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Pharm > Vascular System + Blood > Flashcards

Vascular System + Blood Flashcards

1
Q

Discuss management of anticoagulant overdose:

A
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2
Q

Develop a care plan for clients receiving drugs affecting coagulation:

A
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3
Q

Which prototype is lipid-lowering?

A

Atorvastatin (Lipitor)

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4
Q

Which prototypes treat anemia?

A

Epstein alfa
Ferrous sulfate
Cyanocobalamin (vitamin b12)
Folic acid

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5
Q

Prototypes for anti platelet:

A

Aspirin
Clopidogrel

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6
Q

Prototypes for anticoagulants:
What is the function?

A

Heparin
Enoxaparin
Warfarin
Rivaroxaban
*anticoagulants disrupt clotting cascade making it difficult for blood to clot
*does not get rid of blood clot, prevents clot from getting bigger

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7
Q

Thrombolytic prototype:

A

Alteplase

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8
Q

Antilipemic drug: prototype and use?

A

HMG-COA Reductase inhibitors
“Statins”
Used for hyperlipidemia
*Inhibits cholesterol synthesis in the liver

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9
Q

What is atorvastatin?

A
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10
Q

What is aspirin?

A
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11
Q

What is Clopidogrel?

A
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12
Q

What are nursing assessments and interventions for anti platelet agents?

A

Assessment:
— indication for medication
— prevention of blood clots
Interventions:
— bleeding precautions
— avoid injury and falls
— hold prior to procedure/surgery
— educate patient on medication

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13
Q
A
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14
Q

Diagnostics labs: clotting times
PT
INR
PTT
What are the therapeutic goals? (Need to know)

A
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15
Q

What are general nursing considerations regarding anticoagulants/Thrombolytics?

A

— all anticoagulants have AE of bleeding
*Non-fatal: hematuria, epistaxis, bruising
*FATAL: hemorrhagic stroke, internal bleeding, GI bleeds (higher risk in older adult)
— reduced risk for injury and falls
— BLEEDING PRECAUTIONS

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16
Q

What are contradictions for anticoagulants?

A

PREGNANCY except for heparin/enoxaparin
— bleeding disorders
— hx of bleed
— theombocytopenia- low platelet

17
Q

What are drug-drug interactions with anticoagulants?

A

— anti platelet agents
— NSAIDS
— herbals
ALL INCREASE BLEEDING

18
Q

What is heparin?

A
19
Q

What is enoxaparin?

A
20
Q

Develop a care plan for IV heparin:

A
21
Q

What is warfarin?

A
22
Q

What are special considerations for warfarin?
Dosing
Lab draws
Diet

A

Dosing:
— daily (usually in evening or HS)
— if INR greater than 3.0 HOLD AND CALL PROVIDER
— expect an order for vitamin k if INR greater than 4.0 (PO or SQ)

Lab draws:
— dose change = next lab in 3 days
— long term monitoring = weekly or monthly

Diet:
Teach patient to maintain consistent intake; avoid vitamin k containing foods
*high intake may decrease warfarin effect

23
Q

What are foods high in vitamin K?

A

Green leafy foods:
— kale
— collard greens
— spinach
— Brussels sprouts
— broccoli
— asparagus
— sauerkraut
— soybeans
— edamame

24
Q

What are herbals to avoid when taking warfarin?

A

— St. John’s wart
— garlic
— ginkgo
— ginger root
— chamomile

25
Q

What is rivaroxaban?

A
26
Q

How do you manage your patient with anticoagulant overdose?

A

Assessment:
CM of bleeding and VS: HR/BP/O2

Interventions:
— notify provider
— draw labs ordered: hemoglobin/hematocrit, platelets, clotting times
— administer fluids (NS) and/or packed RBC as ordered
— administer reversal agent

27
Q

What is alteplase?

A
28
Q

What are contraindications to alteplase?

A
29
Q

Client has been dx with DVT in R lower extremity. The primary care provider has prescribed enoxaparin 70mg SQ q 12hr with the first dose STAT. In addition, the provider has prescribed warfarin 5mg PO daily and a PT/INR draw in 3 days.

Why has the primary HCP prescribed both medications simultaneously?

A

Making sure the client has adequate anticoagulation while warfarin reaches therapeutic level
Warfarin onset = 36-48 hours
Enoxaparin onset = 3-5 hours

30
Q

What are drug-drug interactions with anticoagulation drugs?

A

More than 1 anticoagulant/antiplatelet
Aspirin
Warfarin
Herbal supplements
Antibiotic therapy

Increases bleeding

31
Q

What is epoetin alfa?

A
32
Q

What is ferrous sulfate?

A

KEEP OUT OF REACH FOR CHILDREN-FATAL IF OVERDOSED

33
Q

What is cyancobalamin?

A
34
Q

What is folic acid?

A
35
Q

What is pernicious anemia?

A

Also called addisons anemia

— decrease in red blood cells
— cannot absorb enough vitamin B12

Pharm (16 decks)

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