Week 7: Chapter 20

Question 1

What is the main purpose of anticoagulation?

Answer 1

To prevent clots from forming where they are not needed

Question 2

Which condition is a common indication for the use of an anticoagulant drug?

Answer 2

Atrial fibrillation

Question 3

Which of the following drugs or supplements makes the risk for bleeding worse when a patient is also taking an anticoagulant drug?

Answer 3

1. Aspirin
2. Gingko biloba
3. St. John’s Wort

Question 4

What agent is used as an antidote for a warfarin (Coumadin) overdose?

Answer 4

Vitamin K

Question 5

Which action is essential before beginning continuous IV heparin therapy?

Answer 5

Get an accurate baseline patient weight

Question 6

Which anticoagulant drug must be avoided during pregnancy because it can cause birth defects in the fetus?

Answer 6

Warfarin (Coumadin)

Question 7

Which lab test result indicates that an antiplatelet drug is effective?

Answer 7

International Normalized Ratio (INR) is increasing

Question 8

What agent is used as an antidote for a heparin overdose?

Answer 8

Protamine sulfate

Question 9

After bleeding, what is the most common A/E of most antiplatelet drugs?

Answer 9

Decreased platelet count

Question 10

Which action is important to prevent to prevent losing any part of the drug dose when administering low molecular weight heparin?

Answer 10

Not expelling the air bubble before injecting the drug

Question 11

Why is the antiplatelet effect of aspirin longer lasting than that of other NSAIDs?

Answer 11

Aspirin irreversibly inhibits the production of TXA2, whereas NSAIDs cause reversible inhibition of this substance

Question 12

Why is it important to teach the patient starting on the anticoagulant warfarin (Coumadin) to limit his/her intake of leafy green vegetables?

Answer 12

These foods contain vitamin K, which can reduce the effects of warfarin

Question 13

What is the major MOA that allows thrombolytic drugs to dissolve clots?

Answer 13

Increasing the blood level of the enzyme plasmin

Question 14

Which problems, conditions, or drugs are absolute contraindications for thrombolytic therapy?

Answer 14

1. Recent head trauma

2. Undergoing cancer chemotherapy

Question 15

What is the intended response when a patient is prescribed epoetin alfa (Epogen)?

Answer 15

RBC levels normalize

Question 16

What instructions are important to give a patient who is on anticoagulant therapy? (select all that apply)

Answer 16

1. Avoid contact sports
2. Report headaches that will not go away
3. Watch for S/S of bleeding

Question 17

The nurse is caring for a patient admitted after a thrombolytic event. What patient is most at risk for this type of event?

Answer 17

Bedridden patient

Question 18

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)

Answer 18

1. Bleeding ulcer
2. Recent stroke (within 2 months)
3. Recent spinal surgery
4. Delivery of a baby within the past 24 hrs.

Question 19

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?

Answer 19

Recent delivery of a baby

Question 20

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?

Answer 20

1. Decreased platelet count
2. Hair loss
3. Bone thinning

Question 21

The nurse is monitoring a patient who is receiving high-dose heparin therapy. What antidote must the nurse be sure is readily available?

Answer 21

Protamine sulfate

Question 22

At what times might anticoagulant drugs be prescribed? (select all that apply)

Answer 22

1. After heart valve replacement
2. For the dysrhythmia atrial fibrillation
3. To prevent venous thromboembolism
4. If a patient is at risk for a stroke

Question 23

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)

Answer 23

1. Coffee ground emesis
2. Abdominal pain
3. Back pain

Question 24

The prescriber has ordered low-molecular-weight (LMW) heparin to be given to a patient. How is this drug administered?

Answer 24

Subcutaneously

Question 25

The nurse is caring for a patient who is going to be started on IV heparin. What factor determines the initial intravenous (IV) bolus dose for this patient?

Answer 25

Weight

Question 26

The nurse is caring for a patient on embolytic therapy. What possible adverse effects of aspirin therapy should the nurse make sure the patient understands? (select all that apply)

Answer 26

1. Check for headaches or any changes in level of consciousness (LOC).
2. Monitor for bleeding at least every 2 hours.
3. Ensure all follow-up laboratory work for coagulations is completed.

Question 27

A patient is being sent home with instructions to take aspirin daily. The nurse needs to tell the patient what possible adverse effects of aspirin therapy? (select all that apply)

Answer 27

1. Hemorrhage
2. Salicylate poisoning
3. Salicylate poisoning

Question 28

During pregnancy, a woman requires anticoagulation therapy. Which drug is likely to be prescribed?

Answer 28

Enoxaparin (Lovenox) or heparin

Question 29

A patient who has had a heart valve replacement takes warfarin (Coumadin) daily. The patient would require additional teaching if he or she selected which food items for lunch?

Answer 29

Spinach salad with bacon

Question 30

The nurse has an order to administer a thrombopoiesis-stimulating agent oprelvekin (Neumega). How should this medication be administered?

Answer 30

Subcutaneously (SQ)

Question 31

A patient who is taking warfarin (Coumadin) has an international normalized ratio (INR) of 1.0. What change in the warfarin dosage, if any, would the nurse expect?

Answer 31

The dose will increase.

Question 32

The nurse is caring for a patient who has been diagnosed with coronary artery disease. What is the most common antiplatelet drug the nurse would expect to see ordered for this patient?

Answer 32

Aspirin (Ecotrin)