Chapter 26 Pharmacology

Continue with the prescribed rate.

A patient is receiving 1400 units of heparin/hour on an IV pump. The aPTT time is 54. The laboratory control is 25. Which action by the nurse is accurate?

Stop the heparin drip

A patient is receiving IV heparin therapy. The aPTT is 90; the laboratory control is 30 seconds. Which nursing intervention is most accurate?

"Heparin does not dissolve blood clots but neutralizes clotting factors, preventing extension of the clot and the possibility of it traveling elsewhere in your body."

A patient receiving IV heparin therapy for a deep vein thrombosis (DVT) in his right calf asks why his calf remains painful, edematous, and warm to touch after 2 days of anticoagulant therapy. Which response by the nurse is most accurate?

Protamine sulfate

A trauma patient arrives in the emergency department via EMS. He is bleeding profusely. A medical alert bracelet indicates that he is on heparin therapy. The nurse will most likely administer which medication that counteracts the action of heparin?

To prevent stroke in patients at high risk Following a myocardial infarction Following total hip or knee joint replacement surgery With DVT To prevent thrombosis in immobilized patients

Anticoagulant therapy may be used for which situation(s)? (Select all that apply.)

Cardiac valve replacement

Dipyridamole (Persantine) has been used extensively in combination with warfarin to prevent the formation of thromboembolism after which type of event?

for 12 days postsurgically.

Rivaroxaban (Xarelto) is ordered on a patient following knee replacement surgery. When providing education on this medication to the patient, the nurse conveys that treatment will continue

"I will rinse my mouth with mouthwash instead of brushing my teeth."

The nurse has provided instruction to a patient recently prescribed warfarin (Coumadin). Which statement by the patient indicates to the nurse the need for further teaching?

implement deep breathing and coughing exercises.

The nurse is caring for a 27-year-old woman on the postpartum unit one day following a C-section. To prevent clot formation, the nurse will

"Do not make any major changes to your diet without discussing it with your health care provider." "Keep outpatient laboratory appointments for monitoring of therapy." "Report signs of bleeding to your health care provider, including observing skin for bruising; petechiae; blood in emesis, urine, or stools; bleeding gums; cold, clammy skin; faintness; or altered sensorium." "Avoid aspirin products."

The nurse is preparing discharge education for a patient who will be receiving warfarin (Coumadin) at home. Which important point(s) will the nurse include? (Select all that apply.)

inject slowly alternate injection sites every 24 hours.

The nurse is preparing to administer dalteparin (Fragmin) to a patient in order to prevent DVT following a hip replacement. When providing this medication to the patient, the nurse will (Select all that apply.)

Spinach

The nurse is teaching a patient about dietary implications while on warfarin (Coumadin) therapy. Which salad is highest in vitamin K?

Prevent platelet aggregation. Prevent the extension of existing clots. Inhibit steps in the fibrin clot formation cascade. Prolong bleeding time.

The pharmacologic agents used to treat DVT may act in which way(s)? (Select all that apply.)

Preventing platelet aggregation and inhibiting clot formation

What is the mechanism of action of drugs used to treat thromboembolic disease?

Lyses the blood clot

What is the rationale for administering fibrinolytic agents, such as streptokinase, within hours of the onset of myocardial infarction?

Encourage passive leg exercises

Which action will the nurse implement to decrease the risk of clot formation in an older patient on bed rest?

Leave the needle in place for 10 seconds after injection.

Which is an accurate nursing action when administering subcutaneous enoxaparin, a low-molecular-weight heparin product?

Documenting ecchymotic areas Monitoring of vital signs

Which nursing intervention(s) would be accurate when administering heparin subcutaneously? (Select all that apply.)

Petechiae

Which symptom is indicative of bleeding in a patient taking warfarin (Coumadin)?