Anticoagulant – Pharmacology for Nurses: Practical Apps

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Chapter 26: Coagulation Modifier Drugs Test, Anticoagulant, Pharmacology for Nurses

The key terms in this Pharmacology course include Coagulation Modifier Drugs, Anticoagulant, Pharmacology for Nurses: Practical Applications


Enoxaparin sodium is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This medication is in which drug class?

Thrombolytic drug

Oral anticoagulant

Low–molecular-weight heparin

Glycoprotein IIb/IIIa inhibitor

Enoxaparin sodium is a low–molecular-weight heparin.


Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin?

Vitamin E

Vitamin K

Protamine

Phenytoin

Protamine sulfate binds with heparin in the bloodstream to inactivate it and thus reverse its effect.


The nurse is giving discharge instructions to a patient prescribed warfarin for atrial fibrillation. Which statement by the patient indicates a need for further instruction from the nurse?

“I will take my medication in the early evening each day.”

“I will avoid activities that have a risk for injury such as contact sports.”

“I will contact my health care provider if I develop excessive bruising.”

“I will increase the dark green leafy vegetables in my diet.”

Dark green leafy vegetables are rich in vitamin K, which would antagonize the effects of warfarin. Therefore, it is important to maintain a consistent daily intake of vitamin K and avoid eating large amounts of these foods.


The nurse recognizes that the patient understands the teaching about warfarin when the patient verbalizes an increased risk of bleeding with concurrent use of which herbal product/products? (Select all that apply.)

Ginkgo

Glucosamine

Garlic

St. John’s wort

Dong quai


The nurse notes a patient’s international normalized ratio (INR) value of 2.5. What is the meaning of this reported value?

The patient is not receiving enough warfarin for a therapeutic effect.

The patient’s warfarin dose is within the therapeutic range.

The patient is receiving too much heparin and is at risk for bleeding.

The patient needs the subcutaneous heparin dose increased.

INR determination is a routine test to evaluate coagulation while patients are taking warfarin, not heparin. A therapeutic INR is 2 to 3.


The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin?

Complete blood count

Activated partial thromboplastin time (aPTT)

Prothrombin time (PT)

Blood urea nitrogen

Heparin dosing is based on aPTT results. The PT is reflective of warfarin’s anticoagulant effect.


A patient who is prescribed an anticoagulant requests an aspirin (acetylsalicylic acid) for headache relief. What is the nurse’s best action?

Administer 650 mg of acetylsalicylic acid and reassess pain in 30 minutes.

Explain that acetylsalicylic acid is contraindicated and administer ibuprofen.

Explain that a common initial adverse effect is a headache for this drug.

Inform the patient of potential drug interactions with anticoagulants.

Patients taking an anticoagulant should not use medications that would further increase the risk of bleeding.