Questions and Answers
What is the generic name for Coumadin?
What classification does Coumadin fall under?
Which of the following is a side effect of Coumadin?
What should be assessed in patients taking Coumadin?
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What is the therapeutic blood level range for Coumadin?
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What is one potential nursing diagnosis for a patient on Coumadin?
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What should be monitored in patients on Coumadin regarding medication interactions?
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It is safe to interchange different brands of Coumadin.
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Vitamin K is the antidote for _____.
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What should be done if a patient on Coumadin misses a dose?
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What dietary consideration should patients on Coumadin keep in mind?
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Study Notes
Coumadin Overview
- Coumadin is the trade name for the generic drug warfarin.
- Classified as an anticoagulant (therapeutic classification) and falls under the coumarins pharmacologic class.
Therapeutic Action and Side Effects
- Common gastrointestinal side effects include cramps and nausea.
- Dermal necrosis can occur as a skin-related side effect.
- Major risk is bleeding, a hematological side effect.
- Miscellaneous side effects may include fever.
Nursing Implications: Assessment
- Monitor patients for signs of bleeding or hemorrhage.
- Evaluate for additional or increased thrombotic events, with symptoms varying by affected area.
- Older patients (over 60) may respond unpredictably to treatment; more vigilant monitoring is necessary.
- Pediatric patients may require more frequent PT/INR testing to maintain therapeutic levels.
- Frequent monitoring of PT and other clotting factors is essential; therapeutic PT ranges from 1.3 to 1.5 times the control.
- PT values equate to INR, with therapeutic INR range generally being 2-3.
- In high-risk embolism patients, target PT of 1.5-2 or INR of 3-4.5 may be aimed for.
- Track hepatic function and complete blood count (CBC) before and during treatment.
- Check stool and urine for occult blood regularly.
Toxicity and Overdose Management
- If PT is excessively prolonged or mild bleeding occurs, withholding one or more doses of Coumadin may suffice.
- For severe overdose scenarios, vitamin K acts as the antidote; whole blood plasma may be needed in extreme cases due to vitamin K's delayed effect.
Nursing Diagnosis
- Potential nursing diagnoses include ineffective tissue perfusion and risk for injury.
Implementation Strategies
- Coumadin is considered a high-alert medication due to the serious consequences of misadministration.
- Verify recent INR or PT results before administration and have a second practitioner review orders.
- Be aware of interactions with a variety of medications, including prescriptions, over-the-counter drugs, and natural products.
- Administer Coumadin at the same time each day for consistency.
- Medication takes 3-5 days to reach effective levels; often initiated concurrently with heparin.
- Avoid brand interchangeability as potencies may not be equivalent.
- Reconstitute with 2.7 ml of sterile water to create a 2mg/ml solution; discard discolored solutions or those with particulate matter.
- Administer via low bolus injection over 1-2 minutes into a peripheral vein.
Patient and Family Education
- Advise on the importance of consistent medication adherence; missed doses should be taken as soon as remembered but never doubled.
- Inform healthcare providers of any missed doses during check-ups.
- Educate on foods rich in vitamin K and advocate for stable, limited intake to prevent fluctuations in PT levels due to vitamin K acting as a warfarin antidote.
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Description
Test your knowledge on Coumadin, including its generic name, classification, therapeutic action, side effects, and nursing implications. This quiz offers a comprehensive review that is essential for healthcare students and professionals. Perfect for exam preparation or quick revision.
