Exam 4 -coagulation, fluid/electrolyte Flashcards
Hyponatremia labs
Na < 135
Hyperkalemia labs
K above 5.0 mEq/L
Hyokalemia labs
K under 3.5 mEq/L
hypernatremia labs
Na > 145
Controls the fluid, electrolyte, and pH balance in the body
3
kidneys, lungs and GI tract
What hormone regulates potassium levels in/out of cells?
insulin
What hormone effects potassium from kidneys
aldosterone
Normal potassium range
3.5-5 mEq/L
Hypernatremia signs/sx’s
convulsions, AMS, decreased LOC
Hyper and hypokalemia are associated with what
fatal dysrhythmias and serious neuromuscular disorders
Enoxaparin (Lovenox)
Class and MOA
Class: anticoagulant
MOA: binds to and accelerates the activity of antithrombin III
Enoxaparin (Lovenox)
ADE 1, route
Route: only SubQ
ADE: major hemorrhage
Heparin (unfractionated)
Class and MOA
Class: anticoagulant
MOA: prevents blood clots from forming by inactivating coagulation factors
Sodium Bicarbonate (NAHCO3)
ADE 2, Interaction 1
ADE: Hypernatremia and fluid retention
Interactions: salicylates
Potassium Chloride Drug (KCL)
ADE 1, contra 1, max dose, PO consideration
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
Antidote for heparin and lovenox OD
Protamine Sulfate
Warfarin (Coumadin)
Class and MOA
Class: anticoagulant
MOA: functions as a vitamin K antagonist
Warfarin (Coumadin)
ADE 3, Interactions 3
ADE: bleeding/hemorrhage, tissue necrosis/gangrene, GI irritation
Interactions: NSAIDS, aspirin, alcohol
Dabigatran (Pradaxa)
Class and MOA
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
Dabigatran (Pradaxa)
ADE 2
ADE: bleeding/hemorrhage, GI irritation
Clopidogrel (Plavix)
Class and MOA
Class: Antiplatelet
MOA: prevent platelets from forming together
Clopidogrel (Plavix)
ADE 3, contra 1
ADE: bleeding, Thrombotic Thrombocytopenia Purpura (TTP), SJS/TEN
Contra: pregnancy
Vitamin K foods
13 (+2)
- collard greens
- cabbage
- broccoli
- brussel sprouts
- pesto
- coleslaw
- green beans
- kiwi
- blackberries & blueberries
- prunes
- ranch
- soybeans
- spinach & kale
All anticoagulants and antiplatelets should have what lab(s) checked?
- hemoglobin
- platelets
- AST/ALT
- PT/aPTT
Thrombocytopenia
decreaced number of platelets
Signs of thrombocytopenia and bleeding
6
- bleeding gums
- nosebleeds
- extensive bruising
- petechiae
- dark stools
- pink urine
Venous stasis
- aka venous insufficiency
- veins and the valves allow blood to pool rather than move back to heart
PE signs/sx’s
6
- cough
- chest pain
- tachypnea
- dyspnea
- tachycardia
- hemoptysis
Risk factors for clots
- Immobility
- major trauma
- major surgery
- hypercoagulability states (cancer, lupus, pregnancy)
- drug therapy (estrogen increases likelyhood)
