Week 13 & 14 - GI and Hematologic

Question 1

• salt that neutralizes hydrochloric acid; bicarbonate ions and prostaglandins inc which is protectant of the stomach epithelial cells
• Decreases ph - decrease acidity
• Avoid citric food (citrus juices, high level of water content; throughly chew tablets and follow w/ 1/2 cup of water or milk to ensure med is being absorbed
• SE: Constipation
• contain Na so monitor for CHF/HT pts

Answer 1

Antacid: aluminum hydroxide

Question 2

• soluble/broken down fiber
• For constipation, to bulk up stool (bulk up = to stretch/to send signal to brain to defecate)
• Drying in moistures, peristalsis, thickener,
• Drink plenty of water, increase fiber & activity or it will cause bowel obstruction

Answer 2

Bulk-Forming Agent: psyllium

Question 3

• dissolves in the colon and stimulates motility, increase in water content and intestinal secretions
• ADR: abd pain, cramping, diarrhea
• Contra: fecal impacted pt, bowel obstructions, pts w/ nausea, cramping, and abd pain
• Pt ed: dont take if stools loose/diarrhea; work within 6-12hrs; not long term basis
• Don’t give stimulant to fecal impaction
• Knows Bowel hx prior

Answer 3

Stimulant Laxative: bisacodyl

Question 4

The main differences between Heparin and Warfarin

Answer 4

• heparin: aptt
• warfarin: inr; vitK (green leafy veggies); interacts w/ many meds

Question 5

• Anticoagulant = short acting
• High dose - PEs, DVT, evolving stroke, open heart surgery, cath lab, dialysis
• Low dose - out prophylaxis, small DVT, PEs, MIs
• NC: monitor aPTT/Anti Xa lvls - if too high: STOP med & give protamine, monitor bleeding sx (bruising, petechiae, black tarry stool, hematuria, bleeding gums)
• Watch platelets
• No SQ/Stop drip - if HIT too low

Answer 5

Factor Xa/Thrombin Inhibitor: heparin

Question 6

• Anticoagulant = long acting
• VIT K inhibitor
• Used for stroke, MI, A fib
• Prevent thrombi & PE in A Fib
  ↓ risk of TIA/MI
• Pt educ: frequent lab checks for INR result (stop med if too high); signs of liver issues (jaundice, nausea, fatigue); monitor vit K foods (can alter the effects); discuss w MD use of OTC meds; med bracelet alert; bleeding (no straight razors; soft bristle brush, sports that don’t cause large injury)
• NC: INR 2-3 wanted; vitamin K for toxicity - oral/IV push;

Answer 6

Vitamin K Antagonist: warfarin