Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology coagulation and resp drugs > Med affecting coagulation > Flashcards

Med affecting coagulation Flashcards

1
Q

What is the action of an anticoagulant?

A

Prevents clotting by activating antithrombin-hence inactivates both thrombin and factor Xa.

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

Heparin is an anticoagulant-what are some therapeutic uses?/

A

Stroke, PE, DVT, prophylaxis against post op venous thrombosis ( hip/knee & abd surgery

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

What are the complications of heparin?

A

Hemorrhage, the risk of hematoma at a puncture site for spinal or epidural medication is increased while on heparin

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

What drug is given for heparin toxicity?

A

Protamine ( binds with heparin & forms a heparin-protamine complex with no anticoagulant properties). Give it IV slowly

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

What are nursing actions to know about heparin?

A

Advise clients to observe for bleeding, increased heart rate, decreased B/P, bruising, petechiae, hematomas, black-tarry stools, and labs must be monitored ( aPTT). Teach patients to use an electric razor & soft toothbrush

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

What is the lab test for heparin?

A

aPTT ( the lab value should be at 1.5-2 times the baseline

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

What are the contraindications for Heparin?

A

Contraindicated for a patient with a low platelet count, it should NOT be used during or after eye, brain, or spinal cord surgery, or lumbar puncture.

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

What are drug interactions with heparin?

A

Aspirin, NSAIDs, Garlic, Ginger, Glucosamine, Ginkgo biloba, Resveratrol- ( skin of grapes & blueberries)

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

What medication is a Vitamin K inhibitor?

A

Warfarin ( Brand name coumadin)

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

What is the action of Coumarins?

A

Antagonizes vitamin K which prevents the synthesis of 4 coagulation factors factor V11, IX, X & prothrombin

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

When is warfarin used? What conditions?

A

Prevention of venous thrombosis & PE, Afib, & Prosthetic heart valves

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

What are the complications of warfarin?

A

Hemorrhage & Hepatitis

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

If a patient has bleeding, what is given?

A

Vitamin K

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

If vitamin K cannot control the bleeding, what is ordered next?

A

The provider will order Fresh Frozen Plasma

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

What is the lab test for Warfarin ( Brand name - Coumadin)?

A

PT/INR

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

Enoxaparin- know what this does; Understand the differences between this and heparin

A

LMW, more effective for lowering the risk of venous thromboembolism ( VTE) in patients with acute stroke- can give it home, unlike heparin

17
Q

What is enoxaparin?

A

It is a low molecular weight heparin ( LMW)

18
Q

How is enoxaparin ( Lovenox) administered what route/

A

Administer deep subcutaneous injections in the abdomen ensuring a distance of 2 inches from the umbilicus* do not aspirate- Use a 22 or a 20-inch needle from the vial- then change the needle to a smaller needle ( 25-26 inch gauge) 1/2-5/8 inches long- apply gentle pressure for 1-2 minutes after the injection.

19
Q

What are important actions to teach a patient or client when taking enoxaparin ( Lovenox)?

A

Advise clients to use an electric razor for shaving and a soft toothbrush, and avoid the use of over-the-counter ( OTC) NSAIDS or aspirin ( ASA). If they are self-administering the Rx at home and using prefilled syringes, do not expel air bubbles,
Monitor for indications of bleeding) gums bleeding, abdominal pain, nose bleeds, or coffee-ground emesis, and monitor for indications of bleeding (black-tarry stools) Unlike heparin there are no regular lab tests required.

20
Q

What drug is administered for enoxaparin ( Lovenox) toxicity?

A

Protamine ( heparin antagonist) * administer slowly no faster than 20 mg per minute in 10 minutes

21
Q

Describe how to administer a subcutaneous injection- the actual injection

A

Pinch up an area of skin, inject at a 90-degree angle and insert the needle completely. Do not aspirate, do not rub the site for 1-2 minutes after the injection.

22
Q

What is the expected action of Alteplase often called tPA ( tissue plasminogen activator)

A

This is a thrombolytic medication that dissolves clots that have already formed. ( clots are dissolved by converting plasminogen to plasmin which actually destroys*** fibrinogen

23
Q

What conditions is a tpA Alteplase used?

A

Acute myocardial infarction ( AMI), massive PE ( Pulmonary embolism) Acute ischemic stroke, last to restore patency to central IV catheters

24
Q

What is the route of administration?

A

IV only

25
Q

What are the contraindications of Alteplase?

A

Because of the risk of serious bleeding, it is a contraindication in any patients who have any prior intracranial hemorrhage, any known structural cerebral lesion ( AV) formation, or neoplasm, * ischemic stroke within the past 3 months other than the current episode ( ** within 4.5 hours) Use cautiously in patients who have severe uncontrolled HTN. Also, concurrent anticoagulant use at therapeutic levels, major surgery or prolonged CPR within prior 3 weeks, active peptic ulcer & in older adults.

26
Q

How soon after the manifestation of actual symptoms should Alteplase be administered?

A

Within 3 hours is best

27
Q

Nursing administration and care are important with Alteplase because of the potential for bleeding. Nursing care would include what?

A

Patients should be in a monitored setting, monitor frequent vital signs, and continuous hemodynamic monitoring, and ensure adequate IV access (in case of emergency medications are needed) Do not mix any meds with Alteplase. Discontinue if any bleeding occurs.

28
Q

If bleeding occurs what is blood loss treated with?

A

Whole blood, packed red blood cells ( PRBC), and or fresh frozen plasma.

29
Q

Following thrombolytic medications, the provider will order beta blockers to decrease myocardial oxygen consumption and reduce arrhythmias and the provider will also order another medication to prevent GI bleeding known as what?

A

H2 antagonists or proton pump inhibitors which prevent GI bleeding

30
Q

How to evaluate the effectiveness of Alteplase? How does the patient present?

A

Chest pain (CP) is relieved, reduction of the initial ST segment as shown on ECG 60-90 min after Rx

31
Q

What is anemia?

A

A reduction in one or more of the major red blood cells ( RBCs)

32
Q

Anemia is classified on severity. Moderate anemia is present when the hemoglobin is when lab value?

A

approx 7-10 g/dL

33
Q

Severe anemia is when lab value?

A

When the hemoglobin ( hgb) is below 7 g/dL

34
Q

What are the s&s of anemia? Think about the function of RBCs

A

Tachycardia, hypotension, chest pain ( angina),Dyspnea ( diff breathing ) pallor, weakness & fatigue

35
Q
A

Pharmacology coagulation and resp drugs (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions