Okay, let’s warp up these medications that we use to treat clots.
All -- I mean A-L-L, all anticoagulants, antiplatelets and thrombolytics increase the patient’s risk for bleeding.
So it’s so important that you keep that at the forefront of your mind and educate your patients.
You wanna monitor for clinical signs and symptoms of bleeding and not just the obvious ones.
Pay attention to the early signs, so that you can teach your patients to do the same thing.
You want them to know how to self-monitor and to know when they need to call their health care provider.
Now, nurses and health care providers have some extra tricks, right?
We can do some extra labs, so make sure you’re familiar with what these labs are,
when we use them and what their normal values are.
So for anticoagulants medications, we’ll look at the PT/INR. We use that for warfarin.
We use an aPTT, right, an activated partial prothrombin time for heparin.
For heparin anti-Xa, that’s a little bit newer test under the scene, we can use it with unfractionated heparin
and with some patients we’ll even use it with low molecular weight heparin.
So that’s the lab work that we’re gonna look at to monitor patients.
Even though we know the benefits of low molecular weight heparin is we don’t usually test,
that is an option if we need it. So make sure you know who gets an aPTT, who gets a PT
and who we could use in anti-Xa level.
Protamine sulfate is the antidote for heparin, so if my patient is experiencing a heparin overdose for their body
that’s the drug we could give to counteract that. Vitamin K has a dual role,
it’s both the antidote for warfarin and the dietary limitation,
so make sure you know which food are high in vitamin K and you educate your patients.
That sounds like a real easy nursing school question too, to ask you about the appropriate diet for a patient on warfarin.
Now anticoagulants are used for venous thrombosis and antiplatelets are primarily used for arterial thrombosis.
Thrombolytics are high risk and high benefit medications,
so keep in mind you have to screen carefully for potential risk factors for bleeding.
They can have recent trauma, CPR, uncontrolled hypertension, had a history of bleeding in their head,
all those things that put them in an increased risk, because unlike the other medications these drugs are clot busters.
Antiplatelets and anticoagulants might stop a thrombus that you have from getting bigger
and hopefully new ones from forming, but they won’t dissolve a clot.
Thrombolytics, boom, they are like a nuclear warhead, they will blow up every clot.
So screen your patients carefully for any risk factors for bleeding or recent trauma and give these medications
as soon as possible after the symptoms appear.
Remember we’ve got that usually four, maybe you could stretch it to six, but within four hours it’s the best idea.
Thanks for watching our video series today.
Now you know for any patient on an anticoagulant, antiplatelet or thrombolytic,
the signs to watch for and how to administer that patient’s medications safely.