anticoagulants

Question 1

what do anticoagulants do?

Answer 1

prevent blood clotting. It withholds coagulation factors

Question 2

why are anticoagulants given? key word?

Answer 2

prevention of new clots and preventing existing clots. specifically with patients recovering from an mi heart attack or those at risk for a DVT like after a hip or knee surgery

Question 3

what dissolves clots?

Answer 3

thrombolytics like TPA and alteplase

Question 4

do anticoagulants dissolve clots?

Answer 4

no only thrombolytics do this

Question 5

what do anticoagulants block?

Answer 5

fibrin

anticoagulation withholding clotting factors in the coagulation cascade mainly blocking the formation of fibrin since fibrin forms the seals on the clock.

Question 6

what is the difference between warfarin and heparin?

Answer 6

heparin works quickly and can only be injected like IV or SQ into the patient like enoxaparin or Lower weight molecular heparin.

warfarin works slowly it takes 5 days to start working. BUT IT LASTS LONGER AND CAN BE TAKEN LONGER.

Question 7

What is the key word for heparin and warfarin being taken at the same time?

Answer 7

BOTH MEDICATIONS ARE GIVEN TOGETHER FOR SEVERAL DAYS

Question 8

Anticoagulant labs:

Answer 8

IF THEY ARE TOO HIGH THE PATIENT WILL BLEED OUT AND DIE

BUT IF THEY ARE TOO LOW THE RISK FOR CLOTTING GROWS

Question 9

Labs to know for heparin?

Answer 9

PTT: 46 TO 70

ANYTHING MORE THAN 70 Hold medication

Question 10

what is the antidote for heparin?

Answer 10

PROTAMINE SULFATE

Question 11

Heparin drip PTT 85 or 100?

Answer 11

PTT IS OVER 70 so the priority is?
1.) stop the heparin drip and notify HCP

2. ) Prepare antidote protamine sulfate
3. ) reassess labs in 1 hour

Question 12

if their is a patient on a heparin drip with bleeding at the iv site or “BLOOD OOZING AT THE SURGICAL INCISION”?

Answer 12

1. ) Stop the infusion and notify HCP
2. ) ADMINISTER protamine sulfate
3. ) reassess labs in 1 hour

Question 13

labs for warfarin?

Answer 13

INR 2 to 3

heart valve replacements: 2.5 to 3.5

Question 14

what is the antidote for warfarin? and where is it found?

Answer 14

vitamin k

seen in liver and green leafy vegetables like broccoli and spinach

Question 15

when can vitamin K not be given?

Answer 15

when warfarin is in therapeutic range

at least 5 days on warfarin therapy when switching to IV heparin

Question 16

what is patient teaching on vitamin k and warfarin?

Answer 16

consistency and moderation
DO NOT INCREASE
DO NOT DECREASE
DO NOT AVOID TOTALLY

NICE CONSISTENCY MODERATION

Question 17

What does the statement I will increase my intake of dark green leafy vegetables mean?

Answer 17

requires intervention since it has to be a nice consistency in moderation

Question 18

ANTIBIOTICS INCREASE THE RISK OF BLEEDING!!!

Answer 18

since it INCREASES the INR. SINCE ANTIBIOTICS KILLS THE intestinal bacteria that produces vitamin K that ends up with a vitamin K deficiency, which increases the risk for bleeding.

Question 19

what do you do when you are on warfarin with an IINR of 4 or 5?

Answer 19

1. ) assess for bleeding

2. ) get vitamin K antidote ready

Question 20

what to do if your INR is 2.0 and your patient has ischemic CVA?

Answer 20

administer warfarin so that it increases to 2.5

Question 21

Warfarin patient teaching?

Answer 21

1. ) Taken LIFE LONG to prevent clots like in patients with:
2. ) -atrial fibrillation
   - artificial heart valve replacements typically more prevalent in key term -mechanical valve replacements.

3.) FREQUENT BLOOD TESTS to check the therapeutic range

Question 22

what requires frequent blood tests?

Answer 22

WARFARIN ONLY

Question 23

how long is heparin given for? and what is is usually given IV?

Answer 23

A few days or a few weeks

usually given after an mi heart attack or a Pulmonary embolism in the lung to prevent the clot from growing

Question 24

What do heparin SQ end in? and what are they called?

Answer 24

parin like:
enoxaparin
Dalteparin

LESS CHANCE OF BLEEDING
LOWER WEIGHT MOLECULAR HEPARIN

Question 25

What is the key term as to why heparin SQ is given?

Answer 25

PREVENTION OF CLOTS AFTER SURGERY

Question 26

How is SQ heparin administered?

Answer 26

1. ) 25 GAGE NEEDLE with 5/8 inch
2. ) 90 DEGREE ANGLE
3. ) 2 inches from the UMBILICUS

NEVER THE THIGH JUST THE UMBILICUS

Question 27

what should NEVER be done with LMW heparin injections?

Answer 27

1. ) NEVER ASPIRATE SQ injection

2. ) NEVER RUB THE SITE

Question 28

what is a normal finding after a SQ injection?

Answer 28

NORMAL TO HAVE MILD PAIN, BRUISING, IRRITATION, REDNESS AT THE SITE

AN ICE CHIP CAN BE APPLIED tp help with irritation

Question 29

LWM heparin assessment priority?

Answer 29

1. ) assess hemoglobin and hematocrit before giving to patient with open fractures
2. ) Notify HCP and clarify order for enoxaparin if H/H slightly low.

Question 30

When a patient is on enoxaparin when should the HCP be notified for clarification of order?

Answer 30

1. ) H/H SLIGHTY LOW

2. ) blood PRESSURE DROPS BY 20 POINTS

Question 31

WHAT Labs are taken for LWMH like enoxaparin?

Answer 31

1.) Low platelets =FOCUS ON PLATELETS

Question 32

Key numbers for LMWH?

Answer 32

1.) platelets between 150,000 to 400,000

Question 33

When should LMWH be hold?

Answer 33

platelets less than 50,000

Question 34

what is a major risk of LMWH like enoxaparin and dalteparn?

Answer 34

HEPARIN INDUCED THROMBOCYTOPENIA

when the platelet count drops by half WITHIN 24 hours after giving any type of heparin!!!

Question 35

What is the priority action for HIT?

Answer 35

Alert the HCP

Question 36

what should be avoided when on warfarin?

Answer 36

caffeine such as coffee and teas

ethanol which is found in alcohol