Exam (elaborations)
NUR 641E Exam 3 (MIDTERM)2024_2025 fully solved & updated.
- Course
- Institution
NUR 641E Exam 3 (MIDTERM)2024_2025 fully solved & updated.
[Show more]
Content preview
NUR 641E Exam 3 (MIDTERM)2024/2025fully solved & updated
What are indications for anticoagulants? - ANSWER-MI, unstable angina, atrial
fibrillation, indwelling devices (mech heart valve) major orthopedic surgery or
prolonged periods of immobilization or long plane rides, strokes..
What are contraindications for anticoagulants? - ANSWER-Known drug allergy
thrombocytopenia
Pregnancy (Warfarin)
Indwelling epidural catheter (LMWH) d/t link with epidural hematoma
What are adverse rxns with Anticoagulants? - ANSWER-Most common:
BLEEDING (localized or systemic) for all anticoagulants!
Heparin induced thrombocytopenia (HIT)
nausea, vomiting, abdominal cramps, thrombocytopenia, bruises
Route and procedures for anticoagulation therapy - ANSWER-Oral and parenteral
(Injection/IV)
Why is Heparin used for anticoagulation? - ANSWER-Preventative, heparin either
unfractionated or low molecular weight (subcutaneous -lovenox) Both can be
used as preventative and DVT treatment
It works faster than Warfarin/Coumadin.
Can be given subQ or IV
What labwork is needed to monitor pts on Heparins - ANSWER-Heparin =
activated PTT every 6 hrs or so, 2-3 days check a CBC d/p for platelet values.
LMWHeparins = none
,What is special about the low molecular weight Heparin - ANSWER-They are more
predictable because they are specific for activated factor Xa. Greater
bioavailability longer elimination half life than unfractionated.
What are the reversal drugs for warfarin and Heparin? - ANSWER-Warfarin = Vit K
Heparin = Protamine sulfate
Heparin (pg 631 in drug guide) - ANSWER-Given parenteral
Preg category C
Short half life (1-2 hours)
Low molecular weights: Preg category B
Lovenox: Don't give inj near umbilicus
don't require labwork
DONT rub injection sites - could cause bruising
Heparin adverse effects - ANSWER-Bleeding
hematoma
anemia
thrombocytopenia (HIT)
Drug induced hepatitis (inflammation)
alopecia
osteoporosis
fever
hypersensitivity
Know about how Coumadin (Warfarin) works for anticoagulation - ANSWER-
Inhibits Vit K dependent clotting factors II, VII, IX, and X. Used for clot prevention.
Given PO
Important teaching for Heparin - ANSWER-Regular lab testing
Sx of abnormal bleeding
Wear a medical alert bracelet
Use soft toothbrushes to prevent gum bleeding. watch for nose bleeds, bloody
dark stools, can make nauseous
Monitoring lab work for Coumadin? - ANSWER-Coumadin, PT / INR
PT typically 11-13 seconds, therapeutic is 18 seconds
pts not on anticoagulants typically have INR value of 2-3
pts on warfarin/Coumadin value is 2 to 3.5 with a target of 3
What are the Therapeutic Levels, INR, aPTT, PT? - ANSWER-
, Coumadin (pg 1273 in drug guide) - ANSWER-Given orally only
Preg category X
Monitored by PT INR
Genetic factors alter metabolism of drug
Coumadin adverse effects - ANSWER-Bleeding, lethargy, muscle pain, purple
toes (hands and feet)
Report signs of bleeding/bruising
Avoid alcohol/OTC or herbal products, aspirin, NSAIDs, etc, prior to talking to a
health care professional
Emphasize importance of routine labwork (PT/INR)
Important teaching for Coumadin - ANSWER-Avoid excess amounts of foods with
high Vit K, ie leafy greens, maintain a consistent intake
What is the purpose, risk, and adverse effects of thrombolytic (lysing clots)
therapy - ANSWER-Purpose to break down already existing clots
Adverse/risk: BLEEDING
They're not fibrin specific
Can induce a systemic thrombolytic state instead of focusing on the specific
clots
Internal, intracranial, or superficial bleeding
Anemia
Nausea
Vomiting
hypotension
cardiac dysrhythmias
Protamine Sulfate (page 1044 in drug guide) - ANSWER-Antidote for Heparin
toxicity
Typically 1 mg good to reverse up to 100 units unfractionated Heparin
1 mg needed per 1mg of enoxaparin, dose directly proportional.
What are Protamine sulfate adverse effects? - ANSWER-Bleeding
Anaphylaxis
angioedema
pulmonary edema
bradycardia
dyspnea
pulmonary HTN
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller tuition. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81298 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now