Warfarin (Coumadin) Nursing Considerations

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Outline

Generic Name

warfarin

Trade Name

Coumadin

Indication

venous thrombosis, pulmonary embolism, A-fib, myocardial infarction

Action

disrupts liver synthesis of Vitamin K dependent clotting factors

Therapeutic Class

Anticoagulant

Pharmacologic Class

coumarins

Nursing Considerations

• contraindicated with bleeding, severe hypertension
• can cause bleeding
• aspirin and NSAIDs can increase risk of bleeding
• azole antifungals increase effects of warfarin
• cimetadine(Tagamet) increases warfarin levels
• obtain full history of supplements and herbs
• large amounts of vitamin K may antagonize effects of warfarin
• assess for signs of bleeding
• therapeutic levels: PT 1.3-1.5, INR 2.5-3.5
• instruct patient to report any signs of bleeding
• patient should not drink alcohol
• bleeding times need to be monitored frequently
• vitamin K is antidote

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Transcript

Hey guys. Okay. Let’s talk about warfarin. Also known as Coumadin. This is an oral medication, as you can see here. So the therapeutic class of warfarin or how it works in the body is an, an coagulant while the pharmacologic class or its chemical effect is a Rine warfarin works by disrupting liver synthesis of vitamin K dependent cloting factors. We use warfarin for venous thrombosis for pulmonary embolisms AFib, and also for myocardial infarctions. Some of the side effects that we see with warfarin are bleeding, which is definitely its most common side effect, nausea, vomiting in abdominal pain, a few nursing considerations for warfarin. It is contraindicated in a patient who is actively bleeding and also a patient who has severe hypertension, aspirin, and NSAIDs can increase bleeding and AOL antifungal and editing can increase the effects of warfarin. The antidote for warfarin is vitamin K, which is super important to know, be sure to assess your patient for signs of bleeding and also their bleeding times, including their PT and I N R and teach the patient to not drink alcohol and report signs of bleeding to their provider. Immediately guys, vitamin K antagonism. It takes a long time. So if you need more immediate results using fresh frozen plasma in factor seven in factor eight, alongside blood transfusions is going to be your best bet. And here is an interesting fact, warfarin, w a R F a R I N. The name actually came from the Wisconsin alumni research foundation. That’s the w a RF and the a R N came from it being a CIN drug. 

That’s it for warfarin or KU now go out and be your best cell and as always happy nursing.

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Med-Surg Study Plan

Concepts Covered:

  • Shock
  • Cardiac Disorders
  • Vascular Disorders
  • Pregnancy Risks
  • Emergency Care of the Cardiac Patient
  • Medication Administration
  • Acute & Chronic Renal Disorders
  • Central Nervous System Disorders – Brain
  • Cardiovascular Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Postoperative Nursing
  • Intraoperative Nursing
  • Preoperative Nursing
  • Perioperative Nursing Roles
  • Circulatory System
  • Urinary System
  • Integumentary Disorders
  • Labor Complications
  • Eating Disorders
  • Respiratory System
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Hematologic Disorders
  • Oncology Disorders
  • Immunological Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Neurological Trauma
  • Neurologic and Cognitive Disorders
  • Nervous System
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies

Study Plan Lessons

Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Hydralazine (Apresoline) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Enoxaparin (Lovenox) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Digoxin (Lanoxin) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Amlodipine (Norvasc) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Hypoglycemia
Nursing Care and Pathophysiology for Hyperparathyroidism
Discharge (DC) Teaching After Surgery
Surgical Incisions & Drain Sites
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Intraoperative Nursing Priorities
Intraoperative (Intraop) Complications
Intraoperative Positioning
Sterile Field
Surgical Prep
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
General Anesthesia
Intubation in the OR
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Preoperative (Preop)Assessment
Informed Consent
Perioperative Nursing Roles
Perioperative Nursing Course Introduction
Hypoparathyroidism
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Pressure Line Management
Hanging an IV Piggyback
Spiking & Priming IV Bags
IV Push Medications
Central Line Dressing Change
Drawing Blood
Starting an IV
Fluid & Electrolytes Course Introduction
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Hematology Module Intro
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Thrombocytopenia
Oncology Module Intro
Leukemia
Lymphoma
Oncology Important Points
Immunology Module Intro
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Lyme Disease
Systemic Lupus Erythematosus (SLE)
Metabolic & Endocrine Module Intro
Addisons Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Diabetes Mellitus (DM) Module Intro
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Management
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Respiratory Course Introduction
Respiratory A&P Module Intro
Lung Sounds
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Artificial Airways
Airway Suctioning
Blunt Chest Trauma
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Chest Tube Management
Respiratory Procedures Module Intro
Bronchoscopy
Thoracentesis
Neuro A&P Module Intro
Neuro Anatomy
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Neuro Assessment Module Intro
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Cerebral Perfusion Pressure CPP
Neuro Disorders Module Intro
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Brain Tumors
Encephalopathies
Miscellaneous Nerve Disorders
Stroke (CVA) Module Intro
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Cardiovascular Disorders (CVD) Module Intro
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Cardiac Course Introduction
HMG-CoA Reductase Inhibitors (Statins)
Cardiac Glycosides
Calcium Channel Blockers
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System