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ATI med surg ch 35: peripheral vascular disease

Terms in this set (49)

1) Unfractionated heparin
- Given IV to prevent formation of other clots and to prevent enlargement of the existing clot
- It has significant adverse effects and must be given in the facility
- Prior to discharge, the patine will be converted to oral anticoagulation therapy with warfarin

*RN care:
- Monitor aPTT to allow for adjustments of heparin dosage
- Monitor platelet counts for heparin-induced thrombocytopenia
- Monitor for hazards and adverse effects associated with anticoagulant therapy
- PROTAINE SULFATE: THE ANTIDOTE FOR HEPARIN if needed for excessive bleeding

2) Low-molecular weight heparin
- Given SQ and is based on a patient's weight
- enoxaparin (Lovenox): used for the prevention and treatment of DVT

*RN care:
- Instruct the patient to observe or evidence of bleeding
- Instruct the patient on bleeding precautions that should be taken (ex: use electric instead of bladed razor and brush teeth with a soft toothbrush)

3) warfarin (Coumadin)
- Inhibits synthesis of the four vitamin K-dependent clotting factors
- Therapeutic effect takes 3-4 days to develop so administration of the medication is begun while the patient is still of heparin

*RN care:
- Monitor for bleeding, PT/INR
- VITAMIN K: THEANTIDOTE FOR WARFARIN if needed for excessive bleeding
- Instruct the patient about food sources of vitamin K (green leafy vegetables) and to avoid fluctuations in the amount and frequency of consumption
- Instruct the patient about observing for evidence of bleeding
- Instruct the patient on bleeding precautions that should be taken (ex: use electric instead of bladed razor, and brush teeth with soft toothbrush)