Exam 4 -coagulation, fluid/electrolyte

Question 1

Hyponatremia labs

Answer 1

Na < 135

Question 2

Hyperkalemia labs

Answer 2

K above 5.0 mEq/L

Question 3

Hyokalemia labs

Answer 3

K under 3.5 mEq/L

Question 4

hypernatremia labs

Answer 4

Na > 145

Question 5

Controls the fluid, electrolyte, and pH balance in the body

3

Answer 5

kidneys, lungs and GI tract

Question 6

What hormone regulates potassium levels in/out of cells?

Answer 6

insulin

Question 7

What hormone effects potassium from kidneys

Answer 7

aldosterone

Question 8

Normal potassium range

Answer 8

3.5-5 mEq/L

Question 9

Hypernatremia signs/sx’s

Answer 9

convulsions, AMS, decreased LOC

Question 10

Hyper and hypokalemia are associated with what

Answer 10

fatal dysrhythmias and serious neuromuscular disorders

Question 11

Enoxaparin (Lovenox)

Class and MOA

Answer 11

Class: anticoagulant
MOA: binds to and accelerates the activity of antithrombin III

Question 12

Enoxaparin (Lovenox)

ADE 1, route

Answer 12

Route: only SubQ
ADE: major hemorrhage

Question 13

Heparin (unfractionated)

Class and MOA

Answer 13

Class: anticoagulant
MOA: prevents blood clots from forming by inactivating coagulation factors

Question 14

Sodium Bicarbonate (NAHCO3)

ADE 2, Interaction 1

Answer 14

ADE: Hypernatremia and fluid retention
Interactions: salicylates

Question 15

Potassium Chloride Drug (KCL)

ADE 1, contra 1, max dose, PO consideration

Answer 15

ADE: hyperkalemia effects
* generalized fatigue
* muscle weakness
* paresthesias
* flaccid paralysis
* palpitations
* Contra: K>5
Max Dose: 20mEq per hour
PO must be taken with food

Question 16

Antidote for heparin and lovenox OD

Answer 16

Protamine Sulfate

Question 17

Warfarin (Coumadin)

Class and MOA

Answer 17

Class: anticoagulant
MOA: functions as a vitamin K antagonist

Question 18

Warfarin (Coumadin)

ADE 3, Interactions 3

Answer 18

ADE: bleeding/hemorrhage, tissue necrosis/gangrene, GI irritation
Interactions: NSAIDS, aspirin, alcohol

Question 19

Dabigatran (Pradaxa)

Class and MOA

Answer 19

Class: anticoagulant
MOA: directly binds to the active site of the thrombin enzyme, preventing it from converting fibrinogen into fibrin and thus inhibiting clot formation

Question 20

Dabigatran (Pradaxa)

ADE 2

Answer 20

ADE: bleeding/hemorrhage, GI irritation

Question 21

Clopidogrel (Plavix)

Class and MOA

Answer 21

Class: Antiplatelet
MOA: prevent platelets from forming together

Question 22

Clopidogrel (Plavix)

ADE 3, contra 1

Answer 22

ADE: bleeding, Thrombotic Thrombocytopenia Purpura (TTP), SJS/TEN
Contra: pregnancy

Question 23

Vitamin K foods

13 (+2)

Answer 23

• collard greens
• cabbage
• broccoli
• brussel sprouts
• pesto
• coleslaw
• green beans
• kiwi
• blackberries & blueberries
• prunes
• ranch
• soybeans
• spinach & kale

Question 24

All anticoagulants and antiplatelets should have what lab(s) checked?

Answer 24

• hemoglobin
• platelets
• AST/ALT
• PT/aPTT

Question 25

Thrombocytopenia

Answer 25

decreaced number of platelets

Question 26

Signs of thrombocytopenia and bleeding

6

Answer 26

• bleeding gums
• nosebleeds
• extensive bruising
• petechiae
• dark stools
• pink urine

Question 27

Venous stasis

Answer 27

• aka venous insufficiency
• veins and the valves allow blood to pool rather than move back to heart

Question 28

PE signs/sx’s

6

Answer 28

• cough
• chest pain
• tachypnea
• dyspnea
• tachycardia
• hemoptysis

Question 29

Risk factors for clots

Answer 29

• Immobility
• major trauma
• major surgery
• hypercoagulability states (cancer, lupus, pregnancy)
• drug therapy (estrogen increases likelyhood)