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43 Cards in this Set

  • Front
  • Back
A brand of warfarin is?
Coumadin
The therapeutic classification of warfarin is?
anticoagulant
The pharmacologic classification of warfarin is?
coumarins
Warfarin is what kind of agent?
coagulation modifier agent
Indications for warfarin are?
prophylaxis and treatment of:
venous thrombosis
pulmonary embolism
atrial fibrillation with
embolization
managment of myocardial
infarction
decreases risk of death
decreases risk of subsequent
MI
decreases risk of future
thromboembolic events
prevention of thrombus
formation and embolization
after prosthetic valve
replacement
MOA of warfarin?
interferes withh hepatic synthesis of which vitamin-dependent clotting factors?
vitamin K-dependent clotting factors II, VII, IX, X
Therapeutic effects of warfarin include?
prevention of thromboembolic events
Assess patient for signs of which two problems?
bleeding
hemorrhage
Assess patient for what mouth condition?
bleeding gums
Assess patient's face for?
nosebleed
Assess integumentary for?
excessive bruising
Assess bowel movement for?
black, tarry stools
guaiac-positive stools
Assess blood for?
hematuria
fall in hematocrit
fall in blood pressure
Assess urine for?
guaiac-positive urine
Assess nasogastric tube for?
nasogastric aspirate
What are therapeutic ranges for PT and other clotting factors which should be monitored for frequently during therapy?

a standardized system that provides a common basis for communicating and interpreting PT results
1.3 to 1.5 times greater than control

may also be reported as INR...what is INR?
Define INR?
international normalized ratio

2-3 times the control value...PT of 1.5-2 or INR of 3-4.5 may be used for patients with high risk of embolization
a standardized system that provides a common basis for communicating and interpreting PT results...PT values of 1.3-1.5 times the control are equivalent to INR values of?
What liver and blood test should be monitored before and periodically throughout therapy?
hepatic function
CBC
What should be monitored for occult blood before and periodically throughout therapy?
stool
urine
Withholding 1 or more doses of medication is usually sufficient if PT is? (2)
excessively prolonged or if minor bleeding occurs
If overdose occurs or anticoagulation needs to be immediately reversed, the antidote is?
vitamin K (phytonadione,
AquaMEPHYTON)
Administration of whole blood or plasma also may be required in severe bleeding because of the delayed onset of?
vitamin K
Medication errors involving anticoagulants have resulted in serious harm and death from?

INR
PT...and have second physician independently check original order
internal or intracranial bleeding...before administering, evaluate which recent labs?
Because of the large number of medications capable of significantly altering warfarin's effects, careful monitoring is recommended when ______ _______ are started or other agents are discontinued.
new agents
What time of day should warfarin by administered?
same time each day
PO warfarin requires how many days to reach effective levels and is usually begun while patient is still on which med?
3-5 days
heparin
Do not interchange brands because?
potencies may not be equivalent
Direct IV: Reconstitute with 2.7 ml of _____ water
for injection.
Don't use solutions that are?

4 hrs
sterile

discolored or contain particulate matter...reconstituted solution is stable for how many hours at room temp?
Instruct patient to take med exactly as directed. If a dose is missed, tell patient?

at time of checkup or lab tests
to take it as soon as remembered that day, but don't double dose...hcp should be informed of missed doses when?
Review foods high in vitamin

antidote

alternating intake of these foods will cause which level to fluctuate?
K...patient should have consistent limited intake of these foods, as vitamin K is the what for warfarin?

PT
Caution patient to avoid which injections?
IM...and avoid activities leading to injury
Instruct patient to use what kind of toothbrush?
soft...don't floss...shave with electric razor during warfarin therapy
Advise patient that venipunctures and injection sites require application of?

bleeding
hematoma formation
pressure to prevent what?
Advise patient to report any symptoms of unusual?
bleeding or bruising
What should be noted as abnormal in the mouth?
bleeding gums

notify dr
What should be noted as abnormal on the face?
nosebleed

notify dr
What should be noted as abnormal in stools?
black and tarry stools

notify dr
What would be considered abnormal in the blood?
hematuria

notify dr
What would be noted concerning menstrual flow?
excessive flow

notify dr
What should the patient NOT ingest while taking warfarin?
alcohol
OTC meds, esp NSAIDs or
aspirin-containing
don't start or stop any
new meds without dr's
advice
What should be frequently monitored as far as lab tests?
coagulation factors
Instruct patient to carry ID with what?
description of medication regimen...carry at all times and inform hcp caring for patient on anticoagulant therapy before lab tests, treatment or surgery
Clinical response to therapy can be evaluated by?
Prolonged PT (1.3 -2.0
times the control; may
vary)
OR
INR of 2-4.5 without signs
of hemorrhage