p>Epinephrine (C)</p> Signup and view all the answers

What is a key nursing action to take after stopping a transfusion due to a reaction?

<p>Change the administration set and keep IV access patent (A)</p> Signup and view all the answers

Which sign is essential to monitor for in patients during a blood transfusion to prevent complications?

<p>Signs of acute kidney injury (C)</p> Signup and view all the answers

What is the first step to take when a transfusion reaction is suspected?

<p>Stop the transfusion (D)</p> Signup and view all the answers

When dealing with a suspected hemolysis reaction, which action must be taken regarding IV tubing?

<p>Replace the IV tubing down to the catheter hub (B)</p> Signup and view all the answers

What should be done with the blood bag and tubing after a transfusion reaction?

<p>Save them for return to the Blood Bank (D)</p> Signup and view all the answers

What is an important monitoring task after a transfusion reaction is suspected?

<p>Obtain blood and urine specimens per MD order (C)</p> Signup and view all the answers

Which population is at the highest risk for NSAID-related anemia?

<p>Elderly individuals (B)</p> Signup and view all the answers

Which of the following gastrointestinal effects is NOT commonly associated with NSAID use?

<p>Constipation (D)</p> Signup and view all the answers

In the event of an infusion reaction, which type of medication may be administered as needed?

<p>Antihistamines (D)</p> Signup and view all the answers

What is a potential serious cardiovascular effect of NSAID use?

<p>Increased risk of stroke (D)</p> Signup and view all the answers

After stopping a transfusion due to a suspected hemolysis reaction, what is crucial to maintain?

<p>Keep the IV line open (A)</p> Signup and view all the answers

Which of the following is an adverse effect linked to NSAIDs primarily affecting the kidneys?

<p>Acute kidney injury (C)</p> Signup and view all the answers

What symptom would raise suspicion for an acute transfusion reaction?

<p>Sudden fever and chills (D)</p> Signup and view all the answers

Which hematologic effect can result from NSAID usage?

<p>Altered hemostasis (A)</p> Signup and view all the answers

Which factor is critical in the management of transfusion reactions?

<p>Immediate patient stabilization (D)</p> Signup and view all the answers

What is the primary characteristic of respiratory acidosis?

<p>Decreased pH and increased CO2 (B)</p> Signup and view all the answers

Which of the following describes metabolic alkalosis?

<p>Increased bicarbonate with increased pH (A)</p> Signup and view all the answers

What does the mnemonic ROME stand for in acid-base interpretation?

<p>Respiratory – Opposite, Metabolic - Equal (C)</p> Signup and view all the answers

What causes metabolic acidosis?

<p>Loss of acid or excess acid, lowering pH (B)</p> Signup and view all the answers

What is a common condition associated with respiratory alkalosis?

<p>Hyperventilation due to anxiety (B)</p> Signup and view all the answers

What indicates a respiratory disorder when interpreting ABGs?

<p>CO2 and pH are opposite in values (D)</p> Signup and view all the answers

What is the normal range for blood pH in adults?

<p>7.35 - 7.45 (D)</p> Signup and view all the answers

Which condition results from an increase of CO2 due to ineffective lung function?

<p>Respiratory acidosis (B)</p> Signup and view all the answers

What should be done to increase the absorption of ferrous sulfate?

<p>Take it with 4 to 6 oz of water (A)</p> Signup and view all the answers

When should a patient take antacids in relation to ferrous sulfate intake?

<p>2 hours before or after taking ferrous sulfate (D)</p> Signup and view all the answers

Which of the following foods is a good source of folate?

<p>Spinach (B)</p> Signup and view all the answers

Why is adequate folate intake particularly important during pregnancy?

<p>To prevent neural tube defects (C)</p> Signup and view all the answers

What defines anemia?

<p>A reduction in the number of RBCs or hemoglobin (A)</p> Signup and view all the answers

Which of the following is an indicator of anemia for women?

<p>Less than 12.0 g/dL of hemoglobin (A)</p> Signup and view all the answers

What is a common dietary source of iron?

<p>Dark leafy greens (D)</p> Signup and view all the answers

What vitamin is also referred to as folate in its anionic form?

<p>Folic acid (C)</p> Signup and view all the answers

Flashcards

Centrally acting adrenergic drugs

Drugs that modify the sympathetic nervous system's function in the brain by stimulating alpha2 receptors.

Alpha2-adrenergic receptors

Inhibitory receptors that reduce sympathetic outflow from the central nervous system when stimulated.

Sympathetic nervous system (SNS)

Part of the autonomic nervous system that prepares the body for stress responses like fight or flight.

Acute pain

Short-lived, temporary pain typically localized to an injured area and serving a biological purpose.

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Persistent (Chronic) pain

Pain lasting more than 3 months, often diffuse and not confined to one area, and does not serve a biological purpose.

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Nociceptive pain

Pain resulting from damage or inflammation in organs or tissues; from normal senses.

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Neuropathic pain

Pain involving nervous system mechanisms, possibly with or without direct tissue damage.

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Functional Ability

The ability to perform physical movements needed for daily activities, often affected by pain.

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VAD Site Check Frequency

Check VAD (vascular access device) site with each infusion or daily, or at least every 4 hours during waking hours for continuous PICC infusions

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Discontinue IV Access

Stop IV access after the prescribed amount of fluid is infused; in the presence of infiltration, phlebitis, infection, or if the infusion slows/stops (thrombus)

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Oral Fluid Progress

Switching from IV fluids to oral intake shows recovery progress.

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Normal Potassium Level

Potassium levels should be between 3.5-5.0 mEq/L.

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Hyperkalemia

High potassium levels (over 5.0 mEq/L) in the blood serum

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Hyperkalemia Causes

Kidney problems, excessive potassium intake, certain drugs, Cushing syndrome, severe injuries or infection.

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Hyperkalemia Clinical Factors

Rapid IV potassium infusions, ACE inhibitors, and other drugs increase potassium risk.

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Hyperkalemia Symptoms (MURDER)

Neurological (anxiety, confusion), cardiac (irregular heart beat), and GI (N/V/D) issues are symptoms.

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Venous Thrombosis

Formation of a blood clot in a vein, often in the leg.

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Embolus

A dislodged blood clot that travels through the bloodstream.

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Atrial Fibrillation

Irregular heartbeat that can lead to blood pooling in the atria, increasing stroke risk.

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Polycythemia

Increased red blood cell production, potentially leading to clots.

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Hemorrhagic Stroke

Stroke caused by bleeding within the brain.

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Mesenteric Artery Thrombosis

Blood clot in the mesenteric artery, potentially causing bowel issues.

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Renal Artery Thrombosis

Blood clot in the renal artery potentially causing kidney problems.

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Prolonged Bleeding

Excessive bleeding that lasts longer than normal.

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Dehydration

Lack of enough fluid in the body.

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Smoking Cessation

Quitting smoking.

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Respiratory Acidosis

Occurs when the lungs cannot remove enough carbon dioxide (CO2), leading to a buildup of acid and a decrease in blood pH.

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Respiratory Alkalosis

Occurs when the lungs remove too much carbon dioxide (CO2), resulting in a decrease in acid and an increase in blood pH.

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Metabolic Acidosis

Occurs when the body produces too much acid or loses too much bicarbonate, resulting in a decrease in blood pH.

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Metabolic Alkalosis

Occurs when the body has too much bicarbonate or loses too much acid, resulting in an increase in blood pH.

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ROME

A mnemonic device to remember the relationship between blood pH and CO2/HCO3 in acid-base imbalances.

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Acid-base Imbalance

A disruption in the body's pH balance, falling outside the normal range of 7.35-7.45.

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Normal blood pH range

The healthy range for blood pH is 7.35-7.45

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Compensatory Mechanisms

The body's efforts to adapt to acid-base imbalances, though they do not fix the original problem.

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Blood Transfusion Reaction

An adverse event from blood product transfusion, causing immune system reactions ranging from mild to severe (anaphylactic shock or hemolysis).

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Hemolysis Interventions

Stop transfusion immediately, maintain IV line with normal saline, change all tubing, notify doctor, monitor vital signs, and administer emergency drugs as needed.

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Sepsis Blood Transfusion Interventions

Stop transfusion, take blood cultures, send blood bag to lab, give antibiotics, fluids, vasopressors, and corticosteroids as ordered.

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Bacterial Contamination Infusion Reaction Intervention

Stop transfusion, treat shock, give steroids and antibiotics, culture blood, blood components, and IV fluids.

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Acute Intravascular Hemolysis

Serious blood transfusion complication where red blood cells break down rapidly, releasing hemoglobin into the bloodstream.

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Keep IV line open

Maintain IV access with saline to avoid mixing blood clots with the saline.

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Transfusion Reaction

Adverse event during a blood transfusion, often immune-related, with severity ranging from mild to life-threatening.

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Immediate intervention

Quick action necessary when a transfusion reaction occurs to stabilize patient physiological state.

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Chronic Diarrhea Effect on Electrolytes

Chronic diarrhea can lead to a decrease in calcium, potassium, and magnesium levels in the body, due to loss through the feces.

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Hypocalcemia

A low level of calcium in the blood.

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Hypokalemia

A low level of potassium in the blood.

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Blood Transfusion Reaction

An adverse reaction to a blood transfusion, which can have dangerous and life-threatening consequences.

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Hypomagnesemia

Low level of magnesium (Mg) in the blood

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Post-Transfusion Care

Actions to take after a blood transfusion, like monitoring vital signs and saving the blood components.

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Initial Transfusion Monitoring

Close observation of the patient for the first 15 minutes after starting a blood transfusion.

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Transfusion Reaction Interventions

Actions taken when a blood transfusion reaction occurs, including stopping the transfusion, notifying the physician, monitoring vital signs and providing supportive care.

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Anaphylactic Reaction Intervention

Stopping the transfusion, having epinephrine ready for injection, supporting blood pressure, and initiating CPR if needed

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Febrile Nonhemolytic reaction

Most common blood transfusion reaction, typically involving fever and requiring antipyretic medication.

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Mild Allergic Reaction Intervention

Temporarily stopping the transfusion, administering antihistamines, and maintaining IV access with normal saline.

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Blood Transfusion Setup

Verifying the order, obtaining informed consent, explaining the procedure to the patient, checking vital signs, and using 18-20 gauge needles for standard transfusions.

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Post-Transfusion Care

Thorough documentation of the reaction details, keeping transfusion supplies, monitoring for complications like acute kidney injury, and providing supportive care.

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NSAID side effects

NSAIDs (Nonsteroidal anti-inflammatory drugs) can cause various side effects, including stomach pain, heartburn, nausea, vomiting, and bleeding in the stomach or intestines.

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GI ulcer risk

Certain groups, like those with a history of ulcers or taking high doses of NSAIDs, have a higher risk of developing a stomach ulcer from using NSAIDs.

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NSAID-related anemia

NSAIDs can cause anemia by increasing the risk of bleeding in the stomach or intestines, leading to a decrease in red blood cells.

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Kidney damage from NSAIDs

High doses or long-term NSAID use can lead to kidney problems, including acute kidney injury and worsening of existing kidney disease.

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Heart attack and stroke risk (NSAIDs)

NSAIDs can slightly increase the risk of heart attack and stroke in some individuals.

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Dietary Iron Sources

Meats, dark leafy greens, and fortified grains are good sources of dietary iron.

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Folate Sources

Leafy greens, citrus fruits, beans, nuts, whole grains, liver, and fortified foods contain folate.

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Ferrous Sulfate Instructions

Take ferrous sulfate with 4-6 oz of water on an empty stomach, 2 hours before or after antacids.

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Anemia Definition

A condition with reduced red blood cells, hemoglobin, or hematocrit, often due to dietary issues, genetics, or excessive bleeding.

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Anemia in Men

A hemoglobin level below 14 g/dL (8.7 mmol/L) indicates anemia in men.

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Anemia in Women

A hemoglobin level below 12 g/dL (7.4 mmol/L) indicates anemia in women.

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Folate's Importance in Pregnancy

Adequate folate intake is vital during pregnancy to prevent neural tube defects in the fetus.

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Water-Soluble Vitamins

Vitamins that dissolve in water, like folate, are best consumed from fresh foods

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Study Notes

Metabolic Acidosis - Signs and Symptoms

  • Metabolic acidosis arises from increased metabolic acid or decreased base (bicarbonate).
  • Kidneys unable to excrete enough metabolic acids, accumulating in the blood, or bicarbonate removed (diarrhea).
  • Blood HCO3⁻ decreases, pH falls. Increased metabolic acid decreases blood HCO3⁻ because it buffers the acids.
  • Metabolic acidosis characterized by pH < 7.35 and bicarbonate (HCO3⁻) level < 22 mEq/L.

Underlying Causes of Metabolic Acidosis

  • Starvation ketoacidosis: Inadequate caloric intake, prolonged fasting. -What Happens: In the absence of glucose, fat stores used for energy, keto-acids accumulate in the blood.
  • Diabetic ketoacidosis: Type I diabetes mellitus. -What Happens: Glucose is not transported into cells due to lack of insulin. Fat used for energy, keto-acids accumulate in blood.
  • Lactic acidosis: Sepsis, cardiac arrest, trauma, seizures. -What Happens: Lack of oxygen leads to anaerobic metabolism in cells, and lactic acid accumulates.
  • Renal Tubular Acidosis: Renal failure. -What Happens: Kidneys unable to remove acids through urine acidification.

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Description

Test your knowledge on complications associated with atrial fibrillation, blood clotting issues, and related health conditions. This quiz covers symptoms, lab values, and risk management for patients. Ideal for healthcare students and professionals.

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