Week 7: Chapter 20 Flashcards
Drugs That Effect Blood Clotting
What is the main purpose of anticoagulation?
To prevent clots from forming where they are not needed
Which condition is a common indication for the use of an anticoagulant drug?
Atrial fibrillation
Which of the following drugs or supplements makes the risk for bleeding worse when a patient is also taking an anticoagulant drug?
- Aspirin
- Gingko biloba
- St. John’s Wort
What agent is used as an antidote for a warfarin (Coumadin) overdose?
Vitamin K
Which action is essential before beginning continuous IV heparin therapy?
Get an accurate baseline patient weight
Which anticoagulant drug must be avoided during pregnancy because it can cause birth defects in the fetus?
Warfarin (Coumadin)
Which lab test result indicates that an antiplatelet drug is effective?
International Normalized Ratio (INR) is increasing
What agent is used as an antidote for a heparin overdose?
Protamine sulfate
After bleeding, what is the most common A/E of most antiplatelet drugs?
Decreased platelet count
Which action is important to prevent to prevent losing any part of the drug dose when administering low molecular weight heparin?
Not expelling the air bubble before injecting the drug
Why is the antiplatelet effect of aspirin longer lasting than that of other NSAIDs?
Aspirin irreversibly inhibits the production of TXA2, whereas NSAIDs cause reversible inhibition of this substance
Why is it important to teach the patient starting on the anticoagulant warfarin (Coumadin) to limit his/her intake of leafy green vegetables?
These foods contain vitamin K, which can reduce the effects of warfarin
What is the major MOA that allows thrombolytic drugs to dissolve clots?
Increasing the blood level of the enzyme plasmin
Which problems, conditions, or drugs are absolute contraindications for thrombolytic therapy?
- Recent head trauma
2. Undergoing cancer chemotherapy
What is the intended response when a patient is prescribed epoetin alfa (Epogen)?
RBC levels normalize
What instructions are important to give a patient who is on anticoagulant therapy? (select all that apply)
- Avoid contact sports
- Report headaches that will not go away
- Watch for S/S of bleeding
The nurse is caring for a patient admitted after a thrombolytic event. What patient is most at risk for this type of event?
Bedridden patient
The nurse is going to start anticoagulant drug therapy on a patient. Which patient conditions or histories would prohibit this therapy to be given to the patient? (select all that apply)
- Bleeding ulcer
- Recent stroke (within 2 months)
- Recent spinal surgery
- Delivery of a baby within the past 24 hrs.
The nurse is performing an admission assessment on a patient admitted for thrombolytic therapy. The nurse knows that which condition is an absolute contraindication for thrombolytic therapy?
Recent delivery of a baby
The nurse is caring for a patient receiving heparin therapy. Besides an increased risk for bleeding, what are other side effects you should be aware of for patients receiving this therapy?
- Decreased platelet count
- Hair loss
- Bone thinning
The nurse is monitoring a patient who is receiving high-dose heparin therapy. What antidote must the nurse be sure is readily available?
Protamine sulfate
At what times might anticoagulant drugs be prescribed? (select all that apply)
- After heart valve replacement
- For the dysrhythmia atrial fibrillation
- To prevent venous thromboembolism
- If a patient is at risk for a stroke
The nurse is instructing a patient being discharged on anticoagulant drugs about possible signs of bleeding. What symptoms should the nurse tell the patient to look for? (select all that apply)
- Coffee ground emesis
- Abdominal pain
- Back pain
The prescriber has ordered low-molecular-weight (LMW) heparin to be given to a patient. How is this drug administered?
Subcutaneously
