Warfarin typically takes 3 days to achieve its onset of action.
True
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 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 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 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 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
Ms. Adams is started on warfarin therapy. The patient asks the nurse why she is no longer on heparin therapy. What differentiates heparin from warfarin?
Heparin is administered parenterally, while warfarin is administered orally.
What drug may cause increased bleeding when used in conjunction with the aspirin?
NSAIDs
Heparin is the anticoagulant of choice during lactation.
True
Which would the nurse identify as the end of the intrinsic pathway?
Thrombin formation
A patient is to receive abciximab. The nurse would expect to administer the drug by which route?
Intravenous
When describing the action of low-molecular weight heparins, which would the nurse include? (Select all that apply.)
Blockage of factor Xa
Blockage of factor IIa
After teaching a group of students about anticoagulants, the instructor determines that the teaching was successful when the students identify which agents as interacting with warfarin that increase the risk of bleeding? (Select all that apply.)
Salicylates
Ranitidine
Metronidazole
Cefoxitin
Fondaparinux (Arixtra) is indicated for:
DVT prophylaxis.
What are situations in which the nurse would hold the drug and notify the physician? (Select all that apply.)
PT exceeds 1.5 times the control value
There is evidence of bleeding
INR is greater than 3.0
A female patient is being administered heparin IV and has been started on warfarin (Coumadin). The patient asks the nurse why she is taking both medications. What is the nurse's most accurate response?
Warfarin takes 3-5 days to develop anticoagulant effects, and you still need heparin.
Which patients would be the best candidate to receive alteplase recombinant therapy?
A 68-year-old male who has had an ischemic stroke that resulted in neurological deficits
Mr. Bradford is a 66-year-old smoker with a diagnosis of peripheral vascular disease who experiences lower leg pain when walking. In the last several months, his leg pain has progressed to the point where he now needs to take a rest when walking from the
pentoxifylline (Trental).
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.
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
The physician reorders dalteparin for the client. The pharmacy states that the drug is not available. The nurse calls the physician and asks if dalteparin can be replaced with another LMWH. What does the nurse expect to be the physician's response?
The drugs are not interchangeable; have the pharmacy obtain the drug ordered.
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
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 67-year-old man enters the emergency department reporting severe chest pain that is radiating down the left arm. He is diagnosed with a myocardial infarction. What drug does the nurse anticipate the physician ordering for this client?
Alteplase
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
A 79-year-old woman is admitted to the hospital with black, tarry stools and several large, scattered ecchymosis. The patient has a history of TIAs and has taken clopidogrel for several years. What would the nurse expect the physician to prescribe to cont
None of these
Which agent would a nurse expect to administer to a patient with Christmas disease?
Factor IX complex
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 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 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
The physician discovers a clot in the client's left lower leg. The physician prescribes anticoagulant drugs to prevent formation of new clots and to achieve which other effect?
Prevent extension of clots already present
What would be considered a topical hemostatic agent?
Thrombin
A patient receiving heparin has a baseline aPTT of 28 seconds. Which result would the nurse interpret as suggesting too much heparin?
98 seconds
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.
An instructor describes the action of some anticoagulants as blocking the formation of thrombin from prothrombin. Which drugs would the instructor use as examples for this action? (Select all that apply.)
Heparin
Argatroban
Bivalirudin
Ms. Kim is admitted to the hospital for treatment of a pulmonary embolism. Forty-eight hours after therapy has started, Ms. Kim reports bleeding from her gums when she brushes her teeth. The nurse notes this to be an adverse effect of the medication and c
Administer protamine sulfate, at a dosage of 1 mg per 100 units of heparin, for a maximum dose of 100 mg.
What would a nurse identify as a systemic hemostatic agent?
Aminocaproic acid