NCLEX Question: Bridging Coumadin until INR Therapeutic

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• published: 01 Dec 2015
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EmpoweRN.com This is a video nursing exam or NCLEX style question going over the medication coumadin. I have placed this video in the format that helped me pass nursing school with honors and the NCLEX examination on the first attempt in 75 questions. I know it may seem unreasonably long… but it is not. Take your time, follow the instructions and read each word slowly. Lets get started ;) Question Number 1 of 4: Title: NCLEX Question: Bridging Coumadin until INR Therapeutic A client was admitted for the treatment of deep vein thrombosis. The attending physician ordered the following medication: Heparin 5,000 units S.Q. every 8 hours, Warfarin (Coumadin) 5 mg P.O, start today. The nurse’s best action would be: A. Administer neither the heparin nor coumadin B. Administer both heparin and coumadin C. Administer only prescribed coumadin D. Administer only prescribed heparin Correct Answer: B – It takes several days for the Coumadin to reach its maximum anticoagulant effect, and heparin and Coumadin therapy sometimes overlap. For more questions & for the main video visit here: http://wp.me/s4CVjD-coumadin Warfarin aka Coumadin is the most used oral anticoagulant in the world and has been used for more than 50 years for therapy in prevention of thrombus formation and subsequent thromboembolic events. Anticoagulants are blood thinners which prevent formation of blood clots as well as prevent existent blood clots from increasing in size. Blood clots can hinder blood circulation and lead to serious medical conditions, like stroke, heart attack and pulmonary embolism. Thus warfarin is helpful in treating and preventing vein and artery blockage, stroke and heart attack. Mechanism of Action Warfarin slows down the formation of blood clots within 24 hours, but the complete effect takes place between 72 to 96 hours after taking the medication. Blood clot formation is a complicated process which requires certain compounds known as coagulating factors to be present. These coagulating factors are produced by the liver. In the presence of sufficient vitamin K. Warfarin acts by inhibiting the presence of vitamin K and this inhibits the formation of coagulating factors. Substances that require vitamin K for their formation are: the anticoagulant proteins C and S and factors II, VII, IX, and X. Therefore, medications like warfarin block coagulating factors and disturb the process of clot formation. Thus slowing down blood clot formation. In the case of blood clots that are already formed, warfarin stops the clot from getting bigger. It also prevents breakage of the clot which can be otherwise dangerous if it travels in the bloodstream and blocks blood vessels. Warfarin cannot destroy or dissolve a blood clot that is already there. But the blood clot itself may slowly dissolve with time. Nor can Warfarin reverse ischemic tissue damage either, but, may help avoid secondary thromboembolic complications that can be dangerous and even fatal.