Blood Thinners
Reason for giving thrombolytic.
What is lysing (breaking apart) a blood clot causing ischemia?
Classes of antihypertensive medications that can also be used to treat arrythmias.
What are Calcium Channel Blockers and Beta Blockers?
This type of nitroglycerin may be swallowed instead of leaving under the tongue.
What is sustained-release capsules?
Education needed for pt starting warfarin.
What is report signs of bleeding; avoid taking aspirin or NSAIDS; have labs drawn at appointed times, do not miss appointments, give pt list of foods that contain high amounts of Vit K, including leafy green vegetables (lettuce, chard, kale, spinach, collard greens, bok choy, ect), and do not make dietary changes without notifying MD first?
Patients should never take their cardiac medications with this type of food.
What is grapefruit juice?
Labs required to monitor warfarin therapy effectiveness.
What are PT and INR?
The two VS findings that are prioritized when administering antiarrhythmia medications.
What is B/P and pulse?
Types of routes available for administration of Nitroglycerin.
What are PO, sublingual, translingual, buccal, IV, and transdermal?
The nurse would need to reinforce this pt teaching when a pt taking an antiarrthymic medication complains of dizziness when standing?
What is slow, progressive position changes?
Common side effects from the administration of nitrates.
What are headaches, excessive hypotension, dizziness, nausea, facial flushing, and tolerance?
Antidotes for heparin and warfarin.
What are protamine sulfate (heparin) and Vitamin K (warfarin)?
This occurs when an antiarrhythmic medication causes the development of a new arrhythmia.
What is the Pro-arrhythmic Effect?
Time frame needed between doses of nitroglycerin in order to avoid nitro tolerance.
What is 8-12 hours?
Changes in condition that would require immediate notification of the physician when placing pt with arrhythmia, HTN, or angina on new medication.
What is sudden change in LOC, HR less than 50, SBP less than 100, prolonged QTc intervals found on ECG, sustained Vtach, symptoms of hepatotoxicity?
This type of medication may become less effective when pt is concurrently using anticoagulant medications.
What is birth control?
Therapeutic INR levels for warfarin therapy.
What is 2-3?
This route is used for lidocaine administration when used to treat cardiac dysrhythmias.
What is IV?
Pt education needed for the administration of PO nitroglycerin.
What is take 3 tabs 5 minutes apart; call 911 if no relief found after 1st dose; keep in original bottle and store in dark, cool place; keep on their person; sit or lay down prior to taking medication; keep under tongue/in cheek and do not swallow; replace Q 6 months?
Proper steps to giving subcutaneous injection of blood thinning medications.
What is pinch fold of skin, hold needle at 45-90 degree angle depending on amount of adipose tissue pressent, rotate administration sites, verify dosage and medication with another nurse prior to administration?
Common adverse reaction of verapamil.
What is peripheral edema?
Contraindications for thrombolytic therapy.
What is hx of aneurism, hemorrhagic stroke, GI bleed in last 6 months, intracranial or intraspinal surgery in past 2 months, brain tumor, AV malformation, platelet count <100,000, blood glucose <50 and SBP>185?
Steps needed for safe IV administration of adenosine to stop SVT.
What is rapid bolus administration (1-2 seconds); flush with saline immediately; constant ECG monitoring; and baseline VS prior to administration?
Steps taken when administering nitroglycerin ointment.
What is don gloves; remove old nitro paste and clean area with soap and water; carefully dispose of nitro patch or paste by folding patch or applicator paper in half and throwing away without touching with your skin; apply paste gently onto applicator paper; add enough to ensure paste fills to the ordered fill line (0.5-2 inches); place to new area of skin; do not rub into skin; secure with tape and initial, time, date the paper or patch?
Assessment finding noted by the nurse in a patient with internal bleeding.
What are black, tarry stool; coffee ground emesis; hematuria; petechiae; coughing or spitting up blood; joint pain; diffuse bruising; faintness; cool, clammy skin, or altered consciousness?
This possible side effect may be experienced when a patient is taking both phenytoin and amiodarone.
What is increased phenytoin levels?