Chapter 26: Coagulation Modifier Drugs Test, Dalteparin, Pharmacology for Nurses: Practical
The key terms in this Pharmacology course include Coagulation Modifier Drugs, Dalteparin, Pharmacology for Nurses: Practical Applications
The patient asks the nurse, “What is the difference between dalteparin and heparin?” What is the nurse’s best response?
“The only difference is that the heparin dosage calculation is based on the patient’s weight.”
“There is really no difference, but dalteparin is preferred because it is less expensive.”
“Dalteparin is a low–molecular-weight heparin that has a more predictable anticoagulant effect.”
“I’m not really sure why some health care providers choose dalteparin and some heparin.”
A low–molecular-weight heparin is more predictable in its effect than regular heparin. Dalteparin is more expensive than heparin and is dosed based on the patient’s weight.
Which medication is an antiplatelet drug?
Alteplase
Enoxaparin
Heparin
Clopidogrel
Clopidogrel is an antiplatelet drug. Enoxaparin and heparin are anticoagulants. Alteplase is a thrombolytic drug.
The nurse is reviewing new medication orders for a patient who has an epidural catheter for administration of pain medications. One of the orders is for enoxaparin (Lovenox), a low-molecular-weight heparin (LMWH). What is the nurse’s priority action?
Double-check the LMWH order with another nurse, and then administer as ordered.
Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter.
Give the LMWH as ordered.
Stop the epidural pain medication, and then administer the LMWH.
LMWHs are contraindicated in patients with an indwelling epidural catheter; they can be given 2 hours after the epidural is removed. This is very important to remember, because giving an LMWH with an epidural has been associated with epidural hematoma.
A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient’s laboratory work, the nurse interprets that the patient’s international normalized ratio (INR) level of 3 indicates: which of these?
The patient’s warfarin dose is at therapeutic levels.
The patient’s intravenous heparin dose is at therapeutic levels.
The patient is not receiving enough warfarin to have a therapeutic effect.
The patient’s intravenous heparin dose is dangerously high.
A normal INR (without warfarin) is 1.0. A therapeutic INR for patients who have had mechanical heart valve surgery ranges from 2.5 to 3.5, with a middle value of 3.
A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?
Potassium chloride
Vitamin K
Protamine sulfate
Vitamin E
Protamine sulfate is a specific heparin antidote and forms a complex with heparin, completely reversing its anticoagulant properties. Vitamin K is the antidote for warfarin (Coumadin) overdose. The other options are incorrect.