Clotting_Bleeding_Nursing_Education_FullSentences_Dx_Tx_Interventions.pptx

clotting bleeding disorders nursing

1. Clotting & Bleeding in Clinical Practice — Nursing Education Full-sentence slides including nursing interventions, diagnostics, and treatments

2. Ischemic Stroke — Interventions, Diagnostics, and Treatments Ischemic stroke occurs when a clot blocks a cerebral artery, causing sudden, focal neurologic deficits. Priority nursing interventions include performing frequent neurological assessments, maintaining airway and oxygenation, and keeping the head midline with the head of bed elevated if not contraindicated. Key diagnostics include a rapid non-contrast CT to exclude hemorrhage, blood glucose to rule out hypoglycemia, a 12‑lead ECG to assess for atrial fibrillation, and basic labs including CBC, BMP, PT/INR, and aPTT. Time-sensitive treatments include intravenous alteplase (tPA) if the patient is eligible within the treatment window and endovascular thrombectomy for large-vessel occlusions as directed by protocol. Patient education focuses on controlling modifiable risk factors such as hypertension, diabetes, smoking, and hyperlipidemia, and on recognizing FAST warning signs.

3. Myocardial Infarction — Interventions, Diagnostics, and Treatments A myocardial infarction occurs when a coronary artery becomes occluded by a thrombus, leading to myocardial ischemia and necrosis. Priority nursing interventions include obtaining a 12‑lead ECG within minutes, placing the patient on continuous rhythm and ST monitoring, establishing IV access, and administering oxygen only if hypoxemic. Key diagnostics include serial ECGs for ischemic changes, serial troponins to detect myocardial injury, and chest radiography as indicated to evaluate for alternative causes. Evidence-based treatments include rapid reperfusion with percutaneous coronary intervention for STEMI, guideline-directed medications such as aspirin, a P2Y12 inhibitor, anticoagulation, nitrates when appropriate, and beta-blockers and statins as ordered. Discharge planning includes referral to cardiac rehabilitation and teaching on medication adherence, risk factor modification, and symptom recognition.

4. Hypercoagulable States — Interventions, Diagnostics, and Treatments Hypercoagulable states are inherited or acquired conditions that increase the risk of venous or arterial thrombosis. Priority nursing interventions include assessing personal and family history of clots, reinforcing adherence to anticoagulants, and counseling on lifestyle measures that reduce venous stasis. Key diagnostics include targeted thrombophilia testing as directed by hematology, ideally performed away from acute events and anticoagulation when possible. Long‑term treatments typically involve individualized anticoagulation strategies that balance the risk of recurrence with the risk of bleeding, along with patient and family counseling for inherited disorders.

5. Pregnancy and Clotting — Interventions, Diagnostics, and Treatments Normal pregnancy is a hypercoagulable state that increases the risk of deep vein thrombosis and pulmonary embolism, particularly in the postpartum period. Priority nursing interventions include close monitoring of pregnant and postpartum patients for unilateral leg swelling, sudden shortness of breath, chest pain, or bleeding emergencies and initiating early mobilization when appropriate. Key diagnostics include compression ultrasound for suspected DVT, ventilation–perfusion scanning or CT pulmonary angiography for suspected PE, and coagulation studies for suspected DIC in obstetric emergencies. Treatments include pregnancy‑appropriate anticoagulation such as low‑molecular‑weight heparin, supportive management for DIC while treating the obstetric cause, and comprehensive patient education on warning signs and follow‑up.

6. Oncology and Clotting — Interventions, Diagnostics, and Treatments Malignancy increases the risk of thrombosis while chemotherapy can cause bone marrow suppression and bleeding. Priority nursing interventions include routine assessment for signs of DVT and PE, careful line assessments for catheter‑associated thrombosis, and bleeding precautions when platelets are low. Key diagnostics include CBC trends to identify cytopenias and appropriate imaging such as venous ultrasound or CT angiography when VTE is suspected. Treatments include anticoagulation regimens selected with oncology and hematology input (often LMWH or DOACs when appropriate) and transfusion support for symptomatic anemia or severe thrombocytopenia.

7. Complications of Therapy — Interventions, Diagnostics, and Treatments Complications of antithrombotic therapy include anticoagulant‑induced bleeding, heparin‑induced thrombocytopenia, and post‑surgical clots or bleeding. Priority nursing interventions include trending platelet counts and signs of bleeding, promptly recognizing a platelet drop with new thrombosis suggestive of HIT, and escalating care immediately. Key diagnostics include CBC with platelet trend, HIT antibody testing when indicated, and appropriate imaging for suspected bleeding or thrombosis. Treatments include holding or reversing the offending agent as appropriate, initiating a non‑heparin anticoagulant for HIT, and coordinating surgical or interventional management for post‑operative complications.

8. Medication Management — Interventions, Diagnostics, and Treatments Warfarin therapy requires consistent vitamin K intake and routine INR monitoring to maintain the prescribed therapeutic range. Unfractionated heparin requires aPTT or anti‑Xa monitoring, while low‑molecular‑weight heparin is dosed by weight and renal function. Direct oral anticoagulants require strict adherence despite fewer routine laboratory tests, because bleeding risk persists and renal function may affect dosing. Antiplatelet agents such as aspirin and clopidogrel reduce arterial thrombosis but increase bleeding risk and must be coordinated around procedures.

9. Collaborative and Surgical Interventions — Interventions, Diagnostics, and Treatments Collaborative care integrates hematology, cardiology, obstetrics, oncology, pharmacy, dietetics, and case management to optimize outcomes. Priority nursing interventions include comprehensive pre‑procedure teaching, consent verification, peri‑procedural monitoring, and vigilant post‑procedure assessment for complications. Key diagnostics and planning steps include confirming indications and contraindications, reviewing laboratory values, and ensuring medication reconciliation before and after procedures. Treatments and procedures may include inferior vena cava filters when anticoagulation is contraindicated, thrombectomy for selected acute thrombotic events, and splenectomy for refractory immune thrombocytopenia.

10. Nursing Diagnoses — Applied Interventions, Diagnostics, and Treatments Anemia often leads to fatigue and activity intolerance that require energy conservation strategies and evaluation of response to therapy. Hemophilia and von Willebrand disease create a high risk for bleeding that requires bleeding precautions and timely factor or vWF replacement when indicated. Deep vein thrombosis and pulmonary embolism impair gas exchange and tissue perfusion and require anticoagulation safety, oxygenation support, and mobility planning. Disseminated intravascular coagulation carries a risk for shock and anxiety and requires hemodynamic support, blood products as ordered, and clear, compassionate communication.