Chapter 20: Drugs that Affect Clotting Worksheet

Question 1

A 71 y/o man has been prescribed rivaoxaban (Xarelto) 20 mg orally everyday for an atrial fibrillation. He tells you that some of his friends are also taking “blood thinners” and that he is not looking forward to “all of those needle sticks” that his friends seem to get frequently. He also asks whether he needs to change his diet in any way while he is taking the drug (1) How does this drug work / Does it thin blood ?

Answer 1

No, it does not thin blood. It is part of the clotting cascade which is the process of how his body clots

Question 2

(2) What type of drug is rivaroxaban?

Answer 2

Direct thrombin inhibitor

Question 3

(3) What is/ are the major S/E of this drug?

Answer 3

Increased risk of bleeding

Question 4

(4) What will you teach this patient about needed dietary changes?

Answer 4

No

Question 5

(1) A 67 y/o man enters the ED complaining of severe chest pain that is radiating down his left arm. He is Dx with a myocardial infarction. What drug does the nurse anticipate the physician ordering for this pt:

Answer 5

Alteplase - thrombolytic used in life threatening situations

Question 6

(2) A pt (different from the above question) has been prescribed warfarin. His INR is 5.2. At what level is this dose?

Answer 6

Elevated

• Normal INR value: 08. - 1.2
• Therapeutic INR value: 2 - 3

Question 7

(3) The patient presents to the physicians office because the physician is unable tp regulate his Coumadin dosage. During the interview, the nurse finds that the patient began taking what substance, which might increase the effect of warfarin?

Answer 7

Ginseng to improve his energy (herbal supplement)

Question 8

(4) What is the appropriate lab test to monitor Heparin and how do we know if the dose is therapeutic?

Answer 8

aPTT - 1.5 - 2.5 (Twice the control value) is therapeutic