PrepU Pharm Assignment 20

While preparing a patient for discharge, the nurse teaches about the proper use of warfarin, which has been prescribed by the physician. Which statement by the patient indicates that additional teaching is required?

"I should use aspirin to control my arthritis pain."

Which is classified as an antiplatelet agent?

Clopidogrel (Plavix)

Fondaparinux (Arixtra) is indicated for:

DVT prophylaxis.

A patient is admitted with thrombophlebitis and sent home on enoxaparin (Lovenox). Which statement indicates a good understanding of why enoxaparin is being administered?

Enoxaparin inhibits the formation of additional clots.

There are two pathways that can be activated by the coagulation process. One pathway begins when factor XII is activated. The other pathway begins when there is trauma to a blood vessel. What are these pathways?

Extrinsic and intrinsic pathways

A client taking warfarin (Coumadin) tells the nurse she is having bleeding in the gums and teeth. When reviewing client history, the client states she has decided to try an herbal remedy. Which of the following is most likely the cause of increased bleeding?

Ginger

Many commonly used herbs and supplements alter the effects of anticoagulant drugs. Which of the following substances presents an additive bleeding effect when taken concomitantly with warfarin?

Ginger

A nurse is caring for a male patient receiving warfarin drug therapy. The patient informs the nurse that he is also taking chamomile, which is an herbal remedy. What effect of the interaction between warfarin and the herb should the nurse inform the patient about?

Increased risk for bleeding

Use of St. John's wort during warfarin therapy can result in which of the following? (Choose one)

Increased risk of bleeding

What values are used to monitor the effectiveness of warfarin therapy?

PT and INR

A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report what should it occur?

Presence of blood in urine or stools

The nursing instructor is talking about anticoagulant therapy. The instructor explains that when administering warfarin (Coumadin) to a client with deep vein thrombophlebitis, the nurse monitors the PTT, PT, INR, and hematocrit. Which laboratory value would the instructor say indicates warfarin is at therapeutic levels?

Prothrombin time (PT) 1.2 to 1.5 times the control

A nurse is caring for a patient who is going home on warfarin (Coumadin). The nurse will schedule the patient for what laboratory test to help evaluate therapeutic effects of the drug?

Prothrombin time (PT) and international normalized ratio (INR)

A patient is being discharged from the hospital with warfarin (Coumadin) to be taken at home. Which of the following foods should the patient be instructed to avoid in his diet?

Spinach

Enoxaparin (Lovenox) should be administered via which route?

Subcutaneous injection

Ms. Main is sent home with subcutaneous heparin after a total hip replacement. What symptom would indicate a serious drug reaction?

Tarry stools

Warfarin typically takes 3 days to achieve its onset of action.

True

A 73-year-old client receiving warfarin (Coumadin) has blood in his urinary drainage bag this morning. After reporting these observations to the physician, the nurse will expect to administer what substance?

Vitamin K

A patient who has been treated with warfarin (Coumadin) after open heart surgery is involved in a car accident and has a laceration on her head. Which medication will be administered to assist in the development of clotting factors?

Vitamin K

A patient who is receiving warfarin (Coumadin) has blood in his urinary drainage bag. What medication will likely be ordered by the physician?

Vitamin K

The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will the nurse likely administer?

Vitamin K

A nurse has an order to administer heparin. Before initiating this therapy, a priority nursing assessment will be the patient's

aPTT

A 70-year-old resident of a long-term care facility has experienced increasing pain, swelling, and redness to her lower leg over the past 12 hours, prompting the care providers at the facility to have the woman brought to the local emergency department. Diagnostic testing has confirmed deep vein thrombosis (DVT) and an IV infusion of alteplase (Activase) has been initiated? Unlike anticoagulants, a thrombolytic such as alteplase can

break down existing clots.

The physician orders heparin for a 35-year-old female client. The nurse administers the drug only after confirming that the client:

does not have peptic ulcer disease.

A 59-year-old patient is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the patient's:

intake of vitamin K.