Chapter 18 - Hematopoietic System Flashcards
Kenneth is taking warfarin and is asking about what he can take for minor aches and pains. The best recommendation is
Acetaminophen, not to exceed 4 g per day
Juanita had a DVT and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider why she was getting both medications while in the hospital. The best response is to
Explain that warfarin is off and started while patient is still on heparin because warfarin takes a few days to reach effectiveness
The safest drug used to treat pregnant women who require anticoagulant therapy is
Heparin
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should be considered in which patients?
Overweight or obese patients
Cecil and his wife are traveling to South East Asia on vacation and he has come into the clinic to review his medications. He is healthy with only mild hypertension that is well-controlled. He asks about getting a shot to prevent blood clots like his friend Ralph did before international travel. The correct response would be
Explain that Cecil is not at high risk of a blood clot and provide education about how to prevent blood clots while traveling
Robert, age 51 years has been told by his primary care provider to take an aspirin a day. Why would this be recommended?
Aspirin has antiplatelet activity and prevent clots that cause heart attacks
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity she would need to be evaluated for
Tinnitus
Patient education when prescribing clopidorel includes
Do not take any herbal products without discussing with the provider
For patients taking warfarin INR s are best drawn
In the morning if the patient takes their warfarin at night
Patients receiving heparin therapy require monitoring of
Platelets every 2 to 3 days for thrombocytopenia that may occur on day four of therapy
The routine monitoring recommended for low molecular weight heparin is
Factor Xa Levels if patient is pregnant
When writing a prescription for warfarin it is common to write —
The brand name of warfarin and do not substitute
Education of patients who are taking warfarin includes discussing their diet. Instructions include
Avoiding high vitamin K containing foods
Patients who are being treated with Epoetin alpha need to be monitored for the development of
Thrombocytopenia
The FDA issued a safety announcement regarding the use of erythropoiesis-stimulating agents in 2010 with the recommendation that
The risk of tumor development be explained to cancer patients on ESA therapy
When patients are started on DARBEPOETIN alpha they need monitoring of their blood counts to determine a dosage adjustment in
Six weeks if they are a cancer patient
Jim is having hip replacement surgery and would like to self donate blood for the surgery. In addition to being prescribed Epogen alpha he should also be prescribed
Iron, to start when the Epogen starts
Monitoring for a patient being prescribed iron for iron deficiency anemia includes
Reticulocyte count one week after therapy is started
Patient education regarding taking iron replacement includes
Iron is best taken on an empty stomach with juice
Patients with pernicious anemia require treatment with
Vitamin B 12
The first lab values that vitamin B 12 therapy is adequately treating pernicious anemia is
Reticulocyte count begins to rise
Patients who are beginning therapy with vitamin B 12 need to be monitored for
Hypokalemia that occurs in the first 48 hours
