Question

Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.

Can Sandra be placed on Coumadin and Heparin at the same time? Explain your answer.

Develop 3 teaching points important for Sandra to know about her medications regimen.

Teach Back is a great way to find out about patient teaching effectiveness. Watch the following video for an example of Teach Back

What questions would you ask Sandra to verify that she understand the 3 teaching points?

Answer 1

1. yes sandra can take both the medicine same time for more effectiveness. both are anti coagulant. but caumarin act on liver and inhibit the formation of some proteins which are act as coagulant or clotting factor. so both the regimen at same time will cure DVT effectuvely and quickly.

2. teaching points are：

a. sandra should advice about the common side effects of heparinand caumarin like nausea, vomiting, bleeding frequently. it may be internal or external like epistaxis, petechiae, face swelling. and also advice to control birth.

b. she should aware that when episode bleeding is there she should seek hospital treatment and immediately have to come to hospital.

c. she should advice to stop smoking which will definatively reduce blood pressure. nicotine in smoking stimulate increase blood pressure. if BP increased and she develop bleeding then it will be a critical condition.

questions：

1. are you clear about the side effects of caumarin and heparin？

2. what you will do when you are developing bleeding from nose？

3. are you want to quit smoking？

4. do you continue birth control or what？