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DRN 101, Week 9
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Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)

Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)

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Outline

Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT)

 

Definition/Etiology:

  • N/A

 

Pathophysiology:

  • Medication-induced coagulopathies
    • Coumadin
    • Platelet inhibitors
    • Heparin

 

Noticing: Assessment & Recognizing Cues:

  • Bleeding
    • Bruising
    • Petechiae
    • Hematoma

 

Interpreting: Analyzing & Planning:

  • Complete Blood Count
    • Red Blood Cells
    • Hemoglobin
    • Hematocrit
    • Platelets 
  • Coagulation panel
    • PT/INR
    • PTT
    • Anti Xa level
  • Rule of “10”
    • 10 letters= coumadinpt
    • 10 letters=heparinptt

 

Responding: Patient Interventions & Taking Action:

  • Platelet inhibitors= stop; platelet infusion
  • Coumadin= vitamin K
  • Heparin = protamine sulfate
  • HIT= Direct thrombin inhibitor

 

Reflecting: Evaluating Patient Outcomes:

  • Bleeding minimized/stopped
  • Dose/type of medication adjusted
  • Education: s/s for bleeding

 

Linchpins (Key Points):

  • Rule of 10s
  • Coumadin= PT/INR; Vitamin K
  • Heparin= PTT; protamine sulfate
  • HIT=direct thrombin inhibitor
  • Antiplatelet= Plt; stop

 

 

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Transcript

References

  • Baroletti, S. A. & Gladhaber, S. Z. (2006). Heparin-induced thrombocytopenia. Circulation, 114, e355-e356. doi: 10.1161/CIRCULATIONAHA.106.632653.
  • Patriquin, C. & Crowther, M. (2011). Treatment of warfarin-association coagulopathy with vitamin K.  Expert Review of Hematology, 4(60), 657-667. doi: 10.1586/ehm.11.59.
  • Kamath, P. S. (2022). Management of antiplatelet agents in patients undergoing endoscopic procedures. https://www.uptodate.com/contents/management-of-antiplatelet-agents-in-patients-undergoing-endoscopic-procedures.
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DRN 101, Week 9

Concepts Covered:

  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Cardiovascular
  • Vascular Disorders
  • Studying
  • Hematologic Disorders
  • Neurological Emergencies
  • Central Nervous System Disorders – Brain

Study Plan Lessons

Acute Coronary Syndrome (ACS)
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Alteplase (tPA, Activase) Nursing Considerations
Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Aortic Stenosis Symptoms Nursing Mnemonic (SAD)
ASA (Aspirin) Nursing Considerations
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Bleeding Complications (Minor) Nursing Mnemonic (BEEP)
Bleeding Precautions Nursing Mnemonic (RANDI)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiovascular Angiography
Cerebral Angiography
Clopidogrel (Plavix) Nursing Considerations
Coagulation Studies (PT, PTT, INR)
Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)
Coronary Artery Disease Concept Map
Diltiazem (Cardizem) Nursing Considerations
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
HMG-CoA Reductase Inhibitors (Statins)
Myocardial Infarction Nursing Mnemonic (MONATAS)
Myocardial Infarction (MI) Case Study (45 min)
MI Surgical Intervention
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan for Coronary Artery Disease (CAD)
Thrombin Inhibitors
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive