Warfarin (Coumadin) Nursing Considerations

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Drug Card Warfarin (Coumadin) (Cheatsheet)
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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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Study Plan Lessons

02.17 Septic Shock for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.03 Hypoglycemia for CCRN Review
07.10 Neurologic Review questions for CCRN Review
Addisons Disease
Adjunct Neuro Assessments
AIDS Case Study (45 min)
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Amputation
Anion Gap
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
Anti Tumor Antibiotics
Burn Injuries
Cancer – Early Warning Signs Nursing Mnemonic (CAUTION UP)
Cancer – Nursing Priorities Nursing Mnemonic (CANCER)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Chemotherapy Patients
Coagulation Studies (PT, PTT, INR)
Complications of Immobility
Computed Tomography (CT)
D-Dimer (DDI) Lab Values
Different Dressings
DKA Treatment Nursing Mnemonic (KING UFC)
Epinephrine (EpiPen) Nursing Considerations
Fluid Volume Overload
Fractures
Fractures (Open, Closed, Fat Embolus) for Certified Emergency Nursing (CEN)
Gout Case Study (45 min)
Hematology/Oncology/Immunology Course Introduction
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypotonic Solutions (IV solutions)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
Implant Preparation for Certified Perioperative Nurse (CNOR)
Integumentary (Skin) Course Introduction
Integumentary (Skin) Important Points
Integumentary (Skin) Module Intro
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Magnetic Resonance Imaging (MRI)
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Multiple Myeloma
Morphine (MS Contin) Nursing Considerations
Musculoskeletal Assessment
Musculoskeletal Course Introduction
Naproxen (Aleve) Nursing Considerations
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Osteomyelitis
Post-Anesthesia Recovery
Postoperative (Postop) Complications
Preoperative (Preop) Education
Proton Pump Inhibitors
Respiratory Alkalosis
Respiratory A&P Module Intro
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Routine Neuro Assessments
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Skin Cancer
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Systemic Lupus Erythematosus (SLE)
The 5-Minute Assessment (Physical assessment)
Thrombocytopenia
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Vancomycin (Vancocin) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Nursing Care and Pathophysiology for Hypovolemic Shock
Fluid & Electrolytes Course Introduction