Ch 32 Coagulation

Question 0

What does venous thrombosis Iead to?

Answer 0

PE
post phlebitic syndrome ( a syndrome occurring within 1 yr of a DVT with chronic, potentially disabling leg swelling, pain, venous dilation and skin induration.

Question 1

What is arterial thrombosis the most common cause of

Answer 1

MI
Strike
Limb gangrene

Question 2

Hemostasis

Answer 2

A series of events that occurs to prevent blood loss after a injury

Question 3

Thrombolytics

Answer 3

Dissolve clots

Question 4

Anticoagulants

Answer 4

Prevents clots only

Question 5

Hemophilia

Answer 5

Uncontrollable bleeding

Question 6

Where are most clotting factors produced

Answer 6

In the liver, therefor cirrhosis and hepatitis would prevent the synthesis of clotting factors

Question 7

Are clotting factors active

Answer 7

They are inactive in the blood until a injury activates them

Question 8

What does plasmin break down

Answer 8

Fibrin
Fibrinogen
And other plasma proteins

Question 9

How is a arterial thrombus formed

Answer 9

It is formed under high flow conditions

Question 10

How are venous thrombus’ formed

Answer 10

They are formed from stasis of the blood

Question 11

What is a embolism

Answer 11

It is any dissolved matter carried in a blood or lymph vessel to another location where it lodges and occluded the vessel.

Question 12

What does hyper coagulability result from

Answer 12

It results from either a increase in platelets or an increase in the activity of clotting factors or both.

Question 13

Why does excessive bleeding occur

Answer 13

Because the body cannot form a stable clot in response to injury

Question 14

Intrinsic factor

Answer 14

All the clotting factors already present in the blood

Question 15

Vitamin k

Answer 15

Given as a injection for thin blood it helps with the viscosity of the blood

Question 16

Where is vitamin k synthesized

Answer 16

In the colon bowels

Question 17

What ration is heparin always given

Answer 17

1:1 ratio

Question 18

What may continued use of heparin lead to

Answer 18

Osteoporosis

Question 19

When administering Coumadin what labs should be monitored

Answer 19

PT which is an extrinsic factor

Question 20

Coumadin is linked to what

Answer 20

Vitamin k

Question 21

What is the treatment of a overdose of heparin

Answer 21

Protamine

Which is an intrinsic factor measure PTT

Question 22

Can aspirin and warfarin be given together

Answer 22

Yes

Question 23

What is the normal PT

Answer 23

11-16 seconds

Question 24

What does vitamin k do

Answer 24

It helps clot the blood it is a fat soluble vitamin

Question 25

What is clopidogrel ( plavix)

Answer 25

It is an anti platelet that decreases the ability of platelets to stick together. Severe neutropenia is a adverse effect

Question 26

For clot formation what is needed

Answer 26

Fibrin

Question 27

What is the shelf life of all blood products

Answer 27

4 hrs or less.

Question 28

What are hemostatic drugs

Answer 28

It stops blood loss by enhancing blood coagulation( the goal is to form fibrin to stop blood loss) there are two types; systemic and topical.

Question 29

What is parenteral heparin

Answer 29

It is an anticoagulant that interferes with the final steps in the clotting cascade It rapidly promotes the inactivation of factor X which in turn prevents the conversion prothrombin to thrombin

Question 30

What route is heparin given

Answer 30

IV SC Metabolized in the liver and excreted in the kidneys

Question 31

What are adverse effects of heparin

Answer 31

Bleeding and thrombocytopenia

Question 32

What lab should be monitored on heparin therapy

Answer 32

aPTT

Question 33

What is the antidote for heparin

Answer 33

Protamine sulfate

Question 34

What is warfarin used for

Answer 34

It is used prophylactically for ppl with long term risk for thrombus formation

Question 35

What is the pharmacodynamics of warfarin

Answer 35

It competitively blocks vitamin k at its sites of action

Question 36

What are adverse effects of Coumadin

Answer 36

Bleeding and HEMMORRHAGE

Question 37

What should be monitored in a pt receiving warfarin

Answer 37

PT | INR

Question 38

What is the antidote for warfarin

Answer 38

Vitamin k | phytonadione

Question 39

What are low molecular weight heparin used for (LMWH)

Answer 39

Prevention of DVT PE after surgical procedures known to increase the risk of such complications The anticoagulant effect is increased by digitalis, tetracyclines, nicotine, and antihistamines

Question 40

What are adverse effects of LMW

Answer 40

Life threatening bleeding Anemia Thrombocytopenia Local pain or discomfort

Question 41

What are contraindications to heparin and LMWH

Answer 41

``` Active HEMMORRHAGE GI ulcerations Hemophilia Thrombocytopenia Polycythemia Vera Severe liver or kidney disease HTN Recent brain, spinal cord injury, or hemorrhagic stroke Caution is exercised in ppl with diabetes, HTN, endocarditis, ```

Question 42

Name LMWH

Answer 42

Dalteparin Enoxaparin Fondaparinux Tinzaparin

Question 43

What is the prototype anti platelet drug

Answer 43

Clopidogrel ( plavix). Aspirin It is used to reduce atherosclerotic events It is administered orally metabolized in the liver

Question 44

What are adverse effects of anti platelet drugs

Answer 44

Bleeding GI distress Neutropenia

Question 45

What are drug interactions of anti platelet drugs

Answer 45

``` Tamoxifen Tolbutamide Warfarin Torsemide Fluvastatin And many NSAIDS ```

Question 46

Clopidogrel should be cautioned in children younger than what

Answer 46

18

Question 47

What is the most serious adverse effect of clopidogrel

Answer 47

Neutropenia

Question 48

What is the prototype Thrombolytic drug

Answer 48

Alteplase, recombinant ( activate, cathflo, activase)

Question 49

What does Thrombolytic drugs do

Answer 49

Converts plasminogen to plasmin | It is used in thromboembolic conditions

Question 50

Thrombolytic drugs are what type of drug

Answer 50

They are given in emergency situations and can have life threatening adverse effects the pt should be hooked to a cardiac monitor both during the treatment and afterwards

Question 51

What pregnancy category is alteplase

Answer 51

C

Question 52

What are clotting factors

Answer 52

They treat deficiencies of normal clotting factors replacement of theses factors is the treatment of choice Prototype drug: anti hemophilia factor It is essential for the conversion of prothrombin to thrombin.

Question 53

What are adverse effects of the antihemophillic factor

Answer 53

Anaphylaxis, urticaria, nausea,,and chill

Question 54

How should AHF be stored

Answer 54

It should be refrigerated until used before reconstitution, warm the concentrate and the diliuent to room temp... After dilution, administer within 3 hours to prevent bacterial growth Instruct client to observer for bleeding gums, skin, urine, stool, or emesis.

Question 55

What are hemostatic drugs

Answer 55

They stop blood loss by enhancing blood coagulation

Question 56

What do systemic hemostatic drugs do

Answer 56

They interfere with the breakdown of clots

Question 57

What do topical hemostatic agents do

Answer 57

They are used to control small amounts of bleeding for oozing, usually following surgery. Prototype drug; aminocaproic acid ( Amicar)

Question 58

What are adverse effects of aminocaproic acid ( hemostatic drug)

Answer 58

GI distress Headache, dizziness, seizures, hypotension, arrhythmias, tinnitus, nasal congestion, vomiting, abdominal cramps, diarrhea, diuresis

Question 59

What are drug interactions of hemostatic drugs

Answer 59

Oral contraceptives | Estrogen

Question 60

How can one minimize adverse effects of hemostatic drugs

Answer 60

Monitor vital signs Administer via IV pump Monitor I&O neurological status