Heparin – Pharmacology for Nurses: Practical Applications

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Chapter 26: Coagulation Modifier Drugs Test, Heparin, Pharmacology for Nurses: Practical

The key terms in this Pharmacology course include Coagulation Modifier Drugs, Aspirin, Nurse, Patient, Heparin, Pharmacology for Nurses: Practical Applications

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?

Coated tablets may be crushed if necessary for easier swallowing.

Aspirin needs to be taken on an empty stomach to ensure maximal absorption.

Take the medication with 6 to 8 ounces of water and with food.

Low-dose aspirin therapy rarely causes problems with bleeding.

Enteric-coated aspirin is best taken with 6 to 8 ounces of water and with food to help decrease gastrointestinal upset. Enteric-coated tablets should not be crushed. Risk for bleeding increases with aspirin therapy, even at low doses.

When administering heparin subcutaneously, the nurse will follow which procedure?

Using a 1/2- to 5/8-inch 25- to 27-gauge needle

Massaging the site after injection

Aspirating the syringe before injecting the medication

Use the same area for each injection.

A 1/2- to 5/8-inch 25- to 27-gauge needle is the correct needle to use for a subcutaneous heparin injection. Aspirating before the injection and massaging the site after the injection encourage hematoma formation at the injection site. Injection sites need to be rotated with each injection.

The nurse notes in the patient’s medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?

Stabilizing an existing thrombus

Preventing thrombus formation

Dilating the vessel around a clot

Dissolving an existing thrombus

Anticoagulants prevent thrombus formation but do not dissolve or stabilize an existing thrombus, nor do they dilate vessels around a clot.

An elderly patient has had hip surgery and will be receiving heparin, 4000 units subcutaneously every 12 hours. The heparin is available in vials of 5000 units/mL. Calculate how much heparin the nurse will administer for this dose. __note: your answer must contain a decimal point AND ml must follow the number.

Correct Answer

0.8 mL

5000 units:1 mL :: 4000 units:x mL.
Solve for x: (5000 × x) = (1 × 4000); 5000x = 4000; x = 4000 × 5000 = 0.8; x = 0.8.

A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which laboratory test to check the drug’s effectiveness?

Bleeding times

Vitamin K levels

Prothrombin time/international normalized ratio (PT/INR)

Correct Answer

Activated partial thromboplastin time (aPTT)

Ongoing aPTT values are used to monitor heparin therapy. PT/INR is used to monitor warfarin therapy. The other two options are not used to monitor anticoagulant therapy.

A patient has received an overdose of enoxaparin (Lovenox). The order was for 30 mg, but the patient received 90 mg. The nurse notes that the patient is showing signs of bleeding (oozing blood from the intravenous sites, increased bruising) and notifies the physician, who prescribes protamine sulfate to cover the excess amount of enoxaparin that the patient received. Calculate how much protamine sulfate the patient will receive.  note: your answer must be followed by mg: example:  20 mg

Correct Answer

60 mg

Protamine sulfate is used to reverse the effects of low-molecular-weight heparins (LMWHs). A 1-mg dose of protamine is administered for each milligram of the LMWH. This patient received 60 mg of enoxaparin more than the ordered dose of 30 mg; therefore, 60 mg of protamine sulfate will be used as an antidote.
(1 mg × 60 = 60 mg)