Question

After 5 days of heparin therapy, T.M. was prescribed warfarin 5 mg PO daily 4. Why was T.M changed to warfarin? What is the pharmacologic action of warfarin? 5. What laboratory test(s) would be monitored for patients taking warfarin? Explain your answer. 6. Explain the half-life and protein-binding for warfarin. What additional concerns do you have? How does this knowledge impact teaching for patient's taking warfarin? Explain. 7. What assessments should be performed before starting anticoagulant therapy? 8. Explain the nursing considerations and patient teaching for anticoagulant (include rationale)

Answer 1

4. If the patient is admitted in hospital with blood clot to provide immediate relief initially heparin is given. It acts quickly but not advisable for long term use. Hence after the reduce the seriousness of the blood clot patients are switched to warfarin. It is given for blood clot prevention and suitable for long term use. Pharmacologic action of warfarin is anti -coagulant.It inhibits the enzyme needed for the activation of vitamin -K.

5. Prothrombin time (PT) and International Normalized ratio(INR) are the essential laboratory test would be monitored for warfarin therapy. These test reveal the blood clotting nature of the client so it helps to adjust the dose of warfarin according to the need.

6. Half life of warfarin is around 40 hours and the protein binding is nearly 99%. It is highly bounded to the protein such as albumin hence decrease the volume of distribution. So the patient need to know about the importance of Taking drug and never skip the medicines.

7. It is important to perform the basic coagulation parameter study. They are bleeding time, clotting time, PT, PTT, INR. This should be done before anti - coagulant therapy.

8. Nursing considerations:

Teach about the need and purpose to take this medication. ( To improve medication compliance).

Instruct patient to avoid activities that cause bleeding. ( The natural anti coagulant will not act).

Never make adjustments in dosage without physician order. ( self alteration can result in change in viscosity of blood can affect the health further).

Instruct patient to regularly monitor the lab tests. ( To monitor the drug efficiency).