Coagulation Modifiers

Question 1

Drugs affecting Blood coagulation: Children

Answer 1

Injury prevention
Safety precautions
What to do if bleeding begins
Drugs should be based on weight and age
Warfarin used for cardiac surgery
-xaban drugs should not be used in kids
low-molecular weight heparins: unknown safety
no indications for use of antiplatelets or thrombolytics

Question 2

Drugs affecting blood coagulation: Adults

Answer 2

Injury prevention: electric razor, soft bristled toothbrush, no contact sports
What to do if bleeding occurs: constant firm pressure, call provider
Caution with other meds due to interactions
MedicAlert Bracelet
Extreme caution in pregnancy and lactation
Periodic Blood tests: Less testing needed with newer meds

Question 3

Drugs affecting blood coagulation: Older Adults

Answer 3

Drug-Drug interactions
Impaired liver and kidney function
Blood testing: Kidney function and liver function
Start low, go slow
Safety
Careful monitoring with any additions, deletions, or changes to medication regimen including doses

Question 4

Indications for Use: Blood Disorders

Answer 4

Thromboembolic Disorder: Conditions that predispose a person to the formation of clots and emboli
Hemorrhagic Disorder: Disorder in which excess bleeding occurs

Question 5

Antiplatelets

Therapeutic Actions of Blood Coagulation Agents

Answer 5

Alter the formation of the platelet plug

Question 6

Anticoagulants

Therapeutic actions of blood coagulation agents

Answer 6

Interfere with the clotting cascade and thrombin formation

Question 7

Thrombolytic Drugs

Therapeutic actions of blood coagulation agents

Answer 7

Break down the thrombus that has been formed by stimulating the plasmin system

Question 8

Antiplatelet Agents

Answer 8

Action: Blocks the receptor site on the platelet membrane which prevents platelets from sticking together and clumping
Indication: CV diseases that are prone to clogged vessels; keep grafts open/patent; prevent cerebrovascular occlusion (strokes, TIAs); Adjunct to thrombolytic therapy after MI and to prevent another MI; Aspirin: Anti-inflammatory, analgesic and antipyretic effects
Drugs: Aspirin (Prototype), ticagrelor, clopidogrel, eptifibatide, dipyridamole

Question 9

Antiplatelet Agents - contraindications, cautions, ADE, DDI

Answer 9

Contraindications: Allergy, pregnancy/lactation
Cautions: Bleeding disorder, recent surgery, closed head injury
ADE: bleeding, headache, weakness, dizziness, GI distress
DDI: another drug that affects blood clotting, CYP3A inhibitors or inducers

Question 10

Antiplatelet: Nursing Process

Answer 10

Assess: History, pregnancy/lactation, known bleeding disorders, recent surgery or closed head injury; allergy; Physical - baseline, vitals, heart/lung sounds, skin, CNS, perfusion (pulses); Labs - clotting studies
Diagnoses: Risk for injury; acute pain; deficient knowledge
Implementation: provide small frequent meals, safety measures, increased precautions against bleeding during invasive procedures, mark chart of any patient receiving this drug, patient teaching