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NURS 1566 Clinical Form 3: Clinical Medications Worksheets Generic Name Trade Name Warfarin Coumadin Dose Route Time/frequency 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,
  NURS 1566 Clinical Form 3: Clinical MedicationsWorksheets Generic NameWarfarinTrade NameCoumadinClassificationAnticoagulantsDose2.5mg & 5mgalternate everyother dayRoutePOTime/frequencyQ DayPeak 5-7 daysOnset36-72 hoursDuration2-5 days Normal dosage range2.5-10mg per day for 2-4 days then adjust daily dose byresults of prothrombin time or INR.Why is your patient getting this medicationManagement of Myocardial infarction: decreases risk of death, decreases risk of subsequent MI.For IV meds, compatibility with IV drips and/or solutions N/AMechanism of action and indicationsInterferes with hepatic synthesis of vitamin K dependentclotting factors (II, VII, IX, and X)Therapeutic Effects: Prevention of thromboembolicevents. Nursing Implications (what to focus on) Contraindications/warnings/interactionsContraindicated in uncontrolled bleeding. Open wounds.Active ulcer disease. Recent brain, eye, or spinal cord injuryor surgery. Severe liver or kidney disease. Uncontrolledhypertension.Common side effectsGI: Cramps, nausea. Derm: dermal necrosis. Hemat:BLEEDING. Misc: fever Interactions with other patient drugs, OTC or herbalmedicinesAcetaminophen.Lab value alterations caused by medicinePT and other clotting factors should be monitored frequentlyduring therapy. Hepatic function and CBC should bemonitored before and periodically throughout therapy. Stooland urine should be monitored for occult blood before and periodically during therapy.Be sure to teach the patient the following about thismedicationTake medication as directed. If a dose is missed take as soonas remembered that day. Patient should not double doses.Health care professional should be informed of missed dosesat time of checkup or lab tests. Review foods high in vitaminK. Encourage a consistent intake of Vitamin K because it isthe antidote for warfarin alternating intake could cause PTlevels to fluctuate. Avoid IM injections and activities leadingto injury. Use a soft tooth brush, do not floss, and shave withan electric razor. Report any signs of unusual bleeding.  Nursing Process- Assessment (Pre-administration assessment)Assess for signs of bleeding and hemorrhage(bleeding gums, nosebleed; unusual bruising;tarry black stools; hematuria; fall inhematocrit or blood pressure. Assessment Why would you hold or not give thismed?Evidence of bleeding or hemorrhage. Evaluation Check  after givingProlonged PT or INR of 2-4.5without signs of hemorrhage.
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