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39 Cards in this Set

  • Front
  • Back
What are anticoagulants used for?
prevention and treatment of thromboembolic disorders including:
DVT
PE
atrial fibrillation with
embolization
MI management
in combination with thrombo-
lytic agents and/or
antiplatelet agents
Anticoagulants are used to prevent?
clot extension
clot formation
Anticoagulants DO NOT dissolve _____?
clots
Two most commonly used anticoagulants are?
parenteral heparins
oral warfarin
Therapy is usually INITIATED with _____ or a _____- like agent because of rapid onset of action, while MAINTENANCE therapy consists of _____.
heparin
heparin
warfarin
Warfarin takes ______ days to produce therapeutic anticoagulation.
several
In serious or severe thromboemoblic events, _____ therapy may be preceded by thrombolytic therapy.
heparin
Low doses of ______ or ____-like compounds and _____ are mostly used to prevent deep vein thrombosis after certain surgical procedures and in similar situations in which prolonged bedrest increases the risk of thromboembolism
heparin
heparin
fondaparinux
Which two agents are used as anticoagulation in patients who have developed thrombocytopenia during heparin therapy?
argatroban
lepirudin
Contraindications for anticoagulants? (5)
underlying coagulation
disorders
ulcer disease
malignancy
recent surgery
active bleeding
Anticoagulation should be undertaken cautiously in any patient with a potential site for _______.
bleeding
Pregnant or lactating patients should not receive _____.
warfarin
Heparin does not cross the _____
placenta
Heparin and heparin-like agents should be used cautiously in patients receiving ______ analgesia.
epidural
Warfarin is highly _____ bound and may displace or be displaced by other highly _____- bound drugs. The resultant interactions depend on which drug is _____.
protein
protein
displaced
Bleeding may be potentiated by 1_____ or large doses of 2_____ or 3______ -like drugs, cefamandole
cefoletan
cefoperazone
plicamycin
valproic acid
NSAIDS
1 aspirin
2 penicillin
3 penicillin
Assess patient taking anticoagulants for signs of 1_____ and 2______.
Signs of these 2 symptoms include? (9)
1 bleeding
2 hemorrhage

bleeding gums
nosebleed
unusual bruising
tarry, black stools
hematuria
fall in hematocrit or blood
pressure
guaiac-positive stools
urine
NG aspirate
Assess patient for evidence of additional or increased _____. Symptoms will depend on the area of involvement.
thrombosis
Monitor 1_____ _____ or
2_____ with warfarin therapy.
1 prothrombin time
2 INR
Monitor 1______ _____ ______ ____ with full-dose heparin therapy
1 aPTT
Two other lab studies to monitor during therapy are? (2)
hematocrit
other clotting factors
While going through antiplatelet therapy, monitor 1 _____ _____.
Prolonged bleeding time, which is time and dose dependent, is expected.
1 bleeding time
TOXICITY AND OVERDOSE:
If overdose occurs or anticoagulation needs to be immediately reversed, the antidote for heparins is
1 ____ ____
1 protaminen sulfate
TOXICITY AND OVERDOSE:
If overdose occurs or anticoagulation needs to be immediately reversed, the antidote for warfarin is ____ ____
1 vitamin K (phytonadione (AquaMEPHYTON)
Administration of 1____ _____ or 2_____ may also be required in severe bleeding due to warfarin because of the delayed onset of vitamin K.
1 whole blood
2 plasma
Potential Nursing Diagnoses?
(3)
Tissue perfusion, altered
Injury, risk for
Knowledge deficit, related
to medication regimen
Inform all hcps caring for patient of anticoagulant therapy. _______ and ____ sites require application of pressure to prevent bleeding or hematoma formation.
Venipuncture
injection
Use an 1____ _____ with continuous 2_____ to ensure accurate dosage.
1 infusion pump
2 infusions
Caution patient to avoid activities leading to injury, to usa a 1_____ ____
and 2______ _____ and to report any symptoms of unusual bleeding or bruising to hcp immediately.
1 soft toothbrush
2 electric razor
Instruct patient not to take OTC medications, especially those containing (3) without advice of hcp.
aspirin
NSAIDs
alcohol
Review foods high in 1_____ ____ with patients on warfarin. Patient should have consistent limited intake of these foods, as 2 ____ ____ is the antidote for warfarin and greatly alternating intake of these foods will cause PT levels to fluctuate.
1 vitamin K
2 vitamin K
Emphasize the importance of frequent lab tests to monitor 1_____ _____.
1 coagulation factors
Instruct patient to carry ID describing medication regimen at all times and to inform all hcps caring for patient of anticoagulation therapy before 1______ _____,
2______, or 3______.
laboratory tests
treatment
surgery
Clinical response can be evaluated by? (4)
prevention of undesired
clotting and its sequelae
without signs of
hemorrhage
prevention of stroke, MI,
and death in patients
at risk
Four groups of anticoagulants are?
coumarin
factor xa inhibitors
heparin/heparinoids/low-
molecular weight heparins
thrombin inhibitors
Coumarin is? (1)
warfarin Coumadin {Warfilone}
Factor xa inhibitor is? (1)
fondaparinux Arixtra
Heparin/heparinoids/low-molecular weight heparins are? (4)
dalteparin Fragmin
danaparoid Orgaran
enoxaparin Lovenox
tinzaparin Innohep
Thrombin inhibitors are? (3)
argatroban Argatroban
bivalirudin Angiomax
lepirudin Refludan