Week 8 Lecture - The Hematologic System

Question 1

Heparin Class and other

Answer 1

Thrombin/Xa inhibitor

enoxaparin (Lovenox)

Question 2

Heparin therapeutic use

Answer 2

treat blood clot or prophylaxis for blood clot formation
- acute MI
- ischemic stroke
- after major surgery or on bed rest

Question 3

heparin EPA

Answer 3

inhibits factor Xa and thrombin to block clotting process

Question 4

heparin ADRs

Answer 4

uncontrolled bleeding
heparin-induced thrombocytopenia

Question 5

heparin interventions and education

Answer 5

watch for bleeding
monitor therapeutic levels of IV heparin
monitor platelet count
use a soft toothbrush and electric razor

Question 6

heparin contraindications

Answer 6

thrombocytopenia
risk for bleeding
NSAIDs

Question 7

warfarin (Coumadin) class

Answer 7

vitamin K antagonist

Question 8

warfarin (Coumadin) therapeutic use

Answer 8

long-term management or prevention of venous thromboembolic disorders
- DVT
- PE
- atrial fibrillation
- mechanical heart valves

Question 9

warfarin (Coumadin) EPA

Answer 9

prevents synthesis of vitamin-K dependent clotting factors in the liver

Question 10

warfarin (Coumadin) ADRs

Answer 10

bleeding

Question 11

warfarin (Coumadin) interventions and education

Answer 11

monitor for bleeding
narrow therapeutic range
keep consistent intake of vitamin K

Question 12

warfarin (Coumadin) contraindications

Answer 12

teratogenic
bleeding risk - alcohol, GI ulcers, thrombocytopenia
many medications

Question 13

dabigatran (Pradaxa)

Answer 13

Anticoagulant given when patient develops Heparin Induced Thrombocytopenia (HIT)

direct thrombin inhibitor

Question 14

rivaroxaban (Xarelto)

Answer 14

direct factor Xa inhibitor

Question 15

aspirin class

Answer 15

antiplatelet salicylate

Question 16

aspirin therapeutic use

Answer 16

MI, CVA, TIA, coronary stent

Question 17

aspirin EPA

Answer 17

inhibits platelet aggregation via inhibition of cyclooxygenase

Question 18

aspirin ADRs

Answer 18

gastric upset
bleeding risk
renal damage
toxicity: tinnitus, HA, dizziness

Question 19

aspirin interventions and education

Answer 19

monitor for bleeding, kidney function
avoid alcohol

Question 20

aspirin contraindications

Answer 20

do not give <18
caution with peptic ulcer disease
caution with anticoagulants
ibuprofen decreases antiplatelet effect

Question 21

clopidogrel (Plavix) class

Answer 21

Antiplatelets: Adenosine Diphosphate Receptor (ADP) Inhibitor

Question 22

clopidogrel (Plavix) therapeutic use

Answer 22

MI, CVA, TIA, coronary stents

Question 23

clopidogrel (Plavix) EPA

Answer 23

inhibits platelet aggregation by blocking ADP receptors on platelets

Question 24

clopidogrel (Plavix) ADRs

Answer 24

GI upset, bleeding, renal damage
thrombotic thrombocytopenic purpura

Question 25

clopidogrel (Plavix) interventions and education

Answer 25

monitor for bleeding - GI bleeding, bruising, petechiae check platelet count discontinue 5-7 days before elective surgeries take with food and avoid alcohol

Question 26

clopidogrel (Plavix) contraindications

Answer 26

peptic ulcer disease anticoagulants

Question 27

alteplase TPA class

Answer 27

thrombolytic

Question 28

alteplase TPA therapeutic use

Answer 28

dissolves clot MI, CVA establish patency of central IV catheter

Question 29

alteplase EPA

Answer 29

converts plasminogen into plasmin = breaks down fibrin in clot. Plasmin will prevent new clots from forming

Question 30

alteplase ADRs

Answer 30

extreme bleeding intracranial bleeding is biggest concern

Question 31

alteplase interventions and education

Answer 31

close monitoring of vital signs, neuro checks emergency equipment available monitor CBC

Question 32

alteplase contraindications

Answer 32

recent surgery - 2-4 weeks head trauma aneurysm active bleeding hypertension

Question 33

epoetin alfa (Epogen) class

Answer 33

Erythropoietic Growth Factor

Question 34

epoetin alfa (Epogen) therapeutic use

Answer 34

chronic renal failure pre-op anemia given with chemotherapy given with HIV treatment Zidovudine

Question 35

epoetin alfa (Epogen) EPA

Answer 35

mimics erythropoietin in the bone marrow to cause production of RBCs

Question 36

epoetin alfa (Epogen) ADRs

Answer 36

hypertension increased risk of cardiac event or CVA can cause progression of malignancies

Question 37

epoetin alfa (Epogen) interventions and education

Answer 37

report if hemoglobin over 12 monitor blood pressure always give lowest dose possible report signs and symptoms of MI or CVA