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Med Surg 1 > Pharm 36 > Flashcards

Pharm 36 Flashcards

1
Q

Prevent the formation and exhaustion of a thrombus and are used prophylactically in clients who are at high risk for clot formation

A

Anticoagulants

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2
Q

Have no direct effect on an existing thrombus and do not reverse damage cause from the thrombus

A

Anticoagulants

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3
Q

Once the presence of a thrombus has been established ___ can prevent additional clots from forming

A

Anticoagulant therapy

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4
Q

People leaving the hospital will have __ therapy

A

Po anticoagulant therapy

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5
Q

Anticoagulants are contraindicated in clients with
SATA (6)

A

Known hypersensitivity
Active bleeding
Hemorrhagic disease
Tuberculosis
Leukemia
GI ulcers

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6
Q

Anticoagulants are used in caution in all clients with

A

A potential site for bleeding or hemorrhage

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7
Q

Anticoagulation effect with NSAIDS

A

Increased risk of bleeding

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8
Q

Anticoagulation effect with oral contraceptives

A

Decrease effectiveness of the anticoagulant

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9
Q

Warfarin should never be combined with __ & __

A

Ginkgo
Biloba

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10
Q

Anticoagulants prevent thrombosis in the ___

A

Venous system

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11
Q

Anti-platelet drugs are used to prevent thrombus formation in the

A

Arterial system

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12
Q

Antiplatelet drugs are use cautiously in clients with

A

Pancytopenic
Renal impairment
Hepatic impairment

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13
Q

Dissolves blood clots that have already formed within the walls of a blood vessel

A

Thrombolytic drugs

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14
Q

Activase (streptokinase)

A

Theombolytic drugs

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15
Q

Bleeding may be internal and involve areas such as __ __ __

A

GI tract
GU tract
Brain

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16
Q

Bleeding may also be superficial (external) and seen at areas of broken skin such as __ __

A

Venipuncture sites
Recent surgical wounds

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17
Q

When a thrombolytic is administered with __ ___ ___ the client is at increased risk of bleeding

A

Aspirin
Dipyridamole
Anticoagulant

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18
Q

Pre admin assessment when a client is immobilized
SATA (4)

A

Vital signs
Inspect physical appearance, noting skin color, temp & pain, differences bilaterally
Palpate pedal pulses, noting rate & strength if lower limb is involved
Test for positive Homans sign, pain in calf when the foot is dorsiflexed, suggest DVT

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19
Q

Ongoing assessment
SATA

A

Continually assess any signs of bleeding (gums,nose,stool,urine,nasogastric drainage)
Clients on warfarin first time require dose adjustment based on PT/INR

20
Q

If PT exceeds __ times the control value or INR exceeds __, notify PCP before drug is given

A

1.2-1.5
3

21
Q

SATA (3)
Should be performed throughout the corse of heparin therapy

A

Periodic
Platelet counts
Hematocrit
Tests for occult blood in stool

22
Q

For those taking heparin by continuous Iv need __ taken periodically (usually every 4 hours)

A

Blood coagulation tests

23
Q

Examine the __ and ___ in the client with DVT for signs of improvement

A

Skin temp
Color

24
Q

Related to excessive bleeding because of drug therapy

A

Injury risk

25
Q

Related to preparing to communicate drug use if incapacitated

A

Altered health seeking behavior

26
Q

Related to fear of atypical bleeding during thrombolytic drug therapy

A

Anxiety

27
Q

Optimal therapeutic results of warfarin are obtained when the clients PT is __ times the control value

A

1.2-1.5

28
Q

Heparin prep unlike warfarin must be given by parental route preferably
SATA(4)

A

Subcutaneous or Iv
The onset of anticoagulation is almost immediate after a single dose
Max effect occur w in 10 mins of admin
Clotting time returns to normal with in 4 hrs unless redosed

29
Q

Although warfarin is most often admin orally, an ___ form may be given for those who are unable to receive orally

A

Injectable

30
Q

The dose of heparin is measured in __ and is available in various doses, EX:

A

Units
10,000 units/mL

31
Q

Always have nurse check ___

A

Heparin

32
Q

When heparin or other anticoagulants are given by subcu route, admin sites are __ and the site used is ___. The recommended sites for admin are those on the __, but areas w in __ in of the ___ are avoided because of the increased __ of that area

A

Rotated
Documented on clients chart
Abdomen
2
Umbilicus
Vascularity

33
Q

Drugs for DVT prevention (lovenox) are available in __, do not ___ they are administered deep __ tissue by __ the skin. Under the needle into the tissue at a __ angle so the __ is injected last. It is not necessary to __; this may aspirate the needle guard

A

Prefilled syringes
Subcut
Pinching a fold
90
Air bubble
Aspirate

34
Q

Withhold the drug immediately and contact the pcp if any of the following:
SATA (3)

A

PT exceeds 1.5 times the control value
There is evidence of bleeding
INR is greater than 3

35
Q

Be alert to the following indicators of bleeding

A

Decided drop in BP or a rise in pulse

36
Q

Platelet count

A

150,000-350,000

37
Q

APTT Range w heparin

A

120-140 seconds

38
Q

Symptoms of warfarin OD

A

Melena
Petechiae
Oozing from superficial injuries
Excessive menstruation

39
Q

Should be readily available when client is receiving warfarin

A

Vitamin k (phytondadione)

40
Q

Foods high in vitamin k
SATA (8)

A

Leafy green veggies
Beans
Broccoli
Cabbage
Cauliflower
Cheese
Fish
Yogurt

41
Q

Protamine is a specific antidote for

A

Heparin or LMWHs

42
Q

Oral anticoagulants
Generic, trade, use

A

Warfarin (Coumadin)
Prophylaxis/treatment of venous thrombosis

43
Q

Parental anticoagulant
Generic, use

A

Heparin
Clotting prevention

44
Q

Low molecular weight heparins
2 generic, 1 trade

A

Dalteparin
Enoxaparin (lovenox)

45
Q

Anti platelet agents
2 generic 2 trade 1 adverse reaction

A

Clopidogrel (plavid ) skin rash, constipastion
Dipyridamole (persantine)

46
Q

Anticoagulant antagonist
Generics, trades, uses

A

Phytonadione (vitamin k) (mephyton) (aqua-k) (aquamephyton)
Treatment of warfarin OF, prophylaxis of K deficiency of newborns)
Protamine
Treatment of heparin OD

Med Surg 1 (19 decks)

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