CHAPTER 40 Anticoagulants, Antipla telets, and Thrombolytics 591 CRITICAL THINKI
ID: 242028 • Letter: C
Question
CHAPTER 40 Anticoagulants, Antipla telets, and Thrombolytics 591 CRITICAL THINKING CASE STUDY 57-year-old man, has thrombophlebitis in the right lower 4. What is the pharmacologic action of eg. IV hepari n, 5000 units by bolus, was given. Following the IV pharmacologic action of warfarin? Is the war- within the safe daily dosage range? Explain your leg. farin dose heparin 5000 units given subcutaneously every 6 hours answer. was prescribed. Other therapeutic means to decrease pain and 5. What are the half-life and protein binding for warfarin? Ifa allviate swelling and redness were also prescribed, and an patient takes a drug that is highly protein bound, would there aPTT test was ordered. L. Was TM's heparin order within the safe daily dosage range? 6. Why was an INR ordered for TM? What is the desired range? . What are the various methods for administering heparin? 7. What serious adverse reactions could result with p s. Why was an aPTT test ordered? How would you deter- be a drug interaction? Explain your answer mine whether TM is within the desired range? Explain your 8. What patient teaching interventions should the nurse answer fter 5 days of heparin therapy, TM was prescribed oral war- 9. Months later, TM has hematemesis. What nursing action use or large doses of warfarin? include? List three interventions. should be taken? fárin 5 mg daily. An INR test was ordered.Explanation / Answer
1. Yes
Heparin can be administered as prophylaxis for DVT in thrombophlebitis :
Continuous or intermittent IV infusion / injections
-Initial dose: 5000 units by IV injection
-Maintenance dose: 20,000 to 40,000 units per 24 hours by continuous IV infusion or SC
2.
Heparin sodium is not found to be effective in oral administration.
Given by
3.
4. Pharmacologic Action of warfarin
Warfarin inhibits hepatic synthesis of vitamin k, Which decreases prothrombin and clotting factors VII, IX and X.
Patients on warfarin therapy are maintained at an anticoagulant INR of 2 to 3.
Recommended Warfarin dose is within the safe range, the daily starting dose should be 5mg daily. The result of many types of research has shown that patients are more likely to have a therapeutic INR 3 to 5 days after starting warfarin with a 5-mg dose than with a 10-mg dose.
5.
The protein bound drug is kept in the bloodstream and the unbound component only will take part in the action. So it will reduce the side effects.
6. INR is ordered to assess the effectiveness of the therapy.
Patients on warfarin therapy are maintained at an anticoagulant INR of 2 to 3.
7.
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9.