The squad just delivered a 73-year-old man with crushing chest pain to the ED. He has a history of cardiovascular disease. Onset of symptoms is within the last 60 minutes. What medication would the nurse expect the physician to order for this thromboembol
Thrombolytic drugs
Aspirin is the prototype anticoagulant.
False
Enoxaparin (Lovenox) should be administered via which route?
Subcutaneous injection
Which is classified as an antiplatelet agent?
Clopidogrel (Plavix)
A nurse is caring for a patient receiving the anticoagulant drug warfarin. What pre-administration assessments should the nurse perform before administering the drug to the patient?
Assess prothrombin time (PT) and INR.
A patient is receiving low-molecular-weight heparin to prevent thromboembolic complications. The nursing student asks the instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for
LMWH is associated with less thrombocytopenia than standard heparin.
A nurse will use extreme caution when administering heparin to which patient?
A 38-year-old male with peptic ulcer disease
A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be
Protamine sulfate
A 59-year-old patient is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the patient's:
Intake of vitamin K.
A nurse has an order to administer heparin. Before initiating this therapy, a priority nursing assessment will be the patient's
aPTT.
A 61-year-old man is prescribed alteplase for an acute myocardial infarction. A priority nursing intervention will be to monitor for what during and after drug therapy?
Arrhythmias
Mr. Hon has been admitted to the hospital and placed on anticoagulant therapy. For what blood-related disorder is this therapy used?
Hypercoagulation
The nurse is caring for a 76-year-old client who is receiving IV heparin 5000 units q4h. At the initiation of therapy, the patient's control activated thromboplastin time (aPTT) was found to be 35 seconds. One hour prior to the next scheduled dose, aPTT i
hold the dose and contact the physician.
While preparing a patient for discharge, the nurse teaches about the proper use of warfarin, which has been prescribed by the physician. Which statement by the patient indicates that additional teaching is required?
I should use aspirin to control my arthritis pain.
The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will th
Vitamin K
An 86-year-old client who was admitted earlier in the week with thrombophlebitis is being sent home on enoxaparin. Which statement by the client suggests that he understands proper management of his condition and proper use of the drug?
The medication will increase my risk of bleeding.
The client is prescribed warfarin. His INR is 5.2. At what level is this dose?
Elevated
A stable daily dose of warfarin is reached when which parameter is achieved?
The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding.
A client is receiving warfarin. The nurse would expect to administer this drug by which route?
Oral
A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering:
Protamine sulfate
In acute coronary syndrome (unstable angina, MI), platelet aggregation must be inhibited before medical or surgical treatment begins. Which medication exhibits antiplatelet effects during infusion that ceases when the infusion is stopped?
Eptifibatide
A nurse would anticipate the need for an increased dosage of warfarin if the patient was also receiving:
Carbamazepine
A patient is to receive eptifibatide. The nurse would expect to administer this drug by which route?
Intravenous
Warfarin typically takes 3 days to achieve its onset of action.
True
What is used to treat a warfarin (Coumadin) overdose?
Phytonadione
Which of the following statements are true in regards to anticoagulants? Select all that apply:
Anticoagulants prevent formation of a thrombus.
Anticoagulants prevent extension of a thrombus.
A patient who has been treated with warfarin (Coumadin) after open heart surgery is involved in a car accident and has a laceration on her head. Which medication will be administered to assist in the development of clotting factors?
Vitamin K
A patient who is receiving warfarin (Coumadin) has blood in his urinary drainage bag. What medication will likely be ordered by the physician?
Vitamin K
A patient is admitted with thrombophlebitis and sent home on enoxaparin (Lovenox). Which statement indicates a good understanding of why enoxaparin is being administered?
Enoxaparin inhibits the formation of additional clots.
A patient is taking warfarin (Coumadin) to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin (Coumadin) monitored?
PT and INR
Ms. Main is sent home with subcutaneous heparin after a total hip replacement. What symptom would indicate a serious drug reaction?
Tarry stools
What values are used to monitor the effectiveness of warfarin therapy?
PT and INR
The pharmacology instructor is discussing clopidogrel. According to the instructor, this drug is frequently used for
reduction of myocardial infarction in patients with atherosclerosis.
Antiplatelet agents decrease the formation of the platelet plug by decreasing the responsiveness of the platelets to stimuli that would cause them to stick and aggregate on a vessel wall. The nurse knows that which drug is an antiplatelet agent? (Select a
ReoPro
Ticlopidine
A 75-year-old client presents to the physician's office with bleeding gums and multiple bruises. When the nurse reviews the client's drug history, the nurse finds that he is prescribed aspirin 81 mg/d. What drug may cause increased bleeding when used in c
NSAIDs
What would be considered a topical hemostatic agent?
Thrombin
A client is to receive clopidogrel. The nurse would expect to administer this agent by which route?
Oral
A client is receiving heparin. Which would the nurse use to monitor the effects of the drug?
Partial thromboplastin time
The nurse is reviewing the coagulation studies of a client who is receiving a heparin infusion. The client's baseline partial thromboplastin time is 32 seconds. Which result would indicate therapeutic effectiveness?
64 seconds
Heparin is the anticoagulant of choice during lactation.
True
Protamine is used to treat overdose of which medications? (Select all that apply.)
Heparin
Enoxaparin (Lovenox)
A female patient is taking warfarin (Coumadin) after open heart surgery. The patient tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report o
Bleeding
A female patient has a history of clot formation in the past. She is scheduled for bowel resection due to an obstruction. What anticoagulant agent will be administered prophylactically?
Heparin
A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this dru
By inactivating clotting factors and thus stopping the coagulation cascade
Heparin therapy is prescribed to a patient with deep vein thrombosis. Which patient would be at greatest risk of bleeding from this therapy?
A 45-year-old corporate executive with peptic ulcer disease
A 59-year-old client with vascular disorders is prescribed cilostazol. The nurse instructs the client that it is for the treatment of what condition?
Intermittent claudication
The female client is diagnosed with chronic renal insufficiency. Her vascular access site becomes incompetent and the physician orders urokinase to dissolve the clot. What should the nurse do?
Administer the drug as ordered.
The nurse would monitor the platelet levels closely for a client receiving:
Anagrelide
A male client who is experiencing the signs and symptoms of an acute myocardial infarction says that his symptoms started at 10:00 AM this morning. It is now 11:15 AM. The nurse understands that the latest time that the client could receive a thrombolytic
4:00 PM
A client is started on enoxaparin immediately after hip surgery. The nurse would explain to the client that this drug will be continued for how long?
7 to 10 days