Pharm: Module 11 Anticoagulants

Question 1

what is heparin given for

Answer 1

for DVT, pulmonary embolism, open heart surgery

Question 2

what kind of patients are given heparin

Answer 2

both stable clients at risk and already unstable clients

Question 3

how is heparin given

Answer 3

infusion and subcut

Question 4

what is the reversal agent of heparin

Answer 4

protamine sulfate

Question 5

what is warfarin given for

Answer 5

given to PREVENT future episodes(thrombotic condition)

Question 6

how is warfarin given

Answer 6

oral (can be taken at home)

Question 7

what is the reversal agent of warfarin

Answer 7

vitamin K

Question 8

what is the normal prothrombin time (PT) range

Answer 8

11-13.5 seconds

Question 9

what is the normal international normalized ratio (INR) range

Answer 9

0.8-1.1

Question 10

what is the INR therapeutic range

Answer 10

2-3

Question 11

what is the INR

Answer 11

extrinsic pathway that monitors warfarin

Question 12

what is the normal partial thromboplastin time (PTT) range

Answer 12

60-70 seconds

Question 13

what is the PTT therapeutic range

Answer 13

1.5-2.5 times the normal range

Question 14

what does aPTT do

Answer 14

monitors heparin

Question 15

what is the normal range of aPTT

Answer 15

30-40 seconds

Question 16

what is the therapeutic range of aPTT

Answer 16

1.5-2.5 times the normal range

Question 17

what is the normal platelet range

Answer 17

150,000-450,000/ microL

Question 18

what is the normal fibrinogen range

Answer 18

150-400 mg/dL

Question 19

what is the normal D-dimer range

Answer 19

<0.5 micro-g/mL

Question 20

what is the D-dimer a product of

Answer 20

clot breakdown

Question 21

what can lead to Virchow’s Triad

Answer 21

surgery and immobility

Question 22

what are the three aspects of Virchow’s Triad

Answer 22

1) endothelial damage
2) blood flow stasis
3) hypercoagulable state

Question 23

what are the three anticoagulants

Answer 23

heparin, warfarin, enoxaparin

Question 24

how long does warfarin take to work

Answer 24

takes a while to build up and have therapeutic effects

can therefore be temporarily given with heparin

Question 25

when is enoxaparin given

Answer 25

post surgical prophylaxis and | to pregnant women with clotting issues

Question 26

what type of drug is enoxaparin

Answer 26

low molecular weight heparin

Question 27

does enoxaparin have a longer or shorter half life than heparin

Answer 27

longer

Question 28

what do anticoagulants do

Answer 28

helps PREVENT future clots from forming | does NOT bust up existing clots

Question 29

what is the drug for Xa Inhibitor

Answer 29

Xarelto | oral anticoagulant

Question 30

nursing considerations for anticoagulants

Answer 30

Watch for excessive bruising, don’t use razor, watch for bloody gums look for increased heart rate and decreased blood pressure (can indicate internal bleeding)

Question 31

what are the dietary restrictions for those on anticoagulants

Answer 31

Herbal(garlic, ginger) and leafy greens-can affect coumadin

Question 32

what are the common uses of antiplatelet drugs

Answer 32

Stop platelet aggregation | Often given post stroke prophylaxis

Question 33

what gives forewarning of stroke

Answer 33

TIA gives forewarning of future stroke

Question 34

what are the two antiplatelet drugs

Answer 34

Clopidogrel and aspirin

Question 35

another name for Clopidogrel

Answer 35

Plavix

Question 36

when should you stop taking antiplatelets

Answer 36

seven days prior to surgery

Question 37

can antiplatelets be given together

Answer 37

yes

Question 38

what are the side effects of antiplatelets

Answer 38

Bleeding issues, flu like symptoms

Question 39

dietary restrictions for patients on antiplatelets

Answer 39

Ginger and green tea can increase bleeding times

Question 40

where are Thrombolytics typically started

Answer 40

ER and finished in ICU

Question 41

side effects of thrombolytics

Answer 41

Right sided weakness, signs and symptoms of stroke, no ability to talk Location of clot determines what effects the effects are

Question 42

two drugs of thrombolytics

Answer 42

tPa and streptokinase

Question 43

what is an Ischemic stroke

Answer 43

blood clot in brain

Question 44

what is a hemorrhagic stroke

Answer 44

(bleeding out) AKA brain aneurism

Question 45

what type of stroke CANNOT get thrombolytic

Answer 45

hemorrhagic

Question 46

contraindications of thrombolytics

Answer 46

``` Hemorrhagic stroke extreme uncontrolled hypertension Internal bleeding Recent stroke surgery or trauma ```

Question 47

administration considerations for thrombolytics

Answer 47

Highly involved patient: administer for heart attack within 3-4 hours of onset of symptoms or within 30 min of getting to the hospital, know initial timing of stroke (give within 3 hours)

Question 48

side effects of adverse effects of thrombolytics

Answer 48

Anaphylaxis is a common side effect with streptokinase, hemorrhaging or severe bleeding is also common

Question 49

how do you know if thrombolytic has been effective

Answer 49

Effective if some improvement on scans, dissolvement of clot, increased BP, no signs of active bleeding

Question 50

most common signs of blood loss and impending shock

Answer 50

Decrease in BP and increased heart rate