Question

that the infection ave PN 200 Fundamentals of Nursing II harmacology Case Study - Thrombophlebitis-Heparin Tom Moore, a 57 year old man has thrombophlebitis in the right lower leg. units by bolus, was given. Following the IV bolus, Heparin 3000 is, was given. Following the IV bolus. Henarin 50.00 units was given subcutaneously every 6 hours was hours was prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were also prescribed. An aPTT test was ordered. ebitis in the right lower leg. IV Heparin, 5000 1. What are the various methods for the administering Heparin ny was an aPTT test ordered? How would you determine whether Mr. Moore is within the desired range? Explain your answer After 3 days of Heparin therapy, Mr. Moore was prescriber warfarin (Coumadin) 5 mg, by mouth daily. A PT/INR test was ordered. 3. What is the pharmacologie action of warfarin? Is the wasfarin dose within the safe daily dose range? Explain your answer. 4. What are the half-life and protein binding for warfarin? If a patient takes a drug that is highly protein bound, would there be a drug interaction? Explain your answer. Why is a PT/INR ordered for Mr. Moore? What is the desired range? 5. What serious adverse reactions could result with prolonged use of large doses of warfarin? 6. What patient teaching interventions should the nurse include? List three (3) interventions you, as the nurse, would employ 7. Months later, Mr. Moore has hematemesis. What nursing actions should be taken? Revised 1/20

Answer 1

1, Heparin prevents blood clot and it stops the growth of clots that already present in the blood vessels. Heparin should not be given to the muscle it should be administered through intravenous venous route and under the skin in a dilute form for increasing therapeutic effect. It acts as an anticoagulant and called blood thinner to prevent blood clots.
2, PTT is a partial thromboplastin time test that helps assess patient blood clotting ability. Activated PTT used to monitor heparin therapy, it measures the time it takes to make the blood clot. Normal PTT is 25 to 35 using a high dose of heparin that causes loss of sensitivity. activated PTT used as a monitoring tool. PTT assess the protein amount and function in the blood. typical PTT value when taking heparin will be 60 to 80 seconds with a range of 1.5 to 2.5 times with the control value.
3, Warfarin is anticoagulant to prevent blood clots. warfarin is a vitamin K antagonist that inhibits vitamin K production by vitamin K epoxide reductase. Vitamin K important in our body to make clotting factors and prevent bleeding. As an initial dose 2-5mg once daily is a safe dose... The dose will differ for the patient for their age, body weight, race, gender, medical condition, and other factors. It prescribed to the patient's INR and condition to be treated.
4, Warfarin has half-life 20-60 hours, mean plasma half-life 40 hours duration of effect 2 to 5 days, maximum dose effect with 48 hours... warfarin anticoagulant response due to protein binding up to 97%, it has high protein-bound of more than 99% and has a high risk of toxicity and increases warfarin free plasma concentration. PT and INR monitor the patient warfarin effect. Warfarin reduces the blood clot but not prevent blood clots immediately. PT time measures the time of clot to form, INR has an important role in warfarin treatment. It maintains warfarin response in a therapeutic range and it avoids hemorrhage risk when patients using warfarin.