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47 Cards in this Set
- Front
- Back
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What is the indication for heparin?
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Prevent DVT, PE, Stroke
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What are the side effects for heparin?
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Bleeding
Cyanosis Temperature Pain and Tingling HIT- allergic response |
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What are the nursing implications for heparin?
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-always check PTT before giving
Normal: 40 sec If on heparin - should be 60 to 80 sec - Dont give if more than 80 sec -Monitor/educated bleeding gums, nose -Use electric razors -If cut, apply pressure for 10 min with no peeking *check lab for platelet count* *Give Protamine sulfate for OD |
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What is HIT?
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Heparin Induced Thrombocytopenia - an allergic reaction to heparin. FIRST SIGN: Low platelet counts below 150,000
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What is the antidote for a heparin OD?
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Protamine Sulfate
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What is the indication and side effects for enoxaparin (Lovenox)?
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Prevent DVT, PE, MI, Stroke
SE: -Bleeding: less than heparin -Cyanosis -Temp -Pain and Tingling -Allergy (HIT) - 10X less likely |
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What is the indication and side effects for dalteparin (Fragmin)?
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Prevent DVT, PE, MI, Stroke
SE: -Bleeding: less than heparin -Cyanosis -Temp -Pain and Tingling -Allergy (HIT) - 10x less likely |
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What is the indication and side effects for tinzaparin (Innohep)?
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Prevent DVT, PE, MI, Stroke
SE: -Bleeding: less than heparin -Cyanosis -Temp -Pain and Tingling -Allergy (HIT) - 10X less likely |
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What are the nursing implications for enoxaparin (Lovenox)?
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*LEAVE AIR BUBBLE*
-Inject in lovehandles -Always use 90 degree angle -Check platelet counts |
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What are the nursing implications for dalteparin (Fragmin)?
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*LEAVE AIR BUBBLE*
-Inject in lovehandles -Always use 90 degree angle -Check platelet count |
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What are the nursing implications for tinzaparin (Innohep)?
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*LEAVE AIR BUBBLE*
-Inject in lovehandles -Always use 90 degree angle -Check platelet count |
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What is the indication and side effects for fondaparinux (Arixtra)?
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to prevent DVTs
SE: -Bleeding -Anemia, fever -No chance of HIT - not heparin-derived. |
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What is the indication and side effects for danaparoid (Organon)?
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To prevent DVTs
SE: -Bleeding -Anemia, fever -No chance of HIT - not heparin-derived |
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For whom is Arixtra and Organon contraindicated for?
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-Patients with kidney impairment
-Weight < 110 lbs -Elderly -Plateles <100,000 |
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What are the nursing implications for Arixtra and Organon?
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-Once a day administration
-No PTT or PT needed -Watch for bleeding |
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What are the indications for warfarin (Coumadin)?
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Drug of choice for longterm prevention of DVTs
-Atrial Fibrillation -Heart valve replacement |
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What are the side effects for warfarin (Coumadin)?
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-Hemorrhage/Bleeding
-Red or black stools -Bleeding gums, nose, urine -Skin rash or bruising |
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What are the nursing implications for warfarin (Coumadin)?
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*Monitor PT values: normal = 12 sec.
-Educate about electric razor -Educate signs of bleeding -No ASA or NSAIDS -Keep Vitamin K intake constant -Vitamin K is the antidote |
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What is the antidote for a warfarin (Coumadin) OD?
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Vitamin K
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What is the indication and side effects for streptokinase (Sstreptase)?
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Ind: Acute MI, DVT, PE
SE: -Bleeding -Intracranial bleeding *Allergic reaction -Hypotension -Fever |
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What is the indication and side effects for alterplase (tPA, Activase)?
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Ind: Acute MI, DVT, PE
SE: -Bleeding -Intracranial bleeding *Allergic reaction -Hypotension -Fever |
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What is the indication and side effects for tenecteplase (TNKase)?
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Ind: Acute MI, DVT, PE
SE: -Bleeding -Intracranial bleeding *Allergic reaction -Hypotension -Fever |
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What is the indication and side effects for reteplase (Retavase)?
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Ind: Acute MI, DVT, PE
SE: -Bleeding -Intracranial bleeding *Allergic reaction -Hypotension -Fever |
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What is the indication and side effects for antistreplase (Eminase)?
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Ind: Acute MI, DVT, PE
SE: -Bleeding -Intracranial bleeding *Allergic reaction -Hypotension -Fever |
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What is the indication and side effects for urokinase (Abbokinase)?
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Ind: Acute MI, DVT, PE
SE: -Bleeding -Intracranial bleeding *Allergic reaction -Hypotension -Fever |
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What is the first thing to watch for when administering a clot buster (-ase)? What would you do?
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Allergic reaction. Discontinue and administer epinephrine, antihistamine, or steriod.
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What do clot busters do? Who can administer them?
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Dissolve thrombi that have already formed. Only given by skilled clinicians - serious risk of bleeding.
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What is the indication for aspirin (ASA)?
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prevention of MI and stroke
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What are the side effects for aspirin (ASA)?
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GI bleeding
hemorrhagic stroke |
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What are the nursing implications for aspirin (ASA)?
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-Use enteric-coated forms
-Monitor for bleeding (GI) -Avoid other anticoagulants -Stop taking at least 10 days before surgery |
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What is the indication for clopidogrel (Plavix)?
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Prevention of ischemic stroke and TIA
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What are the side effects of clopidogrel (Plavix)?
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-GI bleeding
-hemorrhagic stroke -abdominal pain -dyspepsia |
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What is Aggrenox indicated for?
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extended release aspirin used to prevent recurrent ischemic stroke in patients with a previous stroke or TIA. Prevents clots.
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What is epoetin alfa (Erythropoietin , Epogen, Procrit) indicated for?
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Anemia with CRF, AIDS, or chemo
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What are the side effects for epoetin alfa?
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-Hypertension
-Tachycardia -Seizure -Pain in bones/joints -chest pain -clotting of shunt for dialysis |
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What are the nursing implications for epoetin alfa?
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-Monitor labs
-Costly treatment -Monitor BP - medicate prn -contraindicated in patients with HTN. -Need iron supplement -Need to increase dietary intake of iron, folic acid, B12 |
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What is the indication for darbapoetin alfa?
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Long acting erythropoietin for pts with CRF.
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What is the indication for filgrastim (Neupogen)?
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Severe chronic neutropenia (lack of WBCs)
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What are the side effects of filgrastim (Neupogen)?
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*Bone pain*
leukocytosis |
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What are the nursing implications for filgrastim (Neupogen)?
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*Store at ROOM TEMP*
-Monitor CBCs |
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What is the indication for pegfilgrastim (Neulasta)?
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long acting G-CSF
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What is the indication for oprelvekin (Interleukin-11, Neumega)?
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Stimulates the production of platelets for patients on chemotherapy.
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What are the side effects for oprelvekin (Interleukin-11, Neumega)?
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-Fluid retention
-Cardiac Dysrhythmias |
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What are the nursing implications for oprelvekin (Interleukin-11, Neumega)?
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-Use within 3 hours
-Monitor CBC/Platelets -Monitor fluid/electrolyte status |
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What is the normal range for RBCs?
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4.2 - 6.2
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What is the normal range for WBCs?
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5,000 - 10,000
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What is the normal range for platelets?
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150,000 - 400,000
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