A nurse is caring for a patient who has been prescribed warfarin [Coumadin] in addition to IV heparin therapy after experiencing an acute myocardial infarction (MI). The patient asks why both medications are necessary if they do similar things in preventing clots from forming in his body.
Which response by the nurse best explains why both medications are necessary? (Select all that apply.).
“Heparin works faster than warfarin, so it is given until warfarin reaches an effective level in your blood.”
“Heparin and warfarin work on different clotting factors in your blood, so they have a synergistic effect.”
“Heparin is given by injection, while warfarin is given by mouth, so they have different routes of administration.”
“Heparin prevents new clots from forming, while warfarin helps dissolve existing clots in your blood vessels.”
“Heparin has a shorter duration of action than warfarin, so it is easier to reverse if bleeding occurs.”.
Correct Answer : A,E
Heparin works faster than warfarin, so it is given until warfarin reaches an effective level in your blood.
Heparin has a shorter duration of action than warfarin, so it is easier to reverse if bleeding occurs.
Choice B is wrong because heparin and warfarin do not have a synergistic effect.
They work on different clotting factors, but they do not enhance each other’s effects.
Choice C is wrong because the route of administration is not relevant to the rationale for using both medications.
Heparin and warfarin can be given by different routes, but that does not explain why they are both necessary.
Choice D is wrong because warfarin does not help dissolve existing clots.
Warfarin prevents the synthesis of vitamin K-dependent clotting factors, but it does not break down clots that have already formed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
A patient with a high aPTT result is at risk for bleeding, so assessing for signs and symptoms of bleeding is important.
Holding heparin therapy per protocol is also appropriate, as heparin is the cause of the prolonged aPTT.
The other choices are wrong because:
• Choice B is wrong because continuing heparin therapy at the current rate will increase the risk of bleeding and further prolong the aPTT.
• Choice C is wrong because decreasing heparin therapy per protocol is not enough to reverse the effects of heparin.
Heparin should be stopped until the aPTT returns to the therapeutic range.
• Choice E is wrong because increasing heparin therapy per protocol will worsen the situation and cause more bleeding and coagulation problems.
The normal range for aPTT is 25 to 35 seconds, and the therapeutic range for heparin therapy is 60 to 80 seconds.A result of 90 seconds indicates excessive anticoagulation and increased bleeding risk.
Correct Answer is ["A","C"]
Explanation
Heparin is an anticoagulant that inhibits blood clotting and prevents harmful clots from forming in blood vessels.However, heparin can also cause some serious side effects, such as bleeding, bruising, low platelet count, allergic reactions, and osteoporosis.
Therefore, patients who are at a high risk for developing these adverse effects should be monitored closely and have their heparin dose adjusted accordingly.
Choice A is correct because a patient who is post-op day 1 from brain surgery has a high risk of bleeding from the surgical site or intracranially.Heparin can increase this risk and cause life-threatening hemorrhage.
Therefore, this patient should not receive heparin unless absolutely necessary and under strict supervision.
Choice B is wrong because a patient with a pulmonary embolism (PE) is a candidate for heparin therapy.
A PE is a blood clot that blocks the blood flow to the lungs and can cause respiratory failure and death.Heparin can prevent the clot from becoming larger and causing more damage, and also prevent new clots from forming.
Therefore, this patient would benefit from heparin therapy and is not at a high risk of adverse effects.
Choice C is correct because a patient with active peptic ulcer disease (PUD) has a high risk of bleeding from the stomach or duodenum.
PUD is a condition where the lining of the digestive tract is eroded by stomach acid and bacteria.Heparin can worsen this condition and cause ulcer bleeding or perforation.
Therefore, this patient should avoid heparin therapy unless absolutely necessary and under strict supervision.
Choice D is wrong because a patient with uncontrolled atrial fibrillation (AF) is a candidate for heparin therapy.
AF is an irregular heartbeat that can cause blood clots to form in the heart chambers and travel to other organs, such as the brain or lungs.Heparin can prevent these clots from forming and reduce the risk of stroke or PE.
Therefore, this patient would benefit from heparin therapy and is not at a high risk of adverse effects.
Normal ranges of heparin depend on the type of heparin used (unfractionated heparin or low molecular weight heparin), the method of administration (intravenous or subcutaneous), and the indication for use (prophylaxis or treatment).Generally, the therapeutic range for heparin level is 0.3 - 0.7 U/mL, measured by anti-Xa assay.However, this range may vary depending on the pregnancy stage and the type of heparin used.The dose of heparin should be individualized according to the results of suitable laboratory tests and clinical response.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.