NR293: Week 4 | UPDATED Questions with 100% Verified
Answers
Q1: Two major types of coagulation modifiers are:
A: Anticoagulants Antiplatelets
Q2: Anticoagulants
A: These drugs prevent the formation of new clots and stop existing clots from getting larger.Commonly used in
conditions like atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism (PE). They do not break down
existing clots. Careful monitoring is essential due to a high risk of bleeding and potential for serious adverse effects.
Many anticoagulants are frequently involved in adverse drug events in clinical settings.
Q3: Antiplatelets
A: These medications prevent platelets from clumping together, which is a key first step in clot formation. Often used to
prevent heart attacks, strokes, or clot formation in stents. Common examples include aspirin and clopidogrel.
Q4: Extrinsic Pathway:
A: Activated by external injury to the blood vessel (e.g., trauma).
Q5: Intrinsic Pathway:
A: Activated by internal damage to the vessel (e.g., plaque rupture).
Q6: The 3 Stages of Coagulation
A: 1. Clot Initiation 2. Clot Formation 3. Fibrinolysis
Q7: 1. Clot Initiation
A: Injury to a vessel activates coagulation factors in a step-by-step cascade. Platelets rush to the injury site and become
sticky, adhering to the damaged vessel and each other. This forms a temporary platelet plug to limit blood loss.
Q8: 2. Clot Formation
A: Activated platelets release fibrin, a protein that weaves through Fibrin binds with red blood cells and more platelets to
form a stable clot. As fibrin strands tighten, the clot becomes denser and stronger.
,Q9: 3. Fibrinolysis
A: Once healing begins, the body initiates fibrinolysis, the breakdown of the clot. This ensures clots don't remain and
cause blockages (like strokes or embolisms).
Q10: Anticoagulants Examples
A: Heparin Enoxaparin Warfarin Apixaban Dabigatran
Q11: Anticoagulants Uses
A: Prevent & treat blood clots (DVT, PE, AFib)
Q12: Heparin MOA
A: Inactivates thrombin and clotting factors, particularly Factor Xa. Prevents clot formation and prevents growth of
existing clots.
Q13: Heparin Side/ Adverse Effects
A: Anemia Bleeding Bruising GI upset HIT (heparin-induced thrombocytopenia)
Q14: Heparin Admin.
A: IV SubQ
Q15: Anticoagulant Contraindications
A: KDA Any acute bleeding process/ or high risk for one
Q16: Warfarin MOA
A: Inhibits production of vitamin K-dependent clotting factors: |I, VII, IX, and X Prevents clot formation by interfering with
the clotting cascade
Q17: Warfarin Side/ Adverse Effects:
A: Ecchymosis Bleeding Calciphylaxis (rare)
, Q18: Warfarin Nursing Implications:
A: Slow onset: Warfarin is not effective immediately. Bridging therapy: Often started with heparin until IN reaches a
therapeutic range. Educate patients to maintain consistent vitamin K intake not to eliminate, but avoid large
fluctuations. Avoid alcohol and monitor for signs of bleeding (e.g., tarry stools, bruising, nosebleeds).
Q19: Selective Factor Xa Inhibitors Example
A: Apixaban
Q20: Apixaban MOA
A: Selectively inhibits clotting factor Xa Prevents conversion of prothrombin to thrombin -› inhibits clot formation
Q21: Apixaban Side/ Adverse Effects
A: Ecchymosis Bleeding Hypersensitivity
Q22: Direct Thrombin Inhibitor Examples:
A: Dabigatran
Q23: Dabigatran MOA
A: Directly inhibits thrombin (Factor Ila) Prevents conversion of fibrinogen to fibrin -› reduces clot formation
Q24: Dabigatran Side/ Adverse Effects
A: Abdominal pain, Diarrhea, Dyspepsia Gastritis Bleeding, Hypersensitivity
Q25: Dabigatran Contraindications
A: Black Box Warning: Increased risk of thrombotic events when dabigatran is abruptly discontinued Prosthetic heart
valves Severe renal impairment (CrCI <30 mL/min)
Q26: Dabigatran Nursing Implications:
A: Swallow capsules whole - do not crush or chew. Store in original container - moisture-sensitive. Educate patients to
report: Any unusual bleeding or bruising Symptoms of stroke or PE if stopped suddenly Avoid use with other
anticoagulants or antiplatelets unless specifically ordered.
Answers
Q1: Two major types of coagulation modifiers are:
A: Anticoagulants Antiplatelets
Q2: Anticoagulants
A: These drugs prevent the formation of new clots and stop existing clots from getting larger.Commonly used in
conditions like atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism (PE). They do not break down
existing clots. Careful monitoring is essential due to a high risk of bleeding and potential for serious adverse effects.
Many anticoagulants are frequently involved in adverse drug events in clinical settings.
Q3: Antiplatelets
A: These medications prevent platelets from clumping together, which is a key first step in clot formation. Often used to
prevent heart attacks, strokes, or clot formation in stents. Common examples include aspirin and clopidogrel.
Q4: Extrinsic Pathway:
A: Activated by external injury to the blood vessel (e.g., trauma).
Q5: Intrinsic Pathway:
A: Activated by internal damage to the vessel (e.g., plaque rupture).
Q6: The 3 Stages of Coagulation
A: 1. Clot Initiation 2. Clot Formation 3. Fibrinolysis
Q7: 1. Clot Initiation
A: Injury to a vessel activates coagulation factors in a step-by-step cascade. Platelets rush to the injury site and become
sticky, adhering to the damaged vessel and each other. This forms a temporary platelet plug to limit blood loss.
Q8: 2. Clot Formation
A: Activated platelets release fibrin, a protein that weaves through Fibrin binds with red blood cells and more platelets to
form a stable clot. As fibrin strands tighten, the clot becomes denser and stronger.
,Q9: 3. Fibrinolysis
A: Once healing begins, the body initiates fibrinolysis, the breakdown of the clot. This ensures clots don't remain and
cause blockages (like strokes or embolisms).
Q10: Anticoagulants Examples
A: Heparin Enoxaparin Warfarin Apixaban Dabigatran
Q11: Anticoagulants Uses
A: Prevent & treat blood clots (DVT, PE, AFib)
Q12: Heparin MOA
A: Inactivates thrombin and clotting factors, particularly Factor Xa. Prevents clot formation and prevents growth of
existing clots.
Q13: Heparin Side/ Adverse Effects
A: Anemia Bleeding Bruising GI upset HIT (heparin-induced thrombocytopenia)
Q14: Heparin Admin.
A: IV SubQ
Q15: Anticoagulant Contraindications
A: KDA Any acute bleeding process/ or high risk for one
Q16: Warfarin MOA
A: Inhibits production of vitamin K-dependent clotting factors: |I, VII, IX, and X Prevents clot formation by interfering with
the clotting cascade
Q17: Warfarin Side/ Adverse Effects:
A: Ecchymosis Bleeding Calciphylaxis (rare)
, Q18: Warfarin Nursing Implications:
A: Slow onset: Warfarin is not effective immediately. Bridging therapy: Often started with heparin until IN reaches a
therapeutic range. Educate patients to maintain consistent vitamin K intake not to eliminate, but avoid large
fluctuations. Avoid alcohol and monitor for signs of bleeding (e.g., tarry stools, bruising, nosebleeds).
Q19: Selective Factor Xa Inhibitors Example
A: Apixaban
Q20: Apixaban MOA
A: Selectively inhibits clotting factor Xa Prevents conversion of prothrombin to thrombin -› inhibits clot formation
Q21: Apixaban Side/ Adverse Effects
A: Ecchymosis Bleeding Hypersensitivity
Q22: Direct Thrombin Inhibitor Examples:
A: Dabigatran
Q23: Dabigatran MOA
A: Directly inhibits thrombin (Factor Ila) Prevents conversion of fibrinogen to fibrin -› reduces clot formation
Q24: Dabigatran Side/ Adverse Effects
A: Abdominal pain, Diarrhea, Dyspepsia Gastritis Bleeding, Hypersensitivity
Q25: Dabigatran Contraindications
A: Black Box Warning: Increased risk of thrombotic events when dabigatran is abruptly discontinued Prosthetic heart
valves Severe renal impairment (CrCI <30 mL/min)
Q26: Dabigatran Nursing Implications:
A: Swallow capsules whole - do not crush or chew. Store in original container - moisture-sensitive. Educate patients to
report: Any unusual bleeding or bruising Symptoms of stroke or PE if stopped suddenly Avoid use with other
anticoagulants or antiplatelets unless specifically ordered.
