Ch 48 Drugs Affecting Blood Coagulation

Question 1

What happens during a blood vessel injury?

Answer 1

• local vasoconstriction seals off small injury
• platelet aggregation forms a platelet plug
• hangman factor is activated
• intrinsic pathway converts prothrombin to thrombin to seal system
  -extrinsic pathway clots the blood that has leaked out fo the vascular system

Question 2

what is a platelet?

Answer 2

a tiny disc shaped piece of cell that is found in the blood and spleen; very large pieces of very large cells in the bone marrow called magakaryocytes

Question 3

what is thromboembolic disorder?

Answer 3

conditions that predispose a person to the formation of clots and emboli

Question 4

what is hemorrhagic disorder?

Answer 4

disorder in which excess bleeding occurs

Question 5

what are adverse reactions in blood related medications?

Answer 5

increased bleeding, dizziness, bone marrow suppression, alopecia, dermatitis

Question 6

what are examples of antiplatelet medication?

Answer 6

Aspirin

Question 7

what is the action of anti platelet medication?

Answer 7

inhibit platelet adhesion and aggregation by blocking receptor sites on the platelet membrane

Question 8

what are the uses of aspirin?

Answer 8

anti platelet, analgesic, antipyretic, anti inflammatory, reduce risk of stroke and MI

Question 9

What are adverse effects of anti platelet medications?

Answer 9

bleeding, headache, dizziness, weakness, GI upset

Question 10

what should the nurse consider when giving anti platelet medication?

Answer 10

use cautiously in patients with a bleeding disorder, had recent surgery, or closed head injury

Question 11

What are examples of anticoagulant medication?

Answer 11

Heparin, Warfarin (Coumadin)

Question 12

what is the action of anticoagulant medication?

Answer 12

interfere with the normal clotting cascade

Question 13

what do anticoagulant medications treat?

Answer 13

DVT, Pulmonary Embolism

Question 14

what do anticoagulant medications prevent?

Answer 14

clots

Question 15

what route do you give anticoagulant medication for prevention?

Answer 15

Sub-Q

Question 16

what route do you give anticoagulant medication for treatment?

Answer 16

IV

Question 17

what are the adverse effects of anticoagulant medications?

Answer 17

bleeding, bone marrow depression, hepatic dysfunction, painful erection, GI upset

Question 18

What is the antidote for heparin?

Answer 18

Protamine Sulfate

Question 19

what is the antidote for warfarin?

Answer 19

vitamin K

Question 20

what lab values are important when giving heparin?

Answer 20

aPPT
PPT

Question 21

what lab values are important when giving warfarin?

Answer 21

PT, INR

Question 22

what medications interact with heparin?

Answer 22

nitroglycerin

Question 23

what route do you give heparin?

Answer 23

IV, Sub-Q

Question 24

what route do you give warfarin?

Answer 24

oral

Question 25

what is aPPT (activated partial thromboplastin time) ?

Answer 25

a test of activated blood coagulation used to evaluate the clotting factors fo the intrinsic pathway

Question 26

what is PTT (partial thromboplastin time)?

Answer 26

a test used to measure the time taken for the blood clotting in order to diagnose bleeding problems

Question 27

what is the reference range for aPPT?

Answer 27

30-40 seconds

Question 28

what is the reference range for PTT?

Answer 28

60-70 seconds

Question 29

what is the normal range for PT (prothrombin time)?

Answer 29

11 to 13.5 seconds

Question 30

what is the normal INR range?

Answer 30

0.8 to 1.1 seconds

Question 31

what is the normal INR range on Warfarin?

Answer 31

2-3 seconds

Question 32

what is the normal INR range with a mechanical heart valve?

Answer 32

2.5-3.5 seconds

Question 33

If the INR is too high, what is the patient at risk for?

Answer 33

bleeding

Question 34

If the INR is too low, what is the patient at risk for?

Answer 34

blood clots

Question 35

what foods are high in vitamin K?

Answer 35

leafy green vegetables, kiwi, organ meats, cashews

Question 36

what is an example of a low molecular weight heparin?

Answer 36

Enoxaparin (lovenox)

Question 37

what is the action of low molecular weight heparin?

Answer 37

inhibit thrombus and clot formation by blocking factors Xa and Lia

Question 38

what is the benefit of a low molecular weight heparin?

Answer 38

do not greatly affect thrombin, clouting, or prothrombin times therefore causes fewer systemic adverse affects

Question 39

when is low molecular weight heparin used?

Answer 39

prevention of clots and emboli formation after surgeries or during bed rest

Question 40

what is the route and injection site of low molecular weight heparin?

Answer 40

sub-q in the love handles

Question 41

what are examples of thrombolytic agents?

Answer 41

Urokinase (abbokinase) alteplase (activase) reteplase (retevase)

Question 42

what is the medication ending for thrombolytic agents?

Answer 42

ASE

Question 43

what is the action of thrombolytic agents?

Answer 43

activates plasminogen to plasmin, which breaks down fibrin and dissolves the clot

Question 44

what are thrombolytic agents used for?

Answer 44

thrombus from stroke, MI, PE ; does not prevent

Question 45

what are the adverse effects of thrombolytic agents?

Answer 45

bleeding, cardiac arrhythmias, hypotension

Question 46

what should a nurse consider when giving thrombolytic agents?

Answer 46

do not give with hemorrhagic stroke, only ischemic medication only works within a specific time frame

Question 47

what is the route for thrombolytic agents?

Answer 47

injections/IV