coagulation/GI questions from in class

Question 1

Platelet levels

Answer 1

150,000-400,000

Question 2

things needed to clot

Answer 2

i. tissue factor
ii. -functioning liver
iii. -calcium
iv. -phospholipids
v. -platelets
vi. -intrinsic and extrinsic factors

Question 3

what system does warfarin work on

Answer 3

extrinsic

Question 4

what system does heparin work on

Answer 4

intrinsic

Question 5

what labs monitor clotting?

Answer 5

i. PT-extrinsic
ii. INR-extrinsic
iii. aPTT-intrinsic pathway
iv. XA assay-intrinsic

Question 6

what would you find on assessment if your patient has prolonged clotting

Answer 6

i. INR-high
ii. PT-high
iii. aPTT-high
iv. exam: bruising, petechia, gingival bleeding, gi bleeding, abd pain that is sudden, cranial bleeding (headache, neuro deficit)

Question 7

what would you find on assessment if your patient has decreased clotting time

Answer 7

i. INR-decreased
ii. PT-decreased
iii. aPTT- decreased
iv. exam: DVT, chest. pain, tender, hot, red, swollen, PE (tachycardia, increased RR, decreased O2, emending doom, diaphoretic)

Question 8

types of coag drugs

Answer 8

antiplatelets
thrombolytics
anticoagulants

Question 9

antiplatelets

Answer 9

aspirin

clopidogrel

Question 10

thrombolytics

Answer 10

TPA (ateplase)

Question 11

anticoagulants

Answer 11

i. Heparin-intrinsic
1. effectiveness: aPTT and XA
ii. warfarin-extrinsic
1. measure effectiveness with INR
2. therapeutic: 2-3
iii. rivaroxaban

Question 12

when would they be on anticoag vs antiplatelet

Answer 12

a. depends on why they are clotting
b. antiplatelet: arterial clotting
c. anticoagulant: venous clotting

Question 13

how does coumadin (warfarin) work

Answer 13

vit. K is needed for the clotting process so it goes against vitamin K and stops the clotting process (reduces the formation of clots)
b. works on the clotting cascade and prevents your body from forming clots