Clotting

Question 1

Anticoagulant agents

Answer 1

Warfarin, Heparin, low-molecular-weight heparin

Question 2

Antiplatelet agents

Answer 2

Aspirin, Clopidogrel

Question 3

Clotting Factor

Answer 3

Desmopressin acetate (promotes clotting, antidiuretic)

Question 4

Platelet replacemet agents

Answer 4

Platelet growth factor, platelet transfusion

Question 5

Thrombolytic agents

Answer 5

Streptokinase, alteplase, tenectepase, reteplase

Question 6

Blood transfusion

Answer 6

For severe hemorrhage

Question 7

Thrombin inhibitors

Answer 7

Helps prevent clot formation

Question 8

Heparing/Coumadin Bridge

Answer 8

Heparin is given to the patient until Coumadin reaches a therapeutic level

Question 9

Warfarin - PO anticoagulation

Answer 9

Tx of venous thromosis, tx of thrombus formation in pt w/ a-fib or prosthetic heart valves. Prevention of recurrent MI, TIA, PE, or DVT.

Question 10

Warfarin Complications

Answer 10

Hemorrhage; monitor VS, observe for bleeding - gums, bruising, etc. Baseline PT and monitor INR. Overdose - D/C Warfarin and admin. vit K. Monitor liver enzymes and assess for jaundice.

Question 11

Most common lab to monitor Warfarin

Answer 11

Prothrombin time (PT) ration usually expressed as the internation normalized ration. (INR)

Goal INR is 2-3 w. target of 2.5.

Low molecular weight Heparin (Enoxaparin) and the facotr Xa (fondaparinux) and direct thromib inhibitors do not require monitoring.

Question 12

Foods high in Vitamin K

Answer 12

Leafy greens
Lettuce
Cooked spinach
Brussel sprouts
Mayo
cabbage
broccoli
canola
soybean oil

Question 13

Concurrent use of these meds are discouraged on Warfarin

Answer 13

Heparin
Aspirin
Acetaminophen

Question 14

Heparin reversal agent

Answer 14

Protamine sulfate

Question 15

Warfarin reversal agent

Answer 15

Vitamin K

Question 16

Most common lab to monitor Heparin

Answer 16

PTT

Question 17

Heparin Therapeutic uses

Answer 17

DVT, PE

Question 18

Normal Platelet Count

Answer 18

150,000-450,000 mm3

Question 19

S/S of Excessive Bleeding

Answer 19

Bruising, Increased HR, Decreased BP, bleeding gums

Question 20

Primary Prevention for clotting

Answer 20

Smoking cessation, hydration, exercise (7hrs/week), Prevention of stasis (High-risk patients) - increase mobilization, Compression socks, Weight loss.

Question 21

Clinical Manage

Answer 21

Direct pressure, Ice, Topical agents (Gelfoam, fibrin foam), Blood volume replacements, critical care management if hemorrhage leads to shock state.

Question 22

Clinical Management

Answer 22

Direct pressure, Ice, Topical agents (Gelfoam, fibrin foam), Blood volume replacements, critical care management if hemorrhage leads to shock state.

Question 23

Extremity intervention for Venous Thrombus

Answer 23

Elevate the extremity

Question 24

Activity intervention for DVT

Answer 24

Bed rest to prevent mobilization of clot

Question 25

Thrombolytic agents are:

Answer 25

Clot busting agents. Given to dissolve clots that have already formed

Question 26

Extremity intervention for Arterial Thrombus

Answer 26

Legs dependent - low

Question 27

Hematoma

Answer 27

Pooling of blood beneath the skin. Like a bruise, but is raised.

Question 28

Wells Score

Answer 28

Set of questions used to evaluate for risk of clots. Questions are answered “yes” or “no.” The higher the score, the higher the risk.