part 6

Question 1

When are patients highly susceptible to VTE’s?

Answer 1

• LE after fracture
• total hip or knee replacement surgery
• inactivity = venous stasis

Question 2

How can we prevent VTE?

Answer 2

• prophylactic anticoagulant drugs
• antiembolism stockings
• sequential compression devices
• ROM exercises

Question 3

Heparin has a narrow therapeutic window. What are 2 important adverse side effects of heparin?

Answer 3

• increased risk of bleeding

- HIT (heparin induced thrombocytopenia)

Question 4

If a pt is getting heparin what should you pay attention to during a H2T?

Answer 4

evaluate for bleeding

gums, hematuria, hemorrhage

Question 5

What are the labs to be monitored for a pt on heparin?

Answer 5

1. aPTT
2. Xa
3. CBC
4. PT

Question 6

What are some benefits of LMWH low molecular weight heparin Lovenox (Enoxaparin)?

Answer 6

longer half life
higher bioavailability
predictability
decreased risk of HIT (heparin induced thrombocytopenia)

Question 7

Why can pt’s go home on LMWH Lovenox?

Answer 7

lab monitoring is rarely required

Question 8

What is the dosing for LMWH based on?

Answer 8

weight
administration schedule
pt specific considerations

Question 9

Why is coumadin used?

Answer 9

-long term anticoagulation

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Question 10

What needs to be monitored for a pt taking coumadin?

Answer 10

• monitor for bleeding
• food interactions (high vitamin K)
• certain antibiotics (bactrim, flatly, levofloxacin)

Question 11

When might there be short term duplicate therapy of coumadin and heparin?

Answer 11

during transition to coumadin