Question

PN 200 Fundamentals of Nursing II Pharmacology Case Study - Thrombophlebitis - Heparin Tom Moore, a 57 year-old man, has thrombophlebitis in the right lower leg. IV Heparin, 5000 units by bolus, was given. Following the IV bolus, Heparin 5000 units was given subcutaneously every 6 hours was prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were also prescribed. An aPTT test was ordered. 1. What are the various methods for the administering Heparin 2. Why was an aPTT test ordered? How would you determine whether Mr. Moore is within the desired range? Explain your answer After 5 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 pharmacologic 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

Yes, it is in safe limits as initial dosage valy 2.5mg po q day for 2 days, then check Int Potter a days & adjust the dose according to results. Maintain INR of 2-3.0. @ Half Life of warferin - Zorbo Lore (avog = 40 kn - 99% protein buday That may increase warfarin free plome concentration as a result of displacement of war farin from frstein bringing site. or causes risks of warfarin toxicity MI PAR to check desired effect of - warfarin Ind of 2-3 is desired PT = 13-15 time higher than control. Causes r Scanned with CamScanner

© Methoels of Administering heperin: is Subcutaneous injection? ti) Камелала hi) Intermettend intravenous injections 1) Contenious intravenous infesion' ③ Actuated faretral thomsoplestin time is estimation of intrinsic pouthway of cogulation. It is used to know effect of heparin on copulation of blood & what adjustments need to be made i Desired aPTT is approximately 1.5-2.5 hores the mean normal value A typed apt value = 30-40 seconds. On getting benarin APTT Results should be borgo seconds @ Action of warfarin : Inhibits blood clotting by preventing the proofaction of facters by lover that promote clotting, factors I, I n qa y ante cogulent protein a Scanned with Cash Scanner