NURS 1566 Clinical Form 3: Clinical Medications

Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

Warfarin Coumadin Anticoagulants 2.5mg & 5mg
alternate every PO Q Day
other day
Peak Onset Duration Normal dosage range
2.5-10mg per day for 2-4 days then adjust daily dose by
5-7 days 36-72 hours 2-5 days results of prothrombin time or INR.
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Management of Myocardial infarction: decreases risk of
death, decreases risk of subsequent MI. N/A
Mechanism of action and indications Nursing Implications (what to focus on)
Interferes with hepatic synthesis of vitamin K dependent Contraindications/warnings/interactions
clotting factors (II, VII, IX, and X) Contraindicated in uncontrolled bleeding. Open wounds.
Therapeutic Effects: Prevention of thromboembolic Active ulcer disease. Recent brain, eye, or spinal cord injury
events. or surgery. Severe liver or kidney disease. Uncontrolled
hypertension.
Common side effects
GI: Cramps, nausea. Derm: dermal necrosis. Hemat:
BLEEDING. Misc: fever
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines PT and other clotting factors should be monitored frequently
Acetaminophen. during therapy. Hepatic function and CBC should be
monitored before and periodically throughout therapy. Stool
and urine should be monitored for occult blood before and
periodically during therapy.
Be sure to teach the patient the following about this
medication
Take medication as directed. If a dose is missed take as soon
as remembered that day. Patient should not double doses.
Health care professional should be informed of missed doses
at time of checkup or lab tests. Review foods high in vitamin
K. Encourage a consistent intake of Vitamin K because it is
the antidote for warfarin alternating intake could cause PT
levels to fluctuate. Avoid IM injections and activities leading
to injury. Use a soft tooth brush, do not floss, and shave with
an electric razor. Report any signs of unusual bleeding.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess for signs of bleeding and hemorrhage med? Prolonged PT or INR of 2-4.5
(bleeding gums, nosebleed; unusual bruising; Evidence of bleeding or hemorrhage. without signs of hemorrhage.
tarry black stools; hematuria; fall in
hematocrit or blood pressure.