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29 Cards in this Set
- Front
- Back
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What is the mechanism of action of Heparin?
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Interferes with the activation of fibrin and fibrinogen from thrombin that keeps the clots from forming.
-It cannot break up clots but keeps them from forming. -Repid Acting |
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What is Heparin used for?
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-Prevents and treats DVT, pulmonary embolism and emboli in atrial fibrillation.
-Diagnoses and treats disseminated intravascular coagulation. -Preferred anticoagulant during pregnancy. |
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Which patients are contraindicated from using heparin?
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-Bleeding tendacies (hemophilia, dissecting aneurysm, peptic ulcer)
-Thrombocytopenia, uncontrollable bleeding -Postoperative clients (especially eye, brain, spinal cord surgery, lumbar puncture, and region anesthesia. |
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What are some of the side effects of heparin use?
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Heparin induced thrombocytopenia, Large doses may suppress renal function, spontaneous bleeding at mucous membranes.
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What are the important nursing implications for Heparin?
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-Monitor the partial thromboplsatin time (PTT) and activated PTT (aPTT). It should be 1.5 to 2 times the normal range .
-Watch for bleeding -Antidote=PROTAMINE SULFATE. <>Low-molecular weight heparins does not require PTT or aPTT montirong. |
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What is the mechanism of action of Warfarin Sodium (Coumadin)?
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Antagonist of Vitamin K which is necesarry for the synthesis of clotting factors VII, IX, X and prothrombin, as a result, it disrupts the coagulation cascade.
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What are the side effects of Warfarin Sodim (Coumadin)?
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Spontaneous bleeding!!
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What are the important nursing implications of Warfarin Sodium (Coumadin)?
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-Monitor prothrombin time (PT) and international normalized ration (INR) as ordered (2 to 3 is usually an acceptable INR)
-Interacts with a large number of medications, consequently, monitor for drug interactions before initiating therapy. |
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What is the antidote for Coumadin?
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Vitamin K
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What is important teaching instruction for patients taking Warfarin Sodium (Coumadin)?
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Teach client to decrease intkae of green, leafy vegetables.
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What is Epoetin Alfa (Procrit)?
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It is a synthetic erythropoietin, which increases RBCs.
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What is Epoetin Alfa (Procrit) used for??
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It is used to treat anemia associated with renal failure and chemotherapy.
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What side effects are important to watch for when giving Epoetin Alfa (Procrit)?
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Watch for hypertension (BP), headache, nausea.
-CBC with diff. and platelets. |
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What are important nursing inplications to be aware of when giving Epoetin Alfa (Procrit)?
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-Monitor BP before erythropoietin therapy.
-Do not shake solution because it may denature the glycoprotein. Do not mix with other medicaitons. -Monitor for Seizures (rapid increase in Hct increases risk of hypertensive encephalopathy) |
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What is important to watch for when administering iron supplements?
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Tarry stools (not associated with bleeding), Nausea, Bloating, Contipation, Heartburn.
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What are Iron Supplements used for?
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All anemias other than iron deficiency anemia.
-Also peptic ulcers, regional enteritis, colitis. |
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What are important nursing implications for iron supplement administration?
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-DO NOT GIVE with antacids or tetracyclines or crush or chew sustained release medicaitons.
-Give vitamin C to promote the absorption of the iron. |
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What is important patient teaching for patients taking Iron Supplements.
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-Take between meals to maximize uptake
-Liquid preparations stain teeth, so use a straw or dilute; follow with rinsing the mouth. -Teach the client that oral iron supplements differ from one another and should not be interchanged. -Diet teaching to include iron-rick food--liver, eggs, meat, fish and fowl. |
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What is the serious/life-threatening implications for iron supplements?
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Anaphylaxis with parenteral iron dextran, as well as hypotension, headache, fever, uticaria, arthralgia.
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What is the mechanism of action of thromolytics?
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Work to directly or indirectly convert plasminogen to plasmin, an enzyme that acts to digest the fibrin matrix of clots
<>Breaks Down Clots |
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What are the types of Thrombolytics?
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Alteplase (tPA) and streptokinase
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When are thrombolytics used?
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Used for MI, ischemic stroke and PE.
-Needs to be adminstered via an infusion pump or Iv bolus immeditely after the event. |
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What are the important adverse reactions to watch for when administering thrombolytics?
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Watch for allergic reactions, spontaneous bleeding, and oozing from any fresh wound site.
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What is the expected outcome of thrombolytics?
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There will be an increase in profusion, a decrease in viscosity and an aggregation of RBCs.
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What are the side effects of thrombolytics?
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-Streptokinage: Hemorrhage (intracranial of greatest concern), anaphylaxis.
-Alteplase (tPA) and Tenecteplase: Risk of intracranial hemorrhage is higher. |
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What are some contraindications for using Thrombolytics?
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-Cerebrovascular disease and pregnancy
-Active bleeding, aoritc dissection, pericarditis -History of intracranial hemorrhage -Recent major surgery -history of GI bleeding. |
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What does, and how does Clopidogrel (Plavix) work?
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Plavix works by inhibiting platelet aggregation. Used to decrease incidence of vascular clotting, MIs, stroke and acute coronary syndrome.
--Antiplatelet Agent |
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What adeverse reactions and contraindications are common for patient taking Clopidogrel (Plavix)?
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Watch for rash and GI upset. Use with caution in hepatic and renal problems and with a history of bleeding.
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What are important patient teaching for patients taking Clopidogrel (Plavix)?
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-Adminster with food to diminish GI upset
-teach client to report an unusual bleeding or bruising -teach clients that if surgery is scheduled, medication may be held 3-7 days before surgery. |
