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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker/
Chapter 48: Drugs Affecting Blood CoagulationAce Your Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
2 mins
Aspirin Poisoning (Salicylism) Assessment
- Early Symptoms
- Nausea and Vomiting
- Tinnitus
- Confusion
- Hyperventilation
- Respiratory Alkalosis
- Late Symptoms
- Metabolic Acidosis
- Coma
- Hyperthermia
1 min
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Bleeding Precautions
- Things to Avoid
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Guidelines to Follow
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
3 mins
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
Heparin Induced Thrombocytopenia (HIT)
- Pathophysiology
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Symptoms
- Thrombocytopenia
- Diagnosis
- Serotonin Release Assay (SRA)
- Treatment
- Stop Heparin, Start Direct Thrombin Inhibitor
2 mins
Disseminated Intravascular Coagulation (DIC) Interventions
- Complications
- Risk for Shock
- Renal Failure
- Interventions
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
2 mins
Coagulation Cascade Overview
- Secondary Hemostasis
- Intrinsic Pathway
- Partial Thromboplastin Time (PTT)
- Heparin
- Extrinsic Pathway
- Prothrombin Time (PT)
- Warfarin
- Common Pathway
- Thrombin
- Convert Fibrinogen to Fibrin
- Stabilizes the Platelet Plug
2 mins
Alteplase
- Mechanism
- Tissue Plasminogen Activator
- Indications
- Thrombosis
- Side Effects
- Bleeding
- Contraindications
- Intracranial Hemorrhage
- Internal Hemorrhaging
- Considerations
- Minimize Bleeding
- Monitor for Shock
- Antidote
- Aminocaproic Acid
2 mins
Clopidogrel (Plavix)
- Mechanism
- ADP Receptor Antagonist
- Prevent Platelet Aggregation
- Indications
- Acute Coronary Syndrome (ACS)
- Prevention of Thrombotic Events
- Side Effects
- Bleeding
- Thrombotic Thrombocytopenic Purpura (TTP)
- Pancytopenia
- Abdominal Pain
- Considerations
- Withhold Before Surgery
2 mins
Warfarin Antidotes
- Antidotes
- Vitamin K
- Fresh Frozen Plasma
59 secs
Warfarin (Coumadin)
- Mechanism of Action
- Inhibits Clotting Factors
- Indications
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- Assessment
- PT/INR Levels
- Observe for Bleeding
- Contraindications
- Pregnancy
- Nursing Considerations
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
2 mins
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
1 min
Vitamin K1 (Phytonadione)
- Mechanism
- Synthesizes Clotting Factors II, VII, IX, X
- Indications
- Hypoprothrombinemia
- Newborn Prophylaxis
- Bleeding from Warfarin Overdose
- Side Effects
- Shock
- Kernicterus
- Cardiac Arrest
- Considerations
- Bile Salts required for Intestinal Absorption
- Increased Risks with IV Administration
2 mins
Clotting Overview
- Characteristics
- Endothelial Cells are Damaged
- Platelets Respond to Exposed Collagen and Stick
- Platelets Release Recruiting Factors
- More Platelets are Attracted
- Soluble Fibrinogen Turns to Insoluble Fibrin
- Fibrin Seals the Clot
- Clot Dissolves
- Liver Produces Clotting Factors
2 mins
Disseminated Intravascular Coagulation (DIC) Assessment
- Mechanism
- Improper Initiation of Clotting Cascade
- Signs and Symptoms
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
2 mins
Enoxaparin (Lovenox)
- Mechanism of Action
- Inhibits Clotting Factors
- Factor Xa
- Indications
- Clot Formation Prevention
- Side Effects
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Considerations
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Antidote
- Protamine Sulfate
2 mins
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