Chapter questions-meds affecting blood
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| The nurse knows that the main action of thrombolytic medications is to | Remove the thrombus that has already formed. (thrombolytic medicaitons ac tby dissolving clots that have already formed.)
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| The goal of thrombolytic therapy is to restore blood flow through the blocked coronery arter. The nurse knows that for this therapy to be most effective, this tx must be initiated w/in what time of symptom onset? | 4 to 6 hours.
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| Which of the following reversal agents should the nurse have available in the event of a streptokinase overdose? | Aminocaproic acid (Amicar) (streptokinase overdose results in excessive bleeding, and admin of aminocaproic acid will rapidly reverse fibrinolysis.)
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| When is the initiation of IV heparin therapy appropriate? | Obese clt w/swollen painful lower right calf postoperative abdominal surgery; Clt w/multiple small pulmonary emboli; clt w/an acute myocardial infarction; Clt w/DVT who is 5 months pregnant. (Prevent formation of addl venous thrombi & associated risks.
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| Clt taking warfarin (coumadin) should be instructed to avoid eating excessive amts of which types of foods? | Dark green leafy vegetables and cabbage. (Dark green leafy vegetables, cabbage, cauliflower, and soybeans are high in vit K, excessive amts may decrease effects of warfarin.
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| Which of the following clt findings pose concern for admin of daily dose of warfarin: aPTT 75 sec, PT 18 sec, hgb 12 g/dL, INR 5.6, WBC 9800/mm3, angina unrelieved by rest, nosebleed, melena? | An INR of 5.6 too high(risk for bleeding 2-3 is therapeutic range), nosebleeds (epistaxis) and melena(blood in stool) are signs of bleeding.
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| What following clt finding suggest a need to call the PCP for possible reduction in a clt's ferrous sulfate dose? | Clt reports intolerable nausea and heartburn.
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| Therapeutic use : Folic acid | Clt with megaloblastic anemia w/a normal B12 level.
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| Therapeutic use: Cyanocobalamin (Vitamin B12) | Pernicious anemia
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| Therapeutic use: Whole blood | Clt w/hemoglobin 6 g/dL and blood pressure of 70/40 mm Hg due to sustained massive trauma.
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| Therapeutic use: Packed red blood cells | Clt w/hemoglobin 8.9 g/dL on second day post op total hip replacement.
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| Therapeutic use: Epoetin Alfa (Erythropoietin) | Anemia in clt w/chronic renal failure.
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| Therapeutic use: Platelet concentrate | Treatment of thrombocytopenia
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| Therapeutic use: Filgrastim (Neupogen) | Reduce the risk of infection for a clt receiving chemotherapy.
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| Therapeutic use: Albumin | Hypovolemia secondary to third spacing.
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| Therapeutic use: Oprelvekin (Interleukin-11) | Treatment of thrombocytopenia
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