Pathophysiology
______ provides the first aspect of inhibiting bleeding
- Platelets
All anticoagulants have a risk of ____
Bleeding
What is/are the route this medication goes through
- Parenterally only
What is another term for Coumadin?
- Warfarin
What is the onset of heparin?
- 20-30 minutes
Where can the clotting factor be found?
What can be prescribed to a patient who has a symptom of GI bleeding
- PPI (Proton Pump Inhibitors) Proton-pump inhibitors are a class of medications that cause a profound and prolonged reduction of stomach acid production.
What is the reversal agent for heparin?
What lab values are monitored for warfarin? And what patient education/nursing considerations should be discussed
- PT and INR. Normal INR 1.1 and below. With therapy, it is 2-3
- Labs should be assessed regularly at the start of therapy
What is the meaning of UFH?
- Unfractionated heparin
Platelets are then reinforced with ____ resulting from the coagulation pathway
Fibrin
Provide at least two cams that can interfere with anticoagulants
- Ginkgo biloba
- Garlic
- Ginger
What is the MOA of this medication?
Inactivates thrombin and prevents conversion of fibrinogen to fibrin
What is the MOA of this medication?
- Decreasing production of vitamin K-dependent clotting factors (VII, IX, X, and prothrombin)
In this jeopardy quiz, what medication is considered safe for pregnancy?
- Heparin
When should a patient be discontinued from an anticoagulant medication?
- Prior to surgery
What nursing considerations should be discussed for a patient taking anticoagulants? Think of precautions.
- Bleeding precautions
Provide at least two instances where heparin is used
- atrial fibrillation
- DVT
- pulmonary embolism
- AMI
What is the route used by this medication, and how long is the onset?
- Oral
- Onset is 1-3 days
What is the reversal agent for warfarin?
- Vitamin K
Provide at least four examples of bleeding precautions
- Use of electric razor
- Soft bristle brush
- Avoid risky behavior
- Decrease needle sticks
- Avoid aspirin
- Provide stool softener
What is the importance of plasmin in this module?
Plasmin is the key enzyme in the fibrinolytic cascade dissolving blood clots.
What lab values should you monitor for a patient taking heparin? And what is the normal range and therapy value?
- aPTT, Xa, and PTT
- aPTT - 40 seconds (normal), 60-80 seconds (therapy value)
- Interacts with many medication
- Patients cannot increase their dietary intake of vitamin k
Transition from heparin (acute setting) to warfarin (long term) requires _____ ______
Overlapping dosing