Chapter 48 Drugs Affecting Blood Coagulation

Chapter 48  Drugs Affecting Blood Coagulation

Complete Chapter Questions And Answers
 

Sample Questions

1.
A patient is admitted to the hospital with deep vein thrombosis. A 10,000-unit dose of heparin is administered subcutaneously. What drug does the nurse keep on hand to reverse the effects of heparin if the patient begins to bleed?
A)
Antithrombin (Thrombate III)
B)
Desirudin (Iprivask)
C)
Protamine sulfate
D)
Vitamin K
Ans:
C

Feedback:

The antidote for heparin is protamine sulfate. This drug forms stable salts as soon as it comes in contact with heparin. The reaction immediately reverses heparin’s anticoagulation effects. Vitamin K reverses the effect of warfarin. Antithrombin and desirudin are anticoagulants that would not be administered with heparin.

2.
Prior to beginning anticoagulant therapy, the nurse will question the female patient about what?
A)
Last menstrual period
B)
Peptic ulcers
C)
Urinary tract infection
D)
Weight
Ans:
B

Feedback:

The nurse should screen for conditions that could be exacerbated by increased bleeding tendencies, including hemorrhagic disorders, recent trauma, spinal puncture, gastrointestinal (GI) ulcers, recent surgery, intrauterine device placement, tuberculosis, presence of indwelling catheters, and threatened abortion. Beginning anticoagulant therapy with active peptic ulcers could result in severe bleeding. Last menstrual period, urinary tract infection, and weight should not impact anticoagulant therapy.

3.
The nurse is caring for a female patient who is nursing her 3-month-old infant. What will the nurse instruct the patient to do prior to starting heparin to treat venous thrombosis?
A)
“Wait an hour after taking the anticoagulant before feeding the infant.”
B)
“Push fluids to clear the drug from her system before feeding the infant.”
C)
“Find another method of feeding the infant while taking this drug.”
D)
“Continue breast-feeding because heparin does not enter breast milk.”
Ans:
D

Feedback:

Although some adverse fetal effects have been reported with its use during pregnancy, heparin does not enter breast milk, and so it is the anticoagulant of choice if one is needed during lactation. As a result, there is no need to wait an hour, push fluids, or find another method of feeding the baby.

4.
The nurse receives a patient having an acute myocardial infarction (MI) to the emergency department. What drug will the nurse administer before transferring the patient to a larger facility?
A)
Anagrelide (Agrylin)
B)
Clopidogrel (Plavix)
C)
Ticlopidine (Ticlid)
D)
Tenecteplase (TNKase)
Ans:
D

Feedback:

Arrange to administer tenecteplase to reduce mortality associated with acute MI as soon as possible after the onset of symptoms because the timing for the administration of tenecteplase is critical to resolve the clot before permanent damage occurs to the myocardial cells. Anagrelide is used to treat essential thrombocytopenia. Clopidogrel is used to treat patients who are at risk for ischemic events; ticlopidine is used to reduce the risk of thrombotic stroke.

5.
A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin). While assessing the patient’s knowledge of the drug, what would indicate that the patient needs further instruction concerning drug therapy?
A)
“I love to eat homegrown tomatoes in the summer.”
B)
“I take aspirin for my arthritis.”
C)
“I walk 2 miles a day.”
D)
“I drink a glass of wine about once a week.”
Ans:
B

Feedback:

Increased bleeding can occur if a salicylate is taken in combination with warfarin. The nurse will instruct the patient to stop taking aspirin. Walking, eating tomatoes, and drinking an occasional glass of wine should not interfere with the therapeutic effects of warfarin.