pharm final- hematology

Question 1

clotting process

Answer 1

Balance between coagulation and anticoagulation
Need to keep blood in fluid state
Minimize injury and blood loss

Question 2

result of coagulation system

Answer 2

fibrin, a clot-forming substance

Question 3

injury

Answer 3

Vasoconstriction to minimize blood loss
Platelets clump (ADP, Thromboxane A2)
Clotting factors activated
Produced in the liver

Question 4

virchow’s triad

Answer 4

hypercoagulable state
vascular wall injury
circulatory stasis

Question 5

hypercoagulable state

Answer 5

malignancy
pregnancy and peri-partum period
oestrogen therapy 
trauma or surgery of lower extremity, hip, abdomen ,or pelvis
inflammatory bowel disease
nephrotic syndrome
sepsis
thrombophilia

Question 6

vascular wall injury

Answer 6

trauma or surgery
venepuncture
chemical irritation
heart valve disease or replacement
atherosclerosis
indwelling catherters

Question 7

circulatory stasis

Answer 7

**atrial fibrillation
left ventricular dysfunction
immobility or paralysis
venous insufficiency or varicose veins
venous obstruction from tumor, obesity, pregnancy

Question 8

anticoagulants

Answer 8

Inhibit the action or formation of clotting factors
Prevent clot formation
very potent

Question 9

antiplatelets

Answer 9

Inhibit platelet aggregation

Prevent initial platelet plugs

Question 10

lovenox class

Answer 10

anticoagulant

LMWH- low molecular weight heparin

Question 11

lovenox MOA

Answer 11

Block Factor Xa and IIa

Question 12

lovenox SE

Answer 12

not many

Question 13

lovenox nursing implications

Answer 13

Given subcutaneously in the abdomen
Rotate injection sites
Protamine sulfate can be given as an antidote in case of excessive anticoagulation

Question 14

heparin class

Answer 14

anticoagulant

Question 15

heparin MOA

Answer 15

Block formation of prothrombin to thrombin

Question 16

heparin SE

Answer 16

bleeding

Question 17

heparin nursing implications

Answer 17

Intravenous doses are usually double-checked with another nurse
Ensure that subcutaneous doses are given subcutaneously, not IM
Subcutaneous doses should be given in areas of deep subcutaneous fat, and sites rotated
Do not give subcutaneous doses within 1-2 inches of: The umbilicus, abdominal incisions, or open wounds, scars, drainage tubes, stomas
Do not aspirate subcutaneous injections or massage injection site- May cause hematoma formation
IV doses may be given by bolus or IV infusions
Anticoagulant effects seen immediately
Laboratory values done daily to monitor coagulation effects (aPTT)
Protamine sulfate can be given as an antidote in case of excessive anticoagulation

Question 18

coumadin (warfarin) class

Answer 18

anticoagulant

Question 19

coumadin (warfarin) MOA

Answer 19

inhibits vitamin k synthesis

Question 20

coumadin (warfarin) SE

Answer 20

bleeding

Question 21

coumadin (warfarin) nursing implications

Answer 21

Stay away from foods with vitamin K- leafy green vegetables
Once a day
May be started while the patient is still on heparin until PT-INR levels indicate adequate anticoagulation
Full therapeutic effect takes several days
Monitor PT-INR regularly—keep follow-up appointments (Normal value- 1.0; Therapeutic value- 2.0)

Question 22

coumadin (warfarin) antidote

Answer 22

vitamin k

Question 23

coumadin (warfarin) herbal interactions causin gincreased bleeding

Answer 23

Capsicum pepper
Garlic
Ginger
Ginkgo
St. John’s wart
Feverfew

Question 24

Pradaxa (dabigatran) class

Answer 24

anticoagulant

Question 25

Pradaxa (dabigatran) MOA

Answer 25

Inhibits thrombin induced platelet aggregation

Question 26

Pradaxa (dabigatran) SE

Answer 26

bleeding

Question 27

Pradaxa (dabigatran) nursing implications

Answer 27

No lab monitoring involved PO meds Uses- DVT prophylaxis, Afib

Question 28

anticoagulant patient education

Answer 28

Importance of regular laboratory testing where indicated Signs of abnormal bleeding Safety Measures to prevent bruising, bleeding, or tissue injury Wearing a medical alert bracelet Avoiding foods high in vitamin K (tomatoes, dark leafy green vegetables) Consulting physician before taking other drugs or over-the-counter products, including herbals

Question 29

causes of iron deficiency anemia

Answer 29

lack of iron in the diet, menstruation, GI blood loss,

Question 30

treatment for iron deficiency anemia

Answer 30

iron replacement, red meat, green leafy vegetables, iron fortified cereals/bran, beans

Question 31

iron

Answer 31

Supplemental iron may be given as a single drug or as part of a multivitamin preparation

Question 32

Oral iron preparations are available as ferrous salts

Answer 32

ferrous fumarate (Femiron), ferrous gluconate, ferrous sulfate (FeSO4)

Question 33

Parenteral preparations

Answer 33

``` iron dextran (INFeD, Dexferrum) iron sucrose (Venofer) ```

Question 34

some foods enhance iron absorption

Answer 34

``` vitamin C Orange juice Veal Fish Ascorbic acid ```

Question 35

some foods impair iron absorption

Answer 35

``` Eggs* Corn Beans* Cereal products containing phytates * Also common dietary sources of iron ```

Question 36

iron SE

Answer 36

Most common cause of pediatric poisoning deaths Causes nausea, vomiting, diarrhea, **constipation, and stomach cramps and pain **Causes black, tarry stools Liquid oral preparations may stain teeth (Use straw) Injectable forms cause pain/irritation upon injection (Z-track method)

Question 37

causes of pernicious anemia

Answer 37

lack of B-12 (cyanocobalamin), need intrinsic factor in the stomach to absorb B-12, lack on intrinsic factor, lack of dietary intake

Question 38

symptoms of pernicious anemia

Answer 38

paresthesia, large inflamed tongue (glossitis)

Question 39

treatment of pernicious anemia

Answer 39

replacement of B12

Question 40

cyanocobalamin

Answer 40

Used to treat pernicious anemia and other megaloblastic anemias Administered orally or intranasally to treat vitamin B12 deficiency Usually administered by deep intramuscular injection Meat and dairy products contain B-12

Question 41

epoietin alfa (epogen)

Answer 41

Biosynthetic form of the natural hormone erythropoietin Used for treatment of anemia associated with end-stage renal disease, chemotherapy-induced anemia, and for anemia associated with zidovudine therapy

Question 42

contraindications of epoietin alfa (epogen)

Answer 42

drug allergy, uncontrolled hypertension, head and neck cancers, risk of thrombosis