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Nursing Test One > Anticoagulants > Flashcards

Anticoagulants Flashcards

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1
Q

Pt time

A

12-15 seconds, prothrombin time

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2
Q

INR

A

0.8-1.2 person not receiving anticoagulants

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3
Q

INR for PE, DVT, A-Fib

A

2.0-3.0

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4
Q

INR for mechanical valves

A

3.0-4.0

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5
Q

PTT

A

25-35 seconds

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6
Q

How is heparin given?

A

With a 5/8in. needle 25 to 28 g, at a 90 degree angle

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7
Q

What is the antidote to heparin?

A

protamine sulfate

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8
Q

What is the antidote to lovenox?

A

protamine sulfate

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9
Q

What is the antidote for warfarin?

A

vitamin k

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10
Q

warfarin dietary guidelines

A

avoid alcohol, leafy greens eat consistently

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11
Q

Pradaxa antidote

A

No specific antidote, dialysis may remove

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12
Q

Do NOT administer heparin

A

IM

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13
Q

What intrinsic factor does coumadin act on?

A

IX

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14
Q

What intrinsic factors does heparin act on?

A

X & Xa

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15
Q

What factor does Coumadin act on?

A

X

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16
Q

What factor does Eliquis & Xarelto act on?

A

Xa

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17
Q

What factor does Pradaxa act on?

A

Thrombin

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18
Q

Clotting Sequence

A

X-Xa-Prothrombin-Thrombin-Fibrinogen-Fibrin

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19
Q

Process of Hemostasis

A

Injury to vessel, vessel spasm, formation of platelet plug, formation of fibrin clot, clot retraction, clot dissolution

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20
Q

What are indications for Anticoagulant therapy?

A

DVT, PE, MI, ischemic CVA, Chronic Atrial Fibrillation, Valve Replacement, DVT prophylaxix

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21
Q

Routes of Anticoagulants

A

Oral, IV, SQ

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22
Q

Route of Thrombolytics

A

IV

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23
Q

How does warfarin work?

A

Inhibits vitamin K dependent factors

24
Q

Indications for warfarin

A

a-fib, mechanical valve replacement, history of PE, VTE

25
Q

What do you do if you miss a dose of warfarin?

A

Take as soon as possible on same day, but do not double the next dose

26
Q

Notify physician when on warfarin if..

A

Serious fall or injury, red, dark brown urine or black, tarry stools

27
Q

What is Pradaxa?

A

Direct thrombin inhibitor

28
Q

How often is Pradaxa taken?

A

Twice a day

29
Q

How quickly does Pradaxa reach therapeutic levels?

A

30 min to 2 hours after PO administration

30
Q

What are indications for Pradaxa?

A

Afib not caused by heart valve problem (75-150mg 2X/day)

VTE prevention after hip/knee replacement (150-220mg 1X/day)

31
Q

Dietary restrictions Pradaxa?

A

No

32
Q

What does Pradaxa interact with?

A

Rifampin decreases effectiveness of Pradaxa

33
Q

Does Pradaxa require regular monitoring of blood levels?

A

No

34
Q

How is Xarelto taken?

A

Orally 1X/day

35
Q

Antidote for Xarelto

A

None

36
Q

Xarelto indications

A

A-fib not caused by heart valve problem (20 mg/evening meal), VTE prevention after hip/knee surgery (10 mg 1X day with or without food)

37
Q

What meds increase bleeding with Xarelto/

A

Aspirin, Nsaids, warfarin, heparin, plavix, effient, brilinta

38
Q

Eliquis-when taken? What for?

A

2X/day, 5 mg, for A-fib not caused by heart problem

39
Q

Teaching r/t anticoagulants

A

soft bristle brush, waxed floss, electric razor, medic alert bracelet, inform HCPs of use

40
Q

What does Heparin do?

A
  1. Prevents the activation of clotting factors of X and Xa

2. It inhibits the action of thrombin in forming fibrin threads

41
Q

Heparin indications

A

prevention and treatment of VTE (venous thromboembolus)

treatment of VTE, PE, CVA or TIA

42
Q

How is heparin dosed?

A

5,000-10,000 Units q 8-12 h,
IV: 4,000-5,000 Units initially & then continuous infusion of 20,000-40,000/24 h
IV patency: 10-100 units

43
Q

What do you monitor prior to and during administration heparin

A

PTT

44
Q

When injecting heparin remember..

A

Do not aspirate, do not massage site, ensure that injection is given in fatty area of abdomen at least 2 in away from the umbilicus

45
Q

When giving heparin monitor..

A

for bleeding gums, hematuria, nosebleeds, bloody sputum, and petechiae

46
Q

Protamine Sulfate each mg neutralizes how much heparin?

A

1 mg protamine sulfate neutralizes 100 units heparin

47
Q

No more than this much Protamine sulfate should be administered in any 10 min period

A

no more than 50 mg in any 10 min period or 100 mg in 2 hour period

48
Q

Why are LMWH used

A

action more predictable, less monitoring, can be used outpt, lower incidence of HIT

49
Q

Platelet Aggregate inhibitors or Antiplatelets ex

A

ASA, Plavix, Brilinta, Aggrenox,Persantine, effient

50
Q

Indications for antiplatelets

A

CAD/ACS, Hx of MI, Post cardiac surgery (valve replacements & CABG), CVA, TIA, PVD, PAD

51
Q

S/E antiplatelets

A

headache, dyspnea, nausea

52
Q

Purpose of thrombolytics

A

Dissolve thrombi and restore blood flow to heart or brain during CVA or AMI

53
Q

When to initiate thrombolytics

A

Within 3 hrs

54
Q

Most common thrombolytic

A

tPA (also Streptokinase, Urokinase, Reteplase

55
Q

CONTRAindications thrombolytics

A

recent head injury, bleeding probs, bleeding ulcer, pregnancy, surgery, trauma, UNcontrolled high blood pressure

56
Q

Nursing interventions thrombolytics

A

Hold pressure at site when drawing blood, assess for bleeding & hematomas at puncture sites, avoid IM injections

Nursing Test One (11 decks)

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