ANTICOAGULATION DRUGS - NEW EXAM QUESTIONS AND
CORRECT ANSWERS FOR TOP PERFORMANCE
acute and chronic disorders that require anticoagulation therapy - ANSWER
MI, unstable angina, A-Fib, Indwelling devises such as indwelling heart valves,
conditions in which blood flow may be slowed and blood may pool, such as
major orthopedic surgery; also used in prevention of DVT
common disorders where anticoagulant therapy is contraindicated - ANSWER
Leukemia, pregnancy, gastrointestinal infection (colitis), recent surgery or other
invasive medical procedures; also know drug allergies and acute bleeding risks
as well as thrombocytopenia
major action and use of heparin - ANSWER Works by binding to anti-thrombin
III (AT-III) which turns off three main activating factors: Activated II
(thrombin), activated X, and activated IX
-Mainly work to prevent the formation of a clot or thrombus
routes of administration for heparin and list appropriate nursing measures for
each - ANSWER IV and SQ ONLY!! Requires careful monitoring of PT/INR;
Nurses also want to assess for adverse effects, such as bleeding. Nurses want to
be mindful of drug interactions and other common adverse effects such as
hematoma, nausea, anemia, thrombocytopenia, fever and edema
laboratory test that determines Heparin's effect - ANSWER PT/INR
adverse effects of Heparin and list appropriate nursing action for each -
ANSWER -Bleeding, a hematoma at site of injection, nausea, anemia, fever,
edema; Heparin induced thrombocytopenia (HIT), which is an allergic reaction
mediated by the production of IgG antibodies
-Because of Heparins short half life (1 to 2 hours) stopping the treatment can
alleviate these symptoms
, -Toxicity and Over Dosing: Hematoma, melena (blood in stool) and gum or
mucus membrane bleeding. Stopping treatment can completely reverse
symptoms in 5 minutes. Must have order for Protamine Sulfate
Protamine Sulfate - ANSWER the antagonist used to manage heparin toxicity
benefits of using low molecular weight heparin eg. Enoxaparin (Lovenox). -
ANSWER Lab monitoring isn't necessary because of its high bioavailability and
greater affinity for factor Xa. It is available only in injection form.
Compare the action of Coumadin to Heparin in relation to the clotting process -
ANSWER -Heparins: Inhibit thrombin clotting factors.
-Coumadin: Inhibits vitamin K dependent clotting factors (available in PO form
only).
Compare the onset and duration of action of parenteral and oral anticoagulants -
ANSWER Perenteral Anticoagulants - Onset Immediate (20-60min), Duration:
Dose dependent
-Oral Anticoagulants - Onset: 12-24 hours, Duration: 2-5 Days
State the rationale for continuing parenteral anticoagulant therapy three days
after starting oral therapy - ANSWER Peak time for oral anticoagulant therapy
is 3-4 days. Peak time for perenteral is 4-5hrs. The rational for continuing
perenteral therapy is that it will take 3 days for the full effect of the oral therapy
to take place.
lab test for determining the effect of Coumadin on the clotting process. -
ANSWER PTT
Vitamin K - ANSWER List the antagonist for Coumadin
pertinent information to teach patients receiving either parenteral or oral
anticoagulants - ANSWER It is important to take meds at the same time every
day. It is important inform them of bleeding precautions and to remember to
follow up with doctor to monitor blood levels
the mechanism of action of the antiplatelet drugs - ANSWER Mechanisms of
action vary depending on the drug. Many of the antiplatelet drugs affect the
cyclooxygenase pathway
-Prevents platelet plugs from forming, which can be beneficial in defending the
body against heart attacks and strokes
CORRECT ANSWERS FOR TOP PERFORMANCE
acute and chronic disorders that require anticoagulation therapy - ANSWER
MI, unstable angina, A-Fib, Indwelling devises such as indwelling heart valves,
conditions in which blood flow may be slowed and blood may pool, such as
major orthopedic surgery; also used in prevention of DVT
common disorders where anticoagulant therapy is contraindicated - ANSWER
Leukemia, pregnancy, gastrointestinal infection (colitis), recent surgery or other
invasive medical procedures; also know drug allergies and acute bleeding risks
as well as thrombocytopenia
major action and use of heparin - ANSWER Works by binding to anti-thrombin
III (AT-III) which turns off three main activating factors: Activated II
(thrombin), activated X, and activated IX
-Mainly work to prevent the formation of a clot or thrombus
routes of administration for heparin and list appropriate nursing measures for
each - ANSWER IV and SQ ONLY!! Requires careful monitoring of PT/INR;
Nurses also want to assess for adverse effects, such as bleeding. Nurses want to
be mindful of drug interactions and other common adverse effects such as
hematoma, nausea, anemia, thrombocytopenia, fever and edema
laboratory test that determines Heparin's effect - ANSWER PT/INR
adverse effects of Heparin and list appropriate nursing action for each -
ANSWER -Bleeding, a hematoma at site of injection, nausea, anemia, fever,
edema; Heparin induced thrombocytopenia (HIT), which is an allergic reaction
mediated by the production of IgG antibodies
-Because of Heparins short half life (1 to 2 hours) stopping the treatment can
alleviate these symptoms
, -Toxicity and Over Dosing: Hematoma, melena (blood in stool) and gum or
mucus membrane bleeding. Stopping treatment can completely reverse
symptoms in 5 minutes. Must have order for Protamine Sulfate
Protamine Sulfate - ANSWER the antagonist used to manage heparin toxicity
benefits of using low molecular weight heparin eg. Enoxaparin (Lovenox). -
ANSWER Lab monitoring isn't necessary because of its high bioavailability and
greater affinity for factor Xa. It is available only in injection form.
Compare the action of Coumadin to Heparin in relation to the clotting process -
ANSWER -Heparins: Inhibit thrombin clotting factors.
-Coumadin: Inhibits vitamin K dependent clotting factors (available in PO form
only).
Compare the onset and duration of action of parenteral and oral anticoagulants -
ANSWER Perenteral Anticoagulants - Onset Immediate (20-60min), Duration:
Dose dependent
-Oral Anticoagulants - Onset: 12-24 hours, Duration: 2-5 Days
State the rationale for continuing parenteral anticoagulant therapy three days
after starting oral therapy - ANSWER Peak time for oral anticoagulant therapy
is 3-4 days. Peak time for perenteral is 4-5hrs. The rational for continuing
perenteral therapy is that it will take 3 days for the full effect of the oral therapy
to take place.
lab test for determining the effect of Coumadin on the clotting process. -
ANSWER PTT
Vitamin K - ANSWER List the antagonist for Coumadin
pertinent information to teach patients receiving either parenteral or oral
anticoagulants - ANSWER It is important to take meds at the same time every
day. It is important inform them of bleeding precautions and to remember to
follow up with doctor to monitor blood levels
the mechanism of action of the antiplatelet drugs - ANSWER Mechanisms of
action vary depending on the drug. Many of the antiplatelet drugs affect the
cyclooxygenase pathway
-Prevents platelet plugs from forming, which can be beneficial in defending the
body against heart attacks and strokes
