NURS 6015 LATEST QUESTIONS AND ANSWERS.
Buy Quality Materials!
Ferrous Sulfate for anemia
Iron supplement for anemia - Increases serum iron concentrations to allow conversion
to Hgb to help make RBCs
LABS BEFORE: Hgb & Hct (establish baseline) and monitor*
DO NOT TAKE WITH FOOD
Side Effects: dark stool (normal), constipation, Nausea, abdominal Pain
Contraindications: thalassemias, alcoholism, do not take with antacids, tetracyclines,
quinolones
Cyanocobalamin (Vitamin B12) side effects
hypokalemia, erythema, HTN, we need this for DNA synthesis
-mild diarrhea
- skin rash
- headache
- dizziness
- nausea
- vomiting
- pulmonary edema and - congestive heart failure early in treatment
- vein thrombosis
- sensation of swelling
- polycythemia Vera (rare, slow growing blood cancer)
- allergic reactions (anaphylaxis). This includes swelling of the face, tongue, and throat,
and difficulty swallowing and breathing.
Folic acid side effects
- supplement helps with erythropoiesis
- intense yellow urine
- increases cancer risk
- all routes
heparin
Factor Xa/Thrombin Inhibitors
blocks clotting process
thrombocytopenia
Contraindication for use:
⎼ Hx of peptic ulcers
Avoid giving IM injections while anticoagulated
Goal aPTT level = 1-3x control
⎼ Antidote = protamine sulfate**
Heparin risk factors
• Bleeding history, especially:
, • More severe bleeding episodes (e.g., any CNS bleeding).
• More recent bleeding.
• Coagulopathy, for example:
• Thrombocytopenia (e.g., <30 billion/L is an absolute contraindication)
• Simultaneous use of multiple anticoagulant/antiplatelet agents.
• Renal failure (uremia causes platelet dysfunction).
• Liver disease.
• Vasculopathy, for example:
• Older age.
• Chronic uncontrolled hypertension.
• CNS disease (e.g., prior intracranial hemorrhage, vascular malformation, active
malignancy)
.• Planned procedures
UFH half life
1 hr
heparin protocol
indications: prophylaxis and tx of thromboembolic disorders like acute coronary
syndrome, DVT, PE
high alert
must have second nurse to witness drip
Alt therapy is argatroban which is a direct thrombin inhibitor that acts by thinning blood.
uses are Coronary artery thrombosis and heparin induced thrombocytopenia
antidote: protamine sulfate combines with strongly acidic heparin to form a stable
complex neutralizing the anticoagulant activity. admin very slowly.
enoxaparin
inject in the abdomen
Enoxaparin is a low molecular weight heparin used for the prophylaxis of deep vein
thrombosis and ischemic complications of unstable angina and non-Q-wave myocardial
infarction.
can cause thrombocytopenia - monitor platelets
look for uncontrolled bleeding
black vomit or red/pink urine, dizziness, bruising
warfarin
Vitamin K Antagonists
used to prevent blood clots from forming or growing larger in your blood and
blood vessels
decrease in production of vitaminK-dependent clotting factors in liver causing
depletion
Concurrent medications to avoid:
⎼ NSAIDs
Goal INR level = 2-3
INR
blood clotting test
high value means blood is too thin
low value means blood will clot too easily
warfarin SE and considerations
Buy Quality Materials!
Ferrous Sulfate for anemia
Iron supplement for anemia - Increases serum iron concentrations to allow conversion
to Hgb to help make RBCs
LABS BEFORE: Hgb & Hct (establish baseline) and monitor*
DO NOT TAKE WITH FOOD
Side Effects: dark stool (normal), constipation, Nausea, abdominal Pain
Contraindications: thalassemias, alcoholism, do not take with antacids, tetracyclines,
quinolones
Cyanocobalamin (Vitamin B12) side effects
hypokalemia, erythema, HTN, we need this for DNA synthesis
-mild diarrhea
- skin rash
- headache
- dizziness
- nausea
- vomiting
- pulmonary edema and - congestive heart failure early in treatment
- vein thrombosis
- sensation of swelling
- polycythemia Vera (rare, slow growing blood cancer)
- allergic reactions (anaphylaxis). This includes swelling of the face, tongue, and throat,
and difficulty swallowing and breathing.
Folic acid side effects
- supplement helps with erythropoiesis
- intense yellow urine
- increases cancer risk
- all routes
heparin
Factor Xa/Thrombin Inhibitors
blocks clotting process
thrombocytopenia
Contraindication for use:
⎼ Hx of peptic ulcers
Avoid giving IM injections while anticoagulated
Goal aPTT level = 1-3x control
⎼ Antidote = protamine sulfate**
Heparin risk factors
• Bleeding history, especially:
, • More severe bleeding episodes (e.g., any CNS bleeding).
• More recent bleeding.
• Coagulopathy, for example:
• Thrombocytopenia (e.g., <30 billion/L is an absolute contraindication)
• Simultaneous use of multiple anticoagulant/antiplatelet agents.
• Renal failure (uremia causes platelet dysfunction).
• Liver disease.
• Vasculopathy, for example:
• Older age.
• Chronic uncontrolled hypertension.
• CNS disease (e.g., prior intracranial hemorrhage, vascular malformation, active
malignancy)
.• Planned procedures
UFH half life
1 hr
heparin protocol
indications: prophylaxis and tx of thromboembolic disorders like acute coronary
syndrome, DVT, PE
high alert
must have second nurse to witness drip
Alt therapy is argatroban which is a direct thrombin inhibitor that acts by thinning blood.
uses are Coronary artery thrombosis and heparin induced thrombocytopenia
antidote: protamine sulfate combines with strongly acidic heparin to form a stable
complex neutralizing the anticoagulant activity. admin very slowly.
enoxaparin
inject in the abdomen
Enoxaparin is a low molecular weight heparin used for the prophylaxis of deep vein
thrombosis and ischemic complications of unstable angina and non-Q-wave myocardial
infarction.
can cause thrombocytopenia - monitor platelets
look for uncontrolled bleeding
black vomit or red/pink urine, dizziness, bruising
warfarin
Vitamin K Antagonists
used to prevent blood clots from forming or growing larger in your blood and
blood vessels
decrease in production of vitaminK-dependent clotting factors in liver causing
depletion
Concurrent medications to avoid:
⎼ NSAIDs
Goal INR level = 2-3
INR
blood clotting test
high value means blood is too thin
low value means blood will clot too easily
warfarin SE and considerations
