exam 3: clotting Flashcards
(57 cards)
1
Q
anticoagulation meds
A
- heparin
- enoxaparin
- warfarin
- apixaban
2
Q
antiplatelet meds
A
- aspirin
- clopidogrel
3
Q
thrombolytic med
A
alteplase
4
Q
heparin action
A
- prevention of thromboembolism
- inactivated thrombin, thus preventing the fibrinogen converting to fibrin
5
Q
disorders heparin prevents thromboembolisms with
A
- PE
- MI
- unstable angina
- artificial heart valves
- DVT
- DIC (disseminated intravascular coagulation)
6
Q
why is heparin given SQ/IV?
A
poorly absorbed in the GI system
7
Q
heparin s/e
A
- itching
- chills
- hematoma
- epistaxis
- hematuria
8
Q
major s/e of heparin
A
- anemia
- bone fractures
- osteoporosis
- GI bleeding
- hemorrhage
- thrombocytopenia
9
Q
heparin antidote
A
protamine sulfate
10
Q
pt education for heparin
A
avoid large amounts of green leafy vegetables d/t vitamin k
11
Q
enoxaparin action
A
- prevention of VTE, DVT, or PE
- treatment of DVT with or without PE
12
Q
enoxaparin BBW
A
administering two heparin products concomitantly can result in serious harm or death
13
Q
common s/e of enoxaparin
A
- bleeding
- hematoma
- fever
- anemia
- peripheral edema
- elevated liver enzymes
14
Q
major s/e of enoxaparin
A
- hemorrhage
- hematuria
15
Q
enoxaparin contraindications
A
- stroke
- peptic ulcers
- hypersensitivity to pork
- active bleeding
16
Q
enoxaparin nursing considerations
A
- should not be given to eye, brain or spinal surgery pts
- do not expel the air in the syringe
17
Q
pt education for enoxaparin
A
avoid large amounts of green leafy vegetables, coffee, tea
18
Q
warfarin action
A
inhibits hepatic synthesis of vitamin k clotting factors
18
Q
warfarin indication
A
prevention of thrombophlebitis, PE, and embolism formation r/t stroke
19
Q
common s/e of warfarin
A
- nausea
- GI cramping
- ecchymosis
- h/a
19
Q
major s/e of warfarin
A
- black tarry stool
- hemorrhage
20
Q
BBW for warfarin
A
crosses placenta
may cause fetal fatality from hemorrhage
21
Q
what to monitor during warfarin therapy
A
- PT/INR
- hematuria and occult blood stool
- hepatic function (AST/ALT)
22
Q
pt education for warfarin
A
- eat balanced levels of vitamin k rich foods
- use soft toothbrush, floss carefully, utilize electric razor
- report bleeding
23
apixaban action
inhibits the conversion of prothrombin to thrombin in the prevention of clot formation
24
apixaban treats. . .
- DVT
- PE
- stroke prevention
- a-fib
25
common s/e of apixaban
- hematoma
- anemia
- bleeding
- epistaxis
- hematuria
- menorrhagia
- hemoptysis
26
major s/e of apixaban
- bleeding (vaginal, GI, intracranial)
- hypotension
27
contraindications for apixaban
- active bleeding
- severe hypersensitivity
28
labs to monitor with apixaban
- CBC, platelet count
- PT/INR
29
aspirin prevents/treats. . .
- MI
- TIA
- a-fib
- prophylaxis for TE
30
excessive amounts of aspirin can lead to. . .
- SJS
- anaphylaxis
- laryngeal edema
31
common s/e of aspirin
- tinnitus
- dyspepsia
- GI upset
- nausea
- increased bleeding
- anemia
32
major s/e of aspirin
toxicity
- tinnitus
- hyperventilation
- confusion
- lethargy
- agitation
33
labs to monitor with aspirin
- prolonged bleeding time
- hepatic function
34
pt teaching for aspirin
- avoid alcohol
- inform HCP of med prior to surgery
35
clopidogrel action
inhibition of platelet aggregation- prevention of ADP bonding with the platelet receptor site
36
common s/e of clopidogrel
- abdominal pain
- dizziness
- epistaxis
- h/a
- hematoma
- diarrhea
- constipation
- purpura
- peripheral edema
37
MAJOR s/e of clopidogrel
- bleeding
- peptic ulcer
- intracranial bleeding
38
life threatening s/e of clopidogrel
- aplastic anemia
- agranulocytosis
- SJS
- pancytopenia
- thrombocytopenia
39
agranulocytosis
severe neutropenia
40
contraindications for clopidogrel
- GI bleed
- intracranial hemorrhage
41
administer clopidogrel with caution in pts with. . .
- hepatic/renal disease
- surgery
- peptic ulcer
- trauma
42
labs to monitor with clopidogrel
- prolonged bleeding time
- CBC
- platelet count
43
pt education for clopidogrel
- effects are decreased with grapefruit juice
- call PCP if fever, chills, core throat or unusual bleeding/bruising occur
44
med that needs to be discontinued a minimum of 5 days prior to surgery
clopidogrel
45
alteplase action
promotes plasminogen to plasmin ---> breakdown of fibrin clots
46
alteplase treats. . .
- ischemic CVA or PE
- occluded central lines
47
thromboembolism
occlusion of an artery or vein caused by a thrombus or embolus
48
thromboembolism results in. . .
ischemia: deficient blood flow possibly causing tissue necrosis in obstructed area
49
common s/e of alteplase
- epistaxis
- hypotension
- ecchymosis
- rash
50
major s/e of alteplase
- anaphylaxis
- HTN
- MI
- cerebral edema
51
life threatening s/e of alteplase
- stroke
- dysrhythmia
- pulmonary edema
- renal failure
52
contraindications for alteplase
- internal bleeding
- bleeding disorders
- severe liver dysfunction
- head trauma
53
use caution with these pts if prescribed alteplase
- a-fib
- hepatic/renal disease
- CABG
- PUD
54
what to monitor when administering alteplase
- PT/aPTT
- H/H, platelets
- neuro status
55
avoid administering clotting medications concurrently with. . .
- NSAIDs
- SSNRIs
- SSRIs
