LAB - 7.3 - Bloodclotting and Anticoagulants Flashcards

1
Q

the stopping of blood flow and is an essential mechanism that protects the body from both external and internal injury.

A

Hemostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Without efficient hemostasis, bleeding from wounds or internal injuries would lead to shock and perhaps death

A

NA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hemostasis is a complex process involving a number of clotting factors that are activated in a series of sequential steps, sometimes referred to as a cascade

A

NA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Too much clotting can be just as dangerous

A

NA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diseases can affect hemostasis like MI, cerebrovascular accident (CVA), venous thrombus, valvular heart disease

A

NA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4 steps to hemostasis:

A

Venal injury

Venal spasm

Platelets adhere to injury site and aggregate to form a plug.

Formation of insoluble fibrin strands and coagulation.4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hemostasis is achieved once a ___ is formed, protecting the body from excessive hemorrhage

A

blood clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The clot may restrict blood flow to the affected area; circulation must eventually be restored so that the tissue can resume normal activities

A

NA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The process of clot removal is called ___. It is initiated within ___ hours of clot formation and continues until the clot is dissolved

A

fibrinolysis

24 to 48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Disorders that directly affect the coagulation process fall into two main categories:

A

thromboembolic disorders

hemorrhagic disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

conditions that involve overproduction of clots

A

thromboembolic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

conditions in which the clotting process is not working effectively, resulting in risk for excess bleeding

A

hemorrhagic disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Various drugs are used to maintain or restore circulation, The three major groups are:

A

(1) anticoagulants,
(2) antiplatelet, and
(3) thrombolytics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Drugs used to prolong bleeding time and thereby prevent blood clots from forming

A

Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anticoagulants are also called as

A

blood thinners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

These drugs do not dissolve clots that have already formed, but rather act prophylactically to prevent new clots from forming

A

Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Used in patients with venous and arterial disorders that put them at high risk for clot formation

A

Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Examples of conditions with venous problems

A

thrombosis, pulmonary embolism, & arterial problems like coronary thrombosis, and MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Contrainidication for Anticoagulants

A

Contraindicated with active bleeding, except for DIC, bleeding disorders, or blood dyscracias, ulcers, liver and kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Side effects for Anticoagulants

A

hemorrhage, hematuria, epistaxis, ecchymosis, bleeding gums, thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Examples of Anticoagulants

A

warfarin (Coumadin)

Dabigatran (Pradaxa)

Rivaroxaban (Xarelto)

Heparin

22
Q

Oral drug
Works by interfering with the formation of vitamin K-dependent clotting factors in the liver

A

warfarin (Coumadin)

23
Q

is used to reverse the effects of warfarin.

A

Vitamin K

24
Q

drug administration route for warfarin (Coumadin)

A

oral

25
Q

Tests for Coudin:

A

Prothrombin Time (PT)
International Normalized Ratio (INR)

26
Q

Normal Lab Values for Coumadin:

A

PT - 11 – 12.5 seconds
INR - 0.8 – 1.1

27
Q

Therapeutic Lab Values for Coumadin:

A

PT - 15.5 – 35 seconds
INR - 2 – 3

28
Q

A longer than normal prothrombin time (PT) can mean a lack of or low level of one or more blood clotting factors (factors I, II, V, VII, or X).

A

NA

29
Q

Blood clotting factors

A

factors I, II, V, VII, or X

30
Q

This can also mean a lack of vitamin K or due liver disease, such as cirrhosis; or that a liver injury has occurred

A

A longer than normal prothrombin time (PT)

31
Q

This can also mean a lack of vitamin K or due liver disease, such as cirrhosis; or that a liver injury has occurred

A

A longer than normal prothrombin time (PT)

32
Q

This can be due to Disseminated Intravascular Coagulation (DIC) or It can be due to Disseminated Intravascular Coagulation (DIC)

A

A longer than normal prothrombin time (PT)

33
Q

It can also be caused by treatment with blood-thinning medicines, such as warfarin (Coumadin) or, in rare cases, heparin.

A

A longer than normal prothrombin time (PT)

34
Q

this anticoagulant directly inhibits thrombin, which blocks the last step to clot formation

A

Dabigatran (Pradaxa)

35
Q

this anticoagulant is approved to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF)

A

Dabigatran (Pradaxa)

36
Q

this is the drug of choice over warfarin for treating hemorraghic conditions

A

Dabigatran (Pradaxa)

37
Q

this anticoagulant is a factor Xa inhibitor that stops the coagulation cascade at this early step.

A

Rivaroxaban (Xarelto)

38
Q

the factor being inhibited by Rivoraxaban

A

factor Xa

39
Q

this anticoagulant is approved to prevent deep vein thrombosis, which might lead to pulmonary embolism, in patients undergoing knee or hip replacement surgery.

A

Rivaroxaban (Xarelto)

40
Q

this anticoagulant is a naturally occurring substance that inhibits the conversion of prothrombin to thrombin, thus blocking the conversion of fibrinogen to fibrin – the final step in clot formation

A

Heparin

41
Q

route of administration for Heparin

A

Injected IV or subcutaneously and has an immediate onset of action

42
Q

this is low molecular weight heparin

A

Enoxaparin

43
Q

Low molecular weight heparin like Enoxaparin route of adm.

A

given subcutaneously do not require the same intense monitoring like heparin

44
Q

the antidote for heparin overdose

A

Protamine sulfate

45
Q

the Heparin Test

A

Activated Partial Thromboplastin Time (aPTT)

46
Q

Normal Lab Values for aPTT:

A

30 – 40 seconds

47
Q

Therapeutic Lab Values for aPTT:

A

45 – 100 seconds

48
Q

is a screening test that helps evaluate a person’s ability to appropriately form blood clots. It measures the number of seconds it takes for a clot to form in a sample of blood.

A

The activated partial thromboplastin time (aPTT))

49
Q

This assesses the amount and the function of certain proteins in the blood called coagulation or clotting factors.

A

aPTT

50
Q

Nursing Implementation for Anticoagulants

A

Evaluate for therapeutic effects of warfarin like the prothrombin time (PT) 1.5 to 2.5 times the control value or ratio of PT to International Normalized Ratio (INR) of 2 to 3 to evaluate the effectiveness of the drug dose.

Evaluate for therapeutic effects of heparin like the activated partial thromboplastin time which is 1.5 to 3 times the control value to evaluate the effectiveness of the drug dose.

Evaluate the patient regularly for any sign of blood loss like petechiae, bleeding gums, bruises, dark-colored stools, dark-colored urine

Provide safety measures, such as use of an electric razor and avoidance of contact sports to decrease the risk of bleeding.

Provide increased precautions against bleeding during invasive procedures; use of pressure dressings; avoid IM injections; and do not rub subcutenous injection sites