INDEX NURS 2236 Clinical Form 3: Clinical Medications Worksheet

(You will need to made additional copies of these forms)

Generic Trade Classification Dose Route Time/Frequency
Name Name 2.5-10mg PO Daily for 2-4 days then adjust daily dose by results
anticoagulants of prothrombin time.
warfarin Coumadin

Peak Onset Duration For IV meds, compatability with IV drips and/or solutions
5-7 days 36-72 hours 2-5 days
Why is your patient taking this medication?

Mechanism of action and indications Nursing Implications (what to focus on)

Prophylaxis and treatment of Venous thrombosis,
pulmonary embolism, atrial fibrilation with embolization,
Management of MI's (decreases risk of death, decreases
risk of subsequent MI, and decreases risk of future
thromboembolic events.)
Prevention of thrombus formation and embolization after
prosthetic valve placement.
Contraindications/warnings/interactions Uncontrolled bleeding, open
wounds, active ulcer disease, recent brain, eye, or spinal cord injury, or
surgery, severe liver or kidney disease, uncontrolled hypertension, preganancy
Use cautiously in: malignancy, patients with history of ulcer or liver disease,
history of poor compliance, and women with childbearing potential.
Common side effects
Cramps, nausea, dermal necrosis, bleeding and fever

Prevention of thromboembolic events

Interactions with other patient drugs, OTC, or herbal Lab value alterations caused by medicine
medicines (ask patient specifically)
Abciximab, androgens, capecitabine, cefoperazone,
cefotetan, chloral hydrate, chloramphenicol, clopidogrel,
disulfiram, fluconazole, fluoroquinolones, itraconazole, Be sure to teach the patient the following about this medication
metronidazole, Limit intake of Vitamin K foods, avoid IM injections, or activities leading to
thrombolytics, eptifibatid, tirofiban, ticlopidine, sulfonamides, injury, use soft toothbrush, don't floss, shave with electric razor, venipunctures
quinidine, quinine, NSAID's, valproates, aspirin, acetaminophen, and injection sites require pressure to prevent bleeding or hematoma
alcohol, barbiturates, hormonal contraceptives, formation. Report and sign of bleeding or bruising; Don't dring alcohol or take
OTC, especially those containing aspirin; frequent lab test to monitor.
Nursing Process - Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give Check after giving
Signs of bleeding and hemorrhage (bleeding this med? Prolonged PT (1.3-2.0 times the control; may
gums; nosebleed; unusual bruising; tarry, black PT is excessively prolonged or if minor vary with indication) or INR of 2-4.5 without
stool; hematuria; fall in hematocrit or blood bleeding occurs. signs of hemorrhage.
pressure; guaiac-positive stools, urine, or
nasogastric aspirate.
vital signs