chapter 26

what is so important to report when taking anticoagulant

unusual bleeding -severe headave -blurred vission -bloody vommit -muscle weakness -faint

patients should also avoid activities or errands that may cause ____ ____

tissue injury

what does PT/INR tell you about coumadin/warfarin

to what degree a patients blood coagulability has been reduced by

we only monitor heparin for which medication route and how often

IV every 6 hrs

what kind of test is used to monitor coumadin/warfarin

PT/INR

The nurse is reviewing the use of anticoagulants. Anticoagulant therapy is appropriate for which conditions? (Select all that apply.) a. Atrial fibrillation b. Thrombocytopenia c. Myocardial infarction d. Presence of mechanical heart valve e. Aneurysm f. Leukemia

a. Atrial fibrillation c. Myocardial infarction d. Presence of mechanical heart valve

what kind of test is used to monitor for herparin

aPTT activated partial thromboplastin time

these group of drugs prevent formation of a clut, prevent clots from happening and the spread of existing clots, there most significant side effect is bleeding

anticoagulant heparin and coumadin

_________ are important in preventing serious complications in clotts stoke heart attack dvt heart valve replacement

anticoagulants

patients should avoid what clot preventing measures

avoid tight-fitting clothing, minimize sitting for prolonged periods of time, avoid crossing the legs at the knees wearing of tight-fitting socks/stockings, avoid prolonged bed rest, make stops during long trips to walk around every 1 to 2 hours, keep well hydrated

During teaching of a patient who will be taking warfarin sodium (Coumadin) at home, which state- ment by the nurse is correct regarding over-the- counter drug use? a. "Choose nonsteroidal antiinflammatory drugs as needed for pain relief." b. "Aspirin products may result in increased bleeding." c. "Vitamin E therapy is recommended to improve the effect of warfarin." d. "Mineral oil is the laxative of choice while tak- ing anticoagulants

b. "Aspirin products may result in increased bleeding."

A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.) a. Teach proper subcutaneous administration. b. Administer the oral dose at the same time every day. c. Assess carefully for excessive bruising or unusual bleeding. d. Monitor laboratory results for a target INR of 2 to 3. e. Monitor laboratory results for a therapeutic aPTT value of 1.5 to 2.5 times the control value.

b. Administer the oral dose at the same time every day. c. Assess carefully for excessive bruising or unusual bleeding. d. Monitor laboratory results for a target INR of 2 to 3.

During thrombolytic therapy, the nurse monitors for bleeding. Which symptoms may indicate a serious bleeding problem? (Select all that apply.) a. Hypertension b. Hypotension c. Decreased level of consciousness d. Increased pulse rate e. Restlessness

b. Hypotension c. Decreased level of consciousness d. Increased pulse rate e. Restlessness

. When administering subcutaneous heparin, the nurse will remember to perform which action? a. Use the same sites for injection to reduce trauma. b. Use a 1-inch needle for subcutaneous injections. c. Inject the medication without aspirating for blood return. d. Massage the site after the injection to increase absorption.

c. Inject the medication without aspirating for blood return.

A patient is receiving instructions regarding warfarin therapy and asks the nurse about what medications she can take for headaches. The nurse will tell her to avoid which type of medication? a. Opioids b. acetaminophen (Tylenol) c. NSAIDs d. There are no restrictions while taking warfarin.

c. NSAIDs

in this anticoagulant it must be monitored through this test prothombine/internaiton normalized ratio (PT/INR)

coumadin or warfarin

18 seconds is the therpeutic level for which anticoagulant

coumadin/warfarin

The nurse would recognize which drug as the recommended drug for stroke prevention? a. Warfarin (Coumadin) b. Clopidogrel (Plavix) c. Enoxaparin (Lovenox) d. Aspirin

d. Aspirin

The nurse is monitoring a patient who is receiving antithrombolytic therapy in the emergency department because of a possible MI. Which adverse effect would be of the greatest concern at this time? a. Dizziness b. Blood pressure of 130/98 mm Hg c. Slight bloody oozing from the IV insertion site d. Irregular heart rhythm

d. Irregular heart rhythm

. Which drug is most often used for deep vein thrombosis (DVT) prevention after major orthopedic surgery, even after the patient has gone home? a. Antiplatelet drugs, such as aspirin b. Adenosine diphosphate (ADP) inhibitors, such as clopidogrel (Plavix) c. Anticoagulants, such as warfarin sodium (Coumadin) d. Low-molecular-weight heparins, such as enoxa- parin (Lovenox)

d. Low-molecular-weight heparins, such as enoxa- parin (Lovenox)

what kind of lifestyle is important to teach patient about when using anticoagulant

healthy lifestyle -healthy food low fat low cholesterol -smoking cessation -blood pressure -relieve stress

45-70 sec is the therapeutic level for which anticoagulant

heparin

in this anticoagulant we must do frequent lab monitoring of bleeding times using aPTT (activated patial thromboplastin time)

heparin

patients should wear what when taking anticoagulants

medical alert bracelet or jewelery