Podcast
Questions and Answers
Match the following anticoagulant therapy assessments with their descriptions:
Match the following anticoagulant therapy assessments with their descriptions:
Assess for bleeding = Bruising, blood in urine or stools, vomiting blood Monitor CBC = Decreasing hemoglobin, signs of shock Client teaching = Education on anticoagulant therapy Heparin therapy = Monitoring aPTT values
Match the following lab values with their descriptions:
Match the following lab values with their descriptions:
aPTT = Activated Partial Thromboplastin Time to monitor heparin ACT = Activated Clotting Time to monitor unfractionated heparin UA = Urinalysis to check for RBCs CBC = Complete Blood Count to monitor hemoglobin
Match the following heparin therapy values with their interpretations:
Match the following heparin therapy values with their interpretations:
25-35 sec = aPTT normal value 46-70 sec = aPTT therapeutic value 1.5-2x normal = aPTT therapeutic value 70-120 sec = ACT normal value
Match the following anticoagulant therapy complications with their descriptions:
Match the following anticoagulant therapy complications with their descriptions:
Match the following anticoagulant therapy medications with their monitoring parameters:
Match the following anticoagulant therapy medications with their monitoring parameters:
Match the following patient education topics with their descriptions:
Match the following patient education topics with their descriptions:
Match the following laboratory tests with their descriptions:
Match the following laboratory tests with their descriptions:
Match the following anticoagulant therapy nursing management topics with their descriptions:
Match the following anticoagulant therapy nursing management topics with their descriptions:
Match the following anticoagulant therapy values with their descriptions:
Match the following anticoagulant therapy values with their descriptions:
Match the following anticoagulant therapy complications with their descriptions:
Match the following anticoagulant therapy complications with their descriptions:
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Study Notes
Anticoagulant Therapy: Bleeding Assessment
- Instruct patients to report any signs of bleeding, including bleeding from IV site, bruising, blood in urine or stools, vomiting blood, and bleeding gums.
- Monitor for petechiae, a sign of bleeding.
- Assess for signs of shock, including hypotension, tachycardia, and cold, blue, or painful feet.
Anticoagulant Therapy: Nursing Management
- Heparin and warfarin are two types of anticoagulant therapies.
Heparin: Therapeutic Lab Values
- aPTT (Activated Partial Thromboplastin Time) is used to monitor heparin use.
- Normal aPTT value is 25-35 seconds.
- Therapeutic aPTT value is 46-70 seconds, or 1.5-2 times the normal value.
- ACT (Activated Clotting Time) is used to monitor unfractionated heparin, hirudin derivatives, and synthetic thrombin inhibitors.
- Normal ACT value is 70-120 seconds, and therapeutic value is above 300 seconds.
Heparin-Induced Thrombocytopenia (HIT)
- HIT is an immune reaction to heparin, causing a severe reduction in platelet count and a paradoxical increase in venous or arterial thrombosis.
- HIT is diagnosed by measuring the presence of heparin antibodies in the blood.
Heparin Dosing and Evaluation
- Heparin dose is adjusted based on aPTT lab values.
- Heparin is administered through a continuous IV infusion, with a standardized scale based on patient weight.
- The initial dose is calculated based on patient weight and lab values (e.g., 15 Units/kg/hour).
Heparin Nomogram
- A nomogram is used to manage heparin therapy, with aPTT values guiding dosage adjustments.
- The nomogram provides information on bolus dose, infusion rate change, and repeat aPTT timing.
Heparin Calculations
- Heparin is measured in Units, with the nurse needing to recognize the units of heparin/mL of IV solution.
- The nurse calculates the mL/hour needed for a prescribed dose written in units/hour.
- The nurse may also calculate the units/hour being administered if the IV pump is set at a certain rate in mL/hour.
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