Anticoagulants, Diuretics and Pain Meds Flashcards
Heparin is an
Anticoagulant that helps prevent blood clots from forming and helps keep existing blood clots from getting bigger
What is the antagonist (antidote) to Heparin?
Protamine
What levels are monitored when a client is on Heparin?
aPTT (activated partial thromboplastin time)
Normal level of aPTT
30-40
Warfarin (Coumadin) is an
Anticoagulant that helps prevent blood clots from forming
What is the antagonist (antidote) to Warfarin?
Phytonadione (Vit K)
What levels are monitored when a client is on Warfarin?
PT/INR (prothrombin time/international normalized ration)
Normal level of PT/INR
2-3
Thiazide diuretics and their action site
Hydrochlorothiazide (HCTZ) and Metolazone
In the distal convoluted tubule of the nephron
One side effect of thiazides and what to monitor
Hypokalemia
Nurse should monitor BMP
What symptoms could occur if a client that is taking HCTZ became dehydrated?
B/P could drop too low
Client could become dizzy and fall
Client could have hyponatremia
Client may have AMS
When should clients take diuretics like metolazone?
First thing in the AM
Loop diuretics and their action site
(Lasix) furosemide
(Bumex) bumetanide
In the ascending loop of Henle
What are some therapeutic effects of furosemide?
Large amounts of watery urine
Decreased edema
Vasodilation
What client is especially at risk when taking loop diuretics?
Bonus: Why?
Clients with severe, end-stage heart disease
Clients with weak hearts are not able to pump normal amounts of fluid and may be kept mildly to moderately dehydrated to prevent the weakened heart from fluid overloading.
What are two LMWH (low molecular weight heparin) medications?
enoxaparin (Lovenox)
dalteparin (Fragmin)
What is the antagonist (antidote) to enoxaparin?
Protamine
How many mg of protamine should be given to reverse the action of enoxaparin?
1mg of protamine for every mg of enoxaparin
LMWH meds are given deep subcut. When given in the abdomen, how far away from the umbilicus should it be given?
At least 2 inches away
When should LMWHs be given very cautiously?
When the client is receiving a spinal or epidural anesthesia or pain management
What is Ofirmev?
IV Acetaminophen
What is the daily limit for acetaminophen?
No more than 4,000mg
What are common opioid drugs?
morphine
hydromorphone (Dilaudid)
fentanyl (Dragesic, Sublime)
methadone (Dolphine)
oxycodone (Oxycontin, Percocet)
What is the antagonist to opioids?
naloxone (Narcan)
