Vasodilation situation Flashcards
What is NOT a contraindication for anticoagulants?
A) Hemorrhage
B) Closed head injury
C) Cardiac catheterization surgery
D) Pregnancy/lactation
C) Anticoagulants are not to be given prior to surgery in most situations. However, during cardiothoracic and vascular surgery, anticoagulants are often given intra-operatively.
True or False: Antiplatelet drugs can break down blood clots
False.
Antiplatelets can prevent platelet aggregation leading to new clots, but they cannot break down existing clots.
Which of the following is an example of an antiplatelet drug?
A) Plavix
B) Heparin
C) Enoxaparin
D) Ibuprofen
A) Plavix (Clopidogrel) and aspirin are anticoagulant medications.
Heparin is used for:
A) Acute formation of clots
B) Chronic risk of clotting
C) Both acutely and chronically
C) BOTH. It is both preventative and corrective.
What is not a side effect of heparin?
A) Burning
B) Itching
C) Increased PTT
D) Bleeding
C) An increased PTT is an expected finding of heparin administration
How does heparin work?
A) Activates fibrin in the bloodstream
B) Prevents fibrinogen from converting to fibrin
C) Activates a form of thrombin
D) Makes red blood cells “slippery”
B)
Heparin works by keeping fibrinogen from converting into fibrin, which forms blood clots
How is enoxaparin typically administered?
A) Subcutaneously
B) Intravenously
C) Intrathecally
D) Intraarterially
A) Enoxaparin is usually given SQ injection.
What is the antidote for heparin?
Protamine Sulfate
What is the antidote for warfarin?
Vitamin K
(Not to be confused with K+)
What do you do if the patient has been given heparin, but they are showing signs of bleeding from an arterial line previously placed?
A) D/C heparin and call provider
B) Continue heparin therapy and hold pressure on the arterial line
C) Call the provider for further instructions
D) Administer platelets and give protamine sulfate
A) Immediately D/C the heparin, call the provider, and prepare the protamine for when the order is placed to administer it. Holding pressure will not stop an arterial bleed during heparin therapy, calling the provider is not the very first step in this situation, and you cannot administer platelets or protamine without a physician’s order.
What should you not do when a patient is given heparin?
A) Place an IO line
B) Place an A-line
C) Place a central line
D) Place a peripheral IV
Trick question: NONE OF THE ABOVE. No new access lines should be placed unless absolutely necessary after heparin administration. However, if one MUST be placed it should not be an A-line, IO, or central line because they are not compressible if excessive bleeding occurs.
Does a LMWH have a longer or shorter half life than heparin?
LONGER. It is 2-3 times longer than heparin, which makes it more suitable for home administration. Therefore, frequent blood testing isn’t required.
Which of the following is not a side effect of warfarin?
A) Vitamin K toxicity
B) Anorexia
C) Bleeding
D) N/V/D
A) Vitamin K toxicity. Warfarin inhibits the liver synthesis of vitamin K, leading to a potential vitamin k deficiency.
Which labs should you monitor when giving warfarin?
PT and INR
What is a “normal” PT?
A) 15
B) 25
C) 35
D) 12
D) 12
What is the normal INR range?
A) 1-2 seconds
B) 1.3-2.0 seconds
C) 1.5-2.5 seconds
D) 2-3 seconds
B) A normal INR is 1.3-2.0 seconds
What is the goal INR for a patient taking coumadin?
A) 1-3 seconds
B) 2-3 seconds
C) 3-5 seconds
D) 3.5-5.0 seconds
B) 2-3 seconds
True or False:
Patients taking coumadin (warfarin) should increase their intake of leafy green vegetables?
False
While taking coumadin, the patient should not increase or decrease the amount of green leafy vegetables or vitamin k in their diet. They should get a very consistent amount in their diet and not change it while on therapy.
Which of the following should not be done when taking anticoagulants?
A) Shave with a razor
B) Take a hot shower
C) Trim nails
D) Participate in sports
A) The patient should shave with an electric razor while on anticoagulants.
When do thrombolytics need to be given after an acute thrombin formation?
A) Within 30 minutes
B) Within 3-4 hours
C) Within 3-6 hours
D) Within 24 hours
B) For thrombolytics to be effective in breaking down clots it must be given within 3-4 hours of acute clot formation.
What is a side effect of thrombolytic drugs?
A) Angioedema
B) Coughing
C) Arrhythmia
D) Vasoconstriction
C) Arrhythmias can be caused by thrombolytic drugs
