what should the nurse teach a client who is taking warfarin? This is a topic that many people are looking for. bluevelvetrestaurant.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, bluevelvetrestaurant.com would like to introduce to you Pharmacology – Heparin vs. Warfarin Cartoon Animation & Memory Tricks nursing RN PN NCLEX. Following along are instructions in the video below:
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Below now next up is anticoagulants heparin versus warfarin guys. This is the most tested section of all blood thinners so to make this a little special. Were doing a side skit.
Oh. Yeah. Our anticoagulants.
Slowing down on those coagulation tabs. For you baby boo. No clots here.
Our blood is on this super. Silica smooth flowing through like a river. Oh yeah all right now anticoagulants are given for prevention.
The key word there is prevention of new clots and preventing growth of existing clots specifically with patients recovering from an mi heart attack or those at risk for a dvt like after a hip or knee surgery guys. The key point is that anticoagulants only thrombolytics do that like tpa and alta pace. So guys dont let the nclex trick.
You so let the name help you anticoagulants are anticoagulation withholding clotting factors in the coagulation cascade mainly blocking the formation of fibrin since fibrin forms. The seals on the club. So for warfarin and heparin think wh for withholding clotting factors.
Now heparin works quickly and warfarin works slowly. So think heparin works hella fast like within 20 minutes or think heparin starts in a hurry. But is god in a hurry and can only be injected into the patient iv or sub q.
Like a noc supreme art lower lighter weight heparin which well be covering in a moment now for warfarin. Think warfarin is a weak or start typically taking five days to reach full effect. So warfarin takes a longer time to kick in.
But it actually lasts longer and can be taken longer so guys just think war in warfarin is like a war it lasts. A long time now patients are commonly put on both at the same time. Key word.
Here is both medications are given together for several days. This gives warfarin enough time to catch up guys. That was mentioned a few times on a lot of quiz bangs now labs.
The biggest topic thats tested by far guys. Most test questions come from here since its the most deadly for patients. So just think if labs are too high the patient will bleed out and die.
And if labs are too low. Then guys clots will grow so the key numbers to know heparin we measure ptt with a therapeutic range between 46 and 70 and the antidote is protamine sulfate. Which is not associated with food.
So think hep. It is like hepa to frog since frogs are jumping fast guys. Heparin goes fast so h.
Inhibits is h for heparin and the p. Inhibit is for a protamine sulfate. The antidote and ptt.
The lab to know again is 46 to 70 max range now guys be careful. The nclex is gonna try and trick you so not inr and not a ptt over 70. A common hesse question here was heparin drip.
Ptt 85. Or a ptt of a hundred guys anything over 70. The priority action here is to number one stop.
The heparin drip. And notify the hcp number two prepare the antidote protamine sulfate and number three reassess. The labs in about an hour.
Now will come an ati question. A patient on heparin with bleeding at the iv site. Whats the priority action.
Guys key term here. No blood oozing at the surgical incision or iv site. Again.
Same priority actions. Here number. One stop the heparin.
Notify the hcp prepare protamine sulfate. The antidote and reassess labs. Now on the other side.
Warfarin we measure inr and the therapeutic range is 2 to 3 and. 25 to 35. For heart valve replacements.
Guys. Therapeutic inr was mentioned multiple times across a lot of quiz banks. Now a side note here pt that prothrombin time.
We measure that too. But the values were not tested directly on any question. Mix now guys.
The antidote here is vitamin k. Which you can think kills. The warfarin.
So. The key term is vitamin k. Not to be given.
If warfarin z. within therapeutic range. And not to be given until at least five days of warfarin therapy.
When switching from iv heparin. Now guys vitamin k is found in some very specific foods key term here is liver and green leafy veggies like broccoli and spinach. Now.
The key point for patient teaching is that it should be eaten consistently guys and moderation. So just keep the k consistent.
Key words is not increased not decreased. And not avoided totally just a nice consistent moderation. Now dont be tricked bananas and oranges are okay.
Thats for potassium that is a k plus. Not vitamin k. Now a common ati question is a client on warfarin.
Which statement requires intervention. While the statement that includes i will increase my intake of dark green leafy vegetables guys thats a big no no vitamin k now a side note thats a nice to know antibiotics actually increases the risk for bleeding by increasing inr. This is because antibiotics kill the intestinal bacteria that produced vitamin k.
And we end up with a vitamin k deficiency. Which increases our risk of bleeding. Now the big key point and memory trick your guys write this down.
Warfarin. Think wor kin. Since warfarin takes.
So long to set in youre wondering if its workin. So think dub you in work in is for warfarin. The k in workin is for vitamin k.
The antidotes and work in ending with i n are two to three is the therapeutic range now some common exit exam questions here giving an inr of four or five guys were assessing for bleeding and were getting that vitamin k antidote ready or on the other side of. Things the inr of a 20. With a patient with ischemic cva guys we give warfarin to get up to two point five.
Now for patient teaching warfarin has taken lifelong to prevent clots like with patients with atrial fibrillation or artificial heart valve. Replacements. Typically more prevalent in key term.
Here guys write this one down mechanical valve replacements. So another key term. We always do frequent blood tests definitely needed to check therapeutic range.
Now heparin is different. And that its typically only given for a few days or a few weeks. So heparin iv is usually given after an mi heart attack or a pe in the lung to prevent the clot from growing and heparin sub.
Q. Ends in perrin. Like heparin so just think.
An ox oparin or an oxy prin brand. Name. Lovenox or delta paren guys.
These are lower molecular weight. Heparin. Basically a lighter version sort of like a diet coke theyre just less heavy and a less chance of major bleeding.
Which is a great thing now. Its given for a key term prevention of a dvt after surgery. And as far as administration.
We use a 25 gauge needle with five eighths of an inch we inject 90 degrees angle and location keyword two inches from the embellishes or basically the belly button guys not in the thigh not iv route. So dont get tricked with those common distractors. So number four is the big no no here never aspirate a subcu injection and guys never rub the site now a key point.
And this almost dressed on the hesse. Its normal to have mild pain or bruising or even irritation and redness at the site guys. Theres no need to notify the doctor and you may use ice chips to help with the irritation now a comet.
A ti question is an ox operon. Which statement needs further teaching well the statement that says i will inject them into my thigh guys no in their belicus near the belly button. And i will need frequent blood tests guys.
Know thats warfarin now two special considerations for that low molecular weight. Heparin. We always assess the h and h.
Before keyword giving the clients with open fractures now. We always notified the hcp and clarify the order of an ox operon if the h and h is even slightly low since guys we dont know exactly how much blood has been lost so open fractures and h and h. Low.
Then an ox append is a no go now a common hesse question was a client on an ox a prin. What do you report to the hcp and the answer was h and h. That has been decreased and a blood pressure that is dropping in that scenario.
It dropped by 20 points. So guys decreasing h. And h.
With decreasing blood pressure. Usually means blood loss. Now as far as labs for an oxy prin are low weight heparins we monitor for those low platelets guys were not monitoring for coagulation studies.
So not btt and not inr. This is the most commonly chosen distractor over 30 of students got this wrong. So guys think of the double peas for par ends.
So p4 parran and enoxaparin or in aqsa print is p for platelet focused so just like aspirin. The key numbers here platelet should be between 150 and 400 and guys we hold the med for any platelets less than 50 so less than 50 gets really risky we hold really any now another risk is a deadly condition from any type of heparin now this is called hit or heparin induced thrombocytopenia this happens if platelets are decreased by half within key number here 24 hours after starting heparin of any type this usually indicates hit guys. Very deadly.
So think of the triple hs here h4 hit is when h half the platelets are gone within 24 hours after starting h4 heparin guys. The priority action is number one alert the hcp this was mentioned in multiple hemo sections in three different quislings. Now lastly.
A new one on the market. Is fonda paradox. Now the major advantage to this is no risk for hit well.
The major disadvantage is key term. It can cause epidural bleeds. So we dont give it to a patient thats reporting severe back pain decreased.
Llc or paralysis. We always call the hcp and hold the med. So key terms here.
No fonda paradox for at least 6 hours after surgery. And no anticoagulants while a spinal epidural catheter. Is in place huge risk for epidural bleed.
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