Clotting Flashcards
Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)?
An INR of 4.8
The INR of 4.8 is too high. The dosage of warfarin is adjusted to maintain an INR between 2 and 3.
Which statement by a patient indicates additional teaching is required about the medication warfarin?
“I will increase the intake of green, leafy vegetables for a more healthful diet.”
Foods such as green, leafy vegetables have high levels of vitamin K. Warfarin is an
anticoagulant that acts by interfering with vitamin K-dependent clotting factors. If the amount
of vitamin K is increased in the diet, the medication dose may need to be adjusted.
A patient states that his legs have pain with walking that decreases with rest. The nurse
observes absence of hair on the patient’s lower leg and the patient has a thready, posterior
tibial pulse. How would the nurse position the patient’s legs?
Dependent position
A patient with arterial insufficiency is taught to position their legs in a dependent position to
use gravity to help perfuse the tissues.
The nurse would expect to administer an anticoagulant to a patient following which surgery?
Hip replacement
Prophylactic anticoagulation is used for hip replacement because of the high risk of
developing a deep vein thrombosis after hip replacement
A patient on a medical surgical unit has a platelet count of 90,000 per mm3. The nurse knows to include which of the following precautions in discharge instructions?
Use a soft bristle toothbrush
The use of a soft bristle toothbrush will help prevent bleeding of the gums in a patient with thrombocytopenia
Remember: 150,000-400,000 mm3
The nurse would anticipate that which of the following patient conditions will be treated with the collaborative treatment of regular phlebotomies?
Polycythemia
The removal of blood by using phlebotomy is used for thrombocytopenia to decrease the
blood volume and decrease blood viscosity to prevent the formation of blood clots.
The nurse is making a home visit to a patient who was discharged from the hospital on
Lovenox and warfarin following replacement of the patient’s pacemaker. Which observation
indicates excessive bleeding? (Multiple Response.)
New ecchymosis on the abdomen A nosebleed that does not stop with pressure Extreme fatigue Pallor Sudden onset of severe headache
Excessive bleeding includes large bruises that may be increasing in size, nosebleeds, extreme fatigue from decreased tissue oxygenation due to decreased hemoglobin, and sudden onset of a severe headache, which may indicate a cerebral hemorrhage.
