chapter 20-agents affecting blood clotting Flashcards
The client is receiving heparin by continuous intravenous infusion. While getting out of bed, the client lacerates her arm on the bed rail. The laceration begins to bleed profusely. What is the first action of the nurse?
Apply pressure to the site.
This is the nurse’s first action as basic application of first aid.
The nurse is preparing to administer aminocaproic acid to a client. The nurse understands that this agent:
stops the flow of blood. Aminocaproic acid is a hemostatic agent used to stop the flow of blood.
The nurse is preparing to instill which agent to clear fibrin from the client’s central venous catheters?
Urokinase- is a thrombolytic agent used to clear fibrin from CVADs.
The client is prescribed warfarin 7.5 mg daily. The medication is supplied as 5 mg tablets. How many tablet(s) should the client receive?
1 1/2-7.5 mg divided by 5 mg = 1.5 tablets = 1 1/2 tablets
Alteplase is administered to a client following the diagnosis of acute myocardial infarction. The nurse realizes that for effectiveness the alteplase treatment begins within:
4 to 6 hours
For the most benefit, alteplase should be administered within 4 to 6 hours.
The client was prescribed both heparin and warfarin sodium (Coumadin). What is the rationale for using both of these anticoagulants?
It takes time before the action of oral anticoagulants is evident.
For rapid effects, heparin is needed because it takes time for oral hypocoagulants to produce results.
The client who is experiencing an overdose of heparin overdosage may be treated by:
protamine sulfate.
Heparin is prescribed in:
USP units.
A client is prescribed heparin injections. Which route should the nurse question?
IM injections should not be given, because of the risk of hematoma formation.
A desirable end point for oral anticoagulant therapy is a prothrombin time that is what multiple of the control value?
2- The desirable end point is two times the control value.
To assess the effectiveness of heparin therapy, the nurse looks up what lab value?
partial thromboplastin time (PTT)
A new graduate in orientation prepares to administer heparin subcutaneous. Which action of this nurse would indicate a need for further instruction?
aspirating to be certain the needle is not in a blood vessel
A client has experienced a toxic ingestion of warfarin. The nurse anticipates what antidote to be prescribed?
vitamin K1
The nurse evaluates the understanding of the predischarge client receiving warfarin. Which comment indicates further teaching is needed?
“I should eat lots of dark green, leafy vegetables to increase my vitamin K1.”
A client is receiving an oral anticoagulant. Before the next dose of an oral anticoagulant, the nurse notes that the prothrombin time (PT) is 32 seconds. The nurse should
notify the health care provider.
In assessing for indications of excessive use of anticoagulants by the client, the nurse monitors for:
headache and vertigo. These indicate changes in neurologic status, a sign of increased bleeding.
The nursing student asks if there is a concern related to administration of vitamin K1. The nurse replies that:
“Yes, because it can exert prolonged undesirable effects on future anticoagulation.”
This is the reason for concern about the administration of vitamin K1 for oral anticoagulant toxicity.
The client asks the nurse about drug interactions with oral anticoagulants. The nurse indicates which of the following is known to interact with oral anticoagulants?
Aspirin- increases the activity of oral anticoagulants.
The client asks the nurse if clopidogrel bisulfate works like heparin. The nurse replies:
“No, clopidogrel acts by decreasing platelets’ ability to form clots.”
Clopidogrel decreases the platelets’ ability to aggregate, while heparin acts by interfering with prothrombin conversion to thrombin.
The nurse understands that desmopressin acetate (DDAVP) is a natural hormone produced by the:
posterior pituitary. DDAVP is produced by the posterior pituitary.
The nurse understands that enoxaparin is frequently used for:
prophylaxis for DVT in clients undergoing hip replacements.
Correct: Deep vein thrombosis (DVT) is the most common complication associated with joint replacement, so enoxaparin is used as DVT prophylaxis.
The nurse notes that the client understands information given about thrombolytic therapy when the client makes which of the following statements?
“These drugs can break down clots to help reestablish blood flow in a vessel.”
The nurse wants to avoid administering a subcutaneous dose of heparin intramuscularly. Which of the following actions by the nurse will most effectively reduce the chances of IM administration?
The nurse should administer the drug in the abdomen.
The nurse is providing client education about anticoagulant therapy prior to the client’s discharge. Which of the following statements by the client indicates a need for further teaching?
“I will still be able to use my grandfather’s straightedge razor if I’m careful.”
Clients on anticoagulant therapy should use electric razors.
