heParin #1. ________
QuestionheParin #1. ________ Inactivates clotting factors thrombin and factor Xa through the increased activity of antithrombin Critical adverse effect: #2. __________________**Critical Allergic reaction**#3. _____________ Monitor(labs): #4. ____________Reversal/antidote: #5. _____________Administered Route: #6. _(2 answers)_______________ Apixaban (Eliquis) Anticoagulant inhibits platelet aggregation (factor Xa) induced by thrombin. Critical adverse effect:#7. ________________ 1. Increased risk of hemorrhage in pregnant patients2. Increased risk of bleeding in patients with renal impairment Warfarin (Coumadin) #8. ___________ Decreases the production of vitamin K-dependent clotting factors. (Vit K synthesis) · bruising· ____#9_______ (after long term use) Monitor(labs): INR (2-3 is normal)Reversal/antidote: #10. ____________Nursing Implications: Avoid in pregnancy or breast feedingFrequent monitoring of PT and INR enoxaParin(Lovenox) anticoagulant #11. _____________ · Critical adverse effect is hemorrhage · Critical allergic: · #12 ________ (induced by**hint) Monitor(labs): #13 __________Antidote: #14 _______________ fondaparinux #15 ______________ #16 ______________ 1. Can cause epidural bleeds. Labs to monitor: None Nursing Implications: · Avoid giving in patients with decrease level of consciousness, complains of back pain or is paralyzed.· Do not administer to patients for at least 6 hours after #17_______or with a #18__________ epidural Rivaroxaban (Xarelto)Apixiban (Eliquis)Edoxanban (Savaysa) Anticoagulants Inhibits factor Xa Risk for neurological impairment Lab monitoring: No routine clot studiesNursing Implications: · Avoid over the counter medications (Vit E, ginkgo biloba, fish oils, garlic, NSAIDS)· Teach patients to avoid bleeding by doing the following: (3 examples)___#19______ Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Aspirin (Acetylsalicylic Acid) Indication: Reduce risk of CVA, TIA, prevent of MI Treatment during episodes of unstable angina and MIPrevention: occlusion of stents #20. __________ Decrease platelet aggregation Side effect: · #21_________(given in high doses)· Bruising· Gastric upsetAdverse reaction: · GI bleed· hemorrhagic stroke (uncontrolled HTN) Monitor(labs): plateletsAntidote for ASA toxicity: #22 _______Activated CharcoalMonitor for signs of: ***toxicity – tinnitus, hyperventilation, Clopidogrel (Plavix) Antiplatelet #23 _________ Side effect: · diarrhea· gastric discomfortAdverse Reaction: · bleeding· #24 ________ Monitor (labs): #25 __________Administered: po Abciximab Indicated: after cardiac procedures Antiplatelet(Glycoprotein (GP) receptor inhibitors) Blocks GP IIB/IIIa receptors that stop platelet aggregation Critical adverse reaction: · hemorrhage· Thrombocytopenia Monitor: hgb & Platelets ***Assess for bleeding in 1. #26 _____2. #27_______ 3. IV insertion sitesNursing Implications 4. ECG changes5. No needle sticks or new IV injections Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications tPAAlteplaseStreptokinase Thrombolytics Break down, or lyse or existing clots 1. BleedingSevere Effect: 1. Severe bleeding Administered: #28 _(route)_ ONLYNursing Implications:1. Monitor for mental status changes2. No new IV, ABGS3. Never give through a (route) #29 _________. 4. Do not give within 2 weeks of surgery5. Do not give to patients with active #30 _______6. Can only be administered from #31______ hours from onset of symptoms7. Monitor for cardiac changes/dysrhythmias8. Uncontrolled hypertension or b/p (180/110) Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Erythropoietin Alfa Hematopoietic Agents #32_____________ · #33 ________ · Cardiovascular events- MI, CVA, DVT Monitor (labs): #34 _____ & _______***Iron levels- key ingredient with the production of RBCs Nurse Implications: 1. Monitor: #35 (hint: which main vital sign) during therapy2. Do not administer if hemoglobin 10-11 Filgrastim Indicated for Neutropenia Hematopoietic Agents Increase production of neutrophils (in the bone marrow) · Enlarge spleen· __#36___ pain· Leukocytosis Monitor baseline (labs): CBC and platelet countsAdministered: IV & subQ Oprelvekin Hematopoietic Agents Simulate platelet production · #37_______ (sign of fluid overload) · anemia· Cardiac dysrhythmiasSevere Reaction: · Anaphylaxis Administered: #38 _____Monitor (labs): platelet counts, electrolyte status Nursing Implications: · Fluid retention: Teach patient to contact provider if symptoms worsen. · Use with caution in patients with cardiac history- a-fib, a-flutter Iron SulfateIron deficiency anemia, dietary supplement (prevention) Hematinic Agents Replacement of iron which is critical for hemoglobin function Adverse Reaction· #39_______**· Nausea· Dark Tarry stoolsSerious Side effect with IV route: #40_______ Patient Teaching1. Take with vitamin #41_______ source. 2. Infusion: Give a test dose when administering #42 (which route). Keep epinephrine on h and for anaphylaxis.3. Teach patient to increase fiber and drink plenty of fluids to reduce constipation Folic AcidIndicated: Folic acid anemia, dietary supplement Hematinic Agents Replacement for folic acid 1. Nausea2. Flatulence3. Rash 1. Teach patient dietary/lifestyle changes: – Increase consumption of foods high in #43_______ (e.g., green vegetables, liver). 2. If alcoholism underlies dietary deficiency, offer counseling for alcoholism, as well as dietary advice. ” Vitamin B12 Hematinic Agents Replacement Vitamin B12 anemia, Dietary supplement, absence of intrinsic factor 1. Headache2. NauseaSerious Adverse Reaction1. #44________** (low lab value)2. Pulmonary edema3. Anaphylaxis 1. Labs to Monitor: ***Serum ___#45___Teach patient s/s of hypokalemia and instruct them to contact provider immediate. 2. Treatment duration- is #46 (how long) Answer SheetThere is only one answer per blank. If the question indications there is more than one answer, then you must have all correct to receive credit. 1.2. 3.4.5.6. (2 answers)7.8.9.101112.13.14.15.16.17.18.19. (3) answers20.21.22.23.24.25.26.27.28.29.30. ________________________________________________________________________________________________________________ 31.32.33.34. (2 answers)35.36.37.38.39.40.41.42.43.44.45.46.Health ScienceScienceNursingNSG 220Share Question
