Antiplatelet Therapy
This daily medication prevents platelets from sticking together in patients with coronary stents.
What is clopidogrel?
This anticoagulant cannot be absorbed orally and is given only by injection.
What is heparin?
These drugs are given IV to break down existing blood clots by converting plasminogen to plasmin.
What are fibrinolytics?
Excessive bleeding and thrombocytopenia are common reactions to this anticoagulant class.
What are indirect thrombin inhibitors (heparin, enoxaparin)?
Patients on anticoagulants should report early signs of bleeding, including these common symptoms.
What is easy bruising, gum bleeding, blood in urine/stool, or tarry stools?
This is the teaching point for mild bleeding or bruising while on heparin.
What is that mild bruising is expected, but report heavy or abnormal bleeding immediately?
Patients taking this common antiplatelet drug must be monitored closely for bleeding, especially older adults.
What is aspirin?
The therapeutic aPTT for continuous heparin therapy should be this multiple of the control value.
What is 1.5–2.5 times the control value?
The critical factor in fibrinolytic therapy for MI or stroke is this.
What is timing (within 12 hours for MI or 3 hours for stroke)?
This life-threatening skin reaction may occur in the first 10 days of warfarin therapy.
What is skin necrosis?
This subcutaneous injection technique reduces risk of bleeding and bruising.
What is: do not aspirate, do not massage, do not move the needle?
An older adult on NSAIDs and aspirin develops dark, tarry stools. First action?
What is hold the dose and notify the healthcare provider (risk of bleeding)?
Antacids must be separated from this class of drugs by 1–2 hours to avoid interference.
What are antiplatelet drugs?
These indirect thrombin inhibitors work by increasing this naturally occurring protein.
What is antithrombin III?
These are the only settings where fibrinolytic drugs are used.
What are acute MI, acute pulmonary embolism in unstable patients, acute ischemic stroke, or acute arterial occlusion?
Patients on ESAs are at increased risk for this because blood becomes thicker.
What is hypertension, stroke, MI, or blood clots?
Direct thrombin inhibitors must be stored this way to prevent degradation.
What is in the original bottle, protected from light and moisture?
A patient receiving ESAs reports generalized body aches. What should the nurse do?
hat is monitor but expect mild pain; inform patient this is common at injection site?
Antacids must be separated from this class of drugs by 1–2 hours to avoid interference.
What is St. John’s wort?
The therapeutic INR range for most patients on oral anticoagulants is this.
What is 2.0–3.0?
Fibrinolytic drugs help limit this by restoring blood flow quickly.
What is cellular damage?
Unusually heavy menstrual bleeding in a patient on apixaban may indicate this.
What is internal bleeding?
Foods high in this vitamin may interfere with anticoagulants and should be limited.
What is vitamin K?
A patient on apixaban reports dizziness, cold clammy skin, and hypotension. What is suspected?
What is internal bleeding requiring urgent evaluation?
This is the critical teaching point for patients with stents taking antiplatelet therapy.
What is take it daily for a year or longer to prevent clot formation in the stent?
Unlike warfarin, these newer drugs do not require frequent blood monitoring.
What are direct thrombin inhibitors (apixaban, dabigatran, rivaroxaban)?
This route of administration is always used for fibrinolytics.
What is IV only?
This medication is used as a warfarin antidote to restore clotting factors.
What is phytonadione (vitamin K)?
This is the teaching point for mild bleeding or bruising while on heparin.
What is that mild bruising is expected, but report heavy or abnormal bleeding immediately?
A patient is on warfarin, heparin, and has a history of MI. Labs show low platelets, elevated INR, and blood in urine. Identify the three immediate priorities.
What is risk of active bleeding
What is adjust/hold anticoagulant therapy
What is notify healthcare provider immediately for intervention