University:
College
Course:
College Nursing
Academic year:

2023
Views:

165

Pages:

1
Author:

mnaisikiafb

ACTIVE LEARNING TEMPLATE: Medication Warfarin anticoagulants MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________ CATEGORY CLASS ______________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action interferes with hepatic synthesis of vitamin K-dependent clotting factors (II,VII, IX, and X). Therapeutic Use prevention of thromboembolic events Complications dermal necrosis, cramps, nausea, calciphylaxis, bleeding, fever Medication Administration PO 2-5 mg/day for 2-4 days then adjust daily dose by results of INR Contraindications/Precautions uncontrolled bleeding, open, active ulcer disease, recent brain, eye, or spinal cord injury or surgery, sever liver or kidney disease, uncontrolled hypertension, crosses plancenta and may cause fatal hemorrhage in the fetus. may cause congenital malformation. maglignancy, history of ulcer, liver disease, or acute kidney injury, history of pooor compliance, women of reproductive potential, has been used safely but may require more frequent PT/INR assessments Interactions abciximab, androgens, caecitabine, cefotetan, chloramphenicol, clopidogrel, disulfiram, fluconazole, fluoroquinolones, itraconazole, metronidazole, thrombolytics, eptifibatide, tirofiban, sulfonamides, quinidine, quinine, NSAIDs, valproates and aspirin may increase the response to warfain and increase the risk of bleeding. Chronic use of acetaminophen may up the risk of bleeding. Chronic alcohol ingestion may lower action of warfarin, if chronic alcohol abuse results in significant liver damage, action of warfarin may be elevated due to lower production of clotting factor. barbituates, carbamaepine, rifampin, and hormonal contraceptives containing estrogen may lower anticoag response. st john's wort lowers effect. increased bleeding risk with anise, arnica, chamomile, clove, ginger, ginko. foods high in vitamin K content may antagonize anticoag effect. Evaluation of Medication Effectiveness PT 1.7, no signs of hemorrage, BP 127/78, T-97.6, weight - 186 (stayed same), RBC-4.9, WBC-5200/microliter, INR-2.3 Nursing Interventions daily weight, vitals, assess for signs of bleeding and hemorrhage-bleeding gums, nosebleed, unusual bruising, black tarry stools, hematuria, fall in hematocrit or BP, guaiacpositive stoos, urine, or nasogastric aspirate, assess for additional or increased thrombosis. Monitor PT, INR and other clotting factors. Monitor hepatic functions and CBC before and periodically during therapy. Monitor stool and urine for occult blood before and periodically during therapy. Client Education follow drug regimen exactly. limit foods with vitamin K, avoid IM injections and activities leading to injury, use a soft toothbrush, do not floss, immediately report an s/s of bleeding gums, nosebleed, unusual bruising, black tarry stools, excessive menstrual flow and pain, color or temp change to any area of body. Do not drink alcohol, avoid NSAIDs, and herbal products. Frequent lab tests are necessary and important.