March 31, 2015

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Anemia is defined as a decrease in the number, size or hemoglobin content of erythrocytes. Causes include blood loss, hemolysis, bone marrow dysfunction and deficiencies of substances essential for RBC formation and maturation.

March 30, 2015

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Desmopressin (DDAVP), an analog of antidiuretic hormone, can stop or prevent bleeding in patients with mild hemophilia A. The drug works by releasing stored factor VIII from the vascular endothelium.

March 29, 2015

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In patients with severe hemophilia, the concentration of clotting factor VIII or IX is very low, less than 1% of normal. As a result, these patients experience frequent bleeds within joints and soft tissues, especially muscle.

March 28, 2015

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Hemophilia has two forms: hemophilia A and hemophilia B. In hemophilia A, there is a deficiency of clotting factor VIII (aka antihemophilic factor). In hemophilia B, there is a deficiency of clotting factor IX (aka Christmas factor).

March 27, 2015

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In patients with STEMI, nitroglycerin has several beneficial effects: It can (1) reduce preload; (2) increase collateral blood flow; (3) control hypertension caused by anxiety and (4) limit infarct size and improve LV function.

March 26, 2015

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Intravenous morphine is the treatment of choice for STEMI-associated pain. In addition to relieving pain, morphine can improve hemodynamics. By promoting venodilation, the drug reduces cardiac preload.

March 25, 2015

#AskNacole | Hourly Rounding & HCAHPS Pitfalls

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Warfarin is readily absorbed after oral dosing. Once in the blood, about 99% of warfarin binds to albumin. Warfarin molecules that remain free can readily cross membranes, including those of the placenta and milk-producing glands.

March 24, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Warfarin suppresses coagulation by decreasing production of four clotting factors (VII, IX, X and prothrombin). These factors are known as vitamin K-dependent clotting factors, because an active form of vitamin K is needed to make them.

March 23, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Warfarin was discovered after a farmer noticed that his cattle bled after eating spoiled clover silage. The causative agent was identified as bishydroxycoumarin (dicumarol). Research into derivatives of dicumarol led to the synthesis of warfarin.

March 22, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Protamine sulfate is an antidote to severe heparin overdose. Protamine has multiple positively charged groups. These groups bind with the negative groups on heparin, forming a complex that is devoid of anticoagulant activity.

March 21, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Heparin is a preferred anticoagulant during pregnancy (because it doesn't cross the placenta) and in situations that require rapid onset of anticoagulant effects, including pulmonary embolism (PE), stroke and deep vein thrombosis (DVT).

March 20, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Heparin undergoes hepatic metabolism followed by renal excretion. Under normal conditions, the half-life is short (about 1.5 hours). However, in patients with hepatic or renal impairment, the half-life is increased.

March 19, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Heparin binds nonspecifically to plasma proteins, mononuclear cells, and endothelial cells. As a result, plasma levels of free heparin can be highly variable. Because of this variability, intensive monitoring is required.

March 18, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Because of its polarity and large size, heparin is unable to cross membranes, including those of the GI tract. Consequently, heparin cannot be absorbed if given orally, and therefore must be given by injection (intravenously or subcutaneously).

March 17, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Heparin is present in various mammalian tissues. The heparin employed clinically is prepared from two sources: lungs of cattle and intestines of pigs. The anticoagulant activity of heparin from either source is equivalent.

March 16, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Anticoagulants and antiplatelet drugs both suppress thrombosis by different mechanisms. The antiplatelet drugs are most effective at preventing arterial thrombosis, whereas anticoagulants are most effective against venous thrombosis.

March 15, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Venous thrombi develop at sites where blood flow is slow. Stagnation of blood initiates the coagulation cascade, resulting in the production of fibrin, which enmeshes red blood cells and platelets to form the thrombus.

March 14, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The contact activation pathway is turned on when blood makes contact with collagen that has been exposed as a result of trauma to a blood vessel wall. Collagen contact stimulates conversion of factor XII into its active form, XIIa.

March 13, 2015

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The tissue factor pathway is turned on by trauma to the vascular wall, which triggers release of tissue factor, also known as tissue thromboplastin. Tissue factor then combines with and activates factor VII, which in turn activates factor X.