Coumadin Flashcards

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.

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.