heparin, LMWH,
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| What are anticoagulants | drugs that prevent clots from forming to maintain or restore circulation
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| do anticoagulants dissolve existing clots | NO
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| What are the two types of anticoagulants | Parenteral & Oral
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| What is the prototype drug for parenteral anticoagulants | heparin
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| How is heparin administered | SubQ injection in the abdomen / sites rotated / Never Aspirate
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| When is heparin ( parenteral anticoagulant) given | only in the hospital
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| Why is heparin only given to patients in the hospital | it puts the patient at a high risk for bleeding, and requires frequent PTT monitoring
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| Before you can take a patient off of heparin what has to be done | they are started on coumadin(warfin) the oral anticoagulant
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| What are LMWH (low molecular weight heparins) | a form of heparin that provides equivalent action but has lower risk of bleeding, requires less frequent doses,and monitoring due to longer 1/2 life
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| What is the most common LMWH | enoxaprin (lovenox)
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| Other LMWH are | fragmin, normiflo, orgaran, innohep
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| Can a patient use LMWH at home | YES, b/c less risk of bleeding, pt.& family can be taught how to administer it.
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| How long are patients usually on heparin | short term 7-14days at 1-2 doses a day
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| What conditions require prompt heparin (anticoagulant)therapy | evolving ischemic stroke, pulmonary embolism, massive DVT, DIC
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| What is a ischemic stroke | the blood supply is cut off from the brain
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| what is the only anticoagulant given during pregnancy & why | heparin, it will not cross the placenta
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| What are some common prophylactic reasons for giving heparin | after hip/knee replacement, or abdominal surgery to prevent clots from forming
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| What is DIC | when several microemboli form the body uses all its clotting factors,& the blood thins, pt bleeds from any exit
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| How can heparin help DIC | it stops the body from clotting and reverses the problem which is the formation of several small clots
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| After a acute MI heparin | is given with thrombolytics to prevent clots from forming
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| What are the side effects of heparin | hemorrhage, dose related bone demineralization, thrombocytopenia, hypersensitivity reactions
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| What are the signs of hemorrhage | increased HR..decreased BP..brusing, petechiae, hematomas, black tarry stool
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| What should you do for a overdose of heparin (anticoagulant) | stop heparin, give protamine sulfate, avoid aspirin, monitor PTT (keep <2X base)
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| What is the antidote for heparin | protamine sulfate
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| What can dose related bone demineralization from use of heparin cause | osterprosis
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| If your patient is going to be taking heparin at home you must teach | S/S of bleeding, to use safety razors, electric razors, & soft toothbrushes
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| What are the Nursing Interventions for heparin | monitor PTT,CBC, platelet count, HCT,read label closely to avoid overdose, Always double check dose w/another nurse, use infusion pump for cont.IV.
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| When heparin is given via continuous IV how often should you monitor the rate | q30 - 60 min.
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| How often do you check PTT with heparin therapy | q4-6 hrs until dose is regulated, then daily
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| How do you give heparin SubQ | use 1/2 inc, 25-26 gauge needle, inject into the abdomen 2inc from umbilicus, DO NOT aspirate, & rotate sites
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| What OTC drug should never be taken with heparin (parenteral anticoagulant) | aspirin
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| It is important to check OTC drug labels when on heparin because | many contain aspirin (sylicia)
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| What herbs when taken with heparin increase the risk for bleeding | dong quai, fever few, garlic, ginger, ginko, black haw, chamomile, & bilberry
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| What herbs when taken with heparin decrease the effects of heparin | anise, ginseng, alfalfa, goldenseal, valerian
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| What is the normal PTT level | 60-80 seconds
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| What is the action of oral anticoagulants | inhibit synthesis of vitamin K, and affects clotting factors
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| Anticoagulants are primarily used for | venous thrombosis
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| How do you know if the patient has thrombocytopenia | platlet count will be < 100,000
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| What should be done if a heparin patient has thrombocytopenia | anticoagulant therapy using non heparin agents should be used
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| what are examples of non heparin parentral anticoagulants | refludan & acova
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| What are the S/S of hypersensitivity to anticoagulants (heparin) | chills, fever, urticaria (hives)
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| What is urticaria | hives
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| what should be done to prevent hypersensitivity reactions | a small test does before giving heparin
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