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anticoags Flashcards

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1
Q

anticoagulants (heparin): drug names

A
  • unfractionated heparin (heparin)
  • low molecular weight heparin (LMWH)
    …enoxaparin (lovenox)
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2
Q

anticoagulants (heparin): reasons for taking

A
  • prophylactically to prevent clot formation in pts with the following conditions.
  • MI
  • atrial fibrillation
  • CVA
  • post stent
  • implanted devices
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3
Q

anticoagulants (heparin): action

A
  • inhibits clot formation. specifically, lla (thrombin)
  • lovenox works more on factor X
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4
Q

anticoagulants (heparin): adverse reactions/side effects

A
  • heparin induced thrombocytopenia (HIT)
  • excessive bleeding
  • bruising
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5
Q

anticoagulants (heparin): contraindications

A
  • recent surgeries
  • GI bleed
  • PUD
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6
Q

anticoagulants (heparin): routes

A

SQ, IV

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7
Q

anticoagulants (heparin): pt education
- report any ___ or ___ to the physician
- wear a _____
- rotate ____
- avoid other ___
- medication may ____
- keep ____ in lovenox prefilled syringe

A
  • unusual bleeding, bruising
  • medical alert bracelet
  • injection sites
  • NSAIDS, herbals, and anticoagluants
  • burn/bruise
  • air bubble
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8
Q

anticoagulants (heparin): nursing implications
- assess ___ before and after administering
- assess low ____
- assess ___ levels before administering each dose
- ____ levels between ___ and ___ is considered therapeutic
- check med list for other ____
- HOLD lovenox if ____ are less than ___ thousand

A
  • bleeding
  • hemoglobin
  • PTT
  • PTT, 46, 70
  • anti-coagulants
  • platelets, 50
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9
Q

anticoagulants (heparin):
1. antidote for heparin?
2. what site are these administered on a pt?
3. signs of bleeding to watch for?

A
  • protamine sulfate (1mg/100 units)
  • subcu fat in love handles
  • in stool, gums, foley, IV site, wounds
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10
Q

Anticoagulants (vitamin K factor): drug name

A

warfarin (coumadin)- most common but not the safest

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11
Q

Anticoagulants (vitamin K factor): reason for taking

A
  • long term management of an MI, atrial fibrillation, and implanted devices
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12
Q

Anticoagulants (vitamin K factor): action

A

inhibits production of vitamin K dependent clotting factors

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13
Q

Anticoagulants (vitamin K factor): adverse reactions/side effects

A
  • bleeding
  • purple toe
  • warfarin toxicity
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14
Q

Anticoagulants (vitamin K factor): contraindications

A
  • recent surgeries
  • GI bleed
  • PUD
  • many drug interactions
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15
Q

Anticoagulants (vitamin K factor): route

A

PO

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16
Q

Anticoagulants (vitamin K factor): pt education
- avoid ____
- report any unusual ___ or ____ to physician
- wear a _____
- do not change the intake amount of ____
- avoid all ____ medications

A
  • alcohol
  • bleeding, bruising
  • medical alert bracelet
  • green leafy vegetables
  • herbal
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17
Q

Anticoagulants (vitamin K factor): nursing implications
- assess ____ before and after administering
- monitor ____ levels
- be ready to administer ____ if bleeding occurs
- for ____ bleeding, administer ____

A
  • bleeding
  • PT/INR (2-3.5 is therapeutic)
  • vit K (10mg)
  • life threatening, Kcentra
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18
Q

Anticoagulants (vitamin K factor):
1. what do you do if warfarin level is toxic?
2. what are examples of foods to avoid?
3. what two cardiac medications can decrease the effectiveness of warfarin?
4. often used with ___ IV until warfarin reaches therapeutic level, then heparin is ___
5. pt is resistant to warfarin for up to ___ days after being given vit K

A
  • give pt vit K
  • broccoli, lettuce, spinach, kale, cabbage, tomatoes
  • amiodarone and diltazem
  • heparin, discontinued
  • 7
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19
Q

Anticoagulants (factor X): drug names

A
  • rivaroxaban (xarelto)
  • fondaparinux (arixtra)
  • apixaban (eliquis)
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20
Q

Anticoagulants (factor X): reason for taking

A
  • prevent CVA in pts with afib, post-op ortho surgeries
  • Hx of DVT or PE- to help avoid a recurrence
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21
Q

Anticoagulants (factor X): action

A

inhibits factor Xa production

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22
Q

Anticoagulants (factor X): adverse reactions/side effects

A
  • peripheral edema
  • bleeding and bruising
  • dizziness
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23
Q

Anticoagulants (factor X): contraindications

Study These Flashcards
A
  • recent surgeries
  • GI bleed
  • PUD
  • NSAID
24
Q

Anticoagulants (factor X): route

25
Anticoagulants (factor X): pt education - take whole. do not ___ or ____ - if ____ and ____ occur; do not stop taking medication. Call ____ - stop if any usual ____ or___ - notify physician for ______
- crush, split - nausea, vomiting, MD - bleeding, bruising - black tarry stools
26
Anticoagulants (factor X): nursing implications - monitor ___ - assess for ____ before and after administering - monitor _____ serum enzymes - monitor ___
- vitals - bleeding - renal/liver - BUN, ALT/AST
27
Anticoagulants (factor X): ____after epidural or can cause spine hematoma
6 hours
28
Antiplatelet: drug names
- aspirin (asa) - clopidogrel (plavix)
29
Antiplatelet: reason for taking
post CVA, MI, and stent placements
30
Antiplatelet: action
make platelets slicky so they don't adhere to BV wall
31
Antiplatelet: adverse reactions/side effects
bleeding: - gums - nose bleeds - puncture sites - surgical sites - hematura
32
Antiplatelet: contraindications
many drugs: - amiodorone - PPI (proton pump inhibitor) - CCB(calcium channel blockers)
33
Antiplatelet: routes
PO, ASA rectal
34
Antiplatelet: pt education - take at the ___ every day - report any unusual ____ or ____ to your physician - do not ___ enteric-coated aspirin - take aspirin with ___ to ___ ounces of ___ or with ___ - caution with ___, ____ and st jons wart - do not ___ enteric coated or ___ dose aspirin
- same time - bleeding, bruising - crush - 6, 8, water, food - ginko, ginger - crush, low
35
Antiplatelet: nursing implications - any abnormal ____ - medication list for other _____, anticoagulants - monitor ____ and ____ (very little effect on these labs but if they are already low, could be an issue)
- bleeding - NSAIDS - platelets, HGB
36
Antiplatelet: - avoid herbal drugs with ___ effects - do not ___ a dose - make sure MD knows a pt is taking aspirin for ___ - ADP inhibitor: drug that prevents platelets from ____
- bleeding - skip - arthritis - aggregating (clotting)
37
Antihyperlipidemic (bile acid sequestrants): drug name
cholestyramine (questran)
38
Antihyperlipidemic (bile acid sequestrants): reason for taking
hyperlipidemia (elevated lipids)
39
Antihyperlipidemic (bile acid sequestrants): action
prevents reabsorption of bile acids from the small intestines, excrete bile acid in stool, body will use more cholesterol to make bile acids which lowers amount of cholesterol in blood
40
Antihyperlipidemic (bile acid sequestrants): adverse reactions/side effects
- constipation - headache - loss of appetite - heartburn - vitamin deficiencies
41
Antihyperlipidemic (bile acid sequestrants): contraindications
- bowel obstruction - phenylretohuria (PKU)
42
Antihyperlipidemic (bile acid sequestrants): route
PO
43
Antihyperlipidemic (bile acid sequestrants): pt education - ___ plenty of fluids - eat ____ foods to avoid constipation - lipid cholesterol levels should be <___, if above diet is implemented, if diet doesn't work then med is given
- drink - high fiber - 200
44
Antihyperlipidemic (bile acid sequestrants): nursing implications - caution with ___, ___, and ___ (effects absorption)
- digoxin, warfarin, diuretics
45
Antihyperlipidemic (bile acid sequestrants): - powder mixed with water or juice (except ___) - can be used with ___ - take these meds ___ hour after or ___ hours before a meal to avoid interfering absorption - some literature suggests these meds raise liver enzymes so monitor ___ - long term use may affect vit __, __, __ absorption, so talk to MD abt supplements
- grapefruit juice - statins - 1, 4-6 - ALT/AST - A, D, K
46
Antihyperlipidemic (HMG- CoA inhibitors): ending
- statins
47
Antihyperlipidemic (HMG- CoA inhibitors): drug names
- simvastatin (zocor) - atorvastatin (lipitor) - rosuvastatin (crestor)
48
Antihyperlipidemic (HMG- CoA inhibitors): reason for taking
hyperlipidemia (elevated lipids)- high cholesterol
49
Antihyperlipidemic (HMG- CoA inhibitors): action
inhibits the HMG-CoA enzymes which help makes cholesterol
50
Antihyperlipidemic (HMG- CoA inhibitors): adverse reactions/side effects
- GI upset - rashes - muscle pain - liver problems
51
Antihyperlipidemic (HMG- CoA inhibitors): contraindications
- grapefruit juice - some cardiac drugs - antifungal and antibiotics
52
Antihyperlipidemic (HMG- CoA inhibitors): route
PO
53
Antihyperlipidemic (HMG- CoA inhibitors): pt education - report unusual ___ - check ____ regularly - take with meals or ____ ounces of water - may interact with ____ and ____ - report changes in ____ color - take ___ hour before or ___ hours after a meal to avoid absorption issues
- muscle soreness - liver enzymes - 8 - contraceptives, antibiotics - urine - 1, 4
54
Antihyperlipidemic (HMG- CoA inhibitors): nursing implications - monitor total ____ - monitor HDL and ____ - monitor AST, ALT and ____ - monitor vitamins ___, ___, and ___
- cholesterol - LDL- HDL is GOOD, LDL is BAD - CPK - A, D, K
55
Antihyperlipidemic (HMG- CoA inhibitors): - have a good ____ and ____ - avoid direct sunlight, causes ___
- diet, exercise - photosensitivity "Statins no Sun"

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