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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Concepts Covered:

  • Shock
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  • Cognitive Disorders
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Study Plan Lessons

Sepsis Concept Map
Shock
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Concept Map
Stroke for Certified Emergency Nursing (CEN)
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Surgical Incisions & Drain Sites
Surgical Prep
Surgical Counts for Certified Perioperative Nurse (CNOR)
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Tension and Cluster Headaches
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
Thoracentesis
Thrombocytopenia
Thrombolytics
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Vancomycin (Vancocin) Nursing Considerations
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Wound Infections for Certified Emergency Nursing (CEN)
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)
Wound Dressing Maintenance for Certified Perioperative Nurse (CNOR)
Wound Classification for Certified Perioperative Nurse (CNOR)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
02.14 Shock Stages for CCRN Review
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
ACE (angiotensin-converting enzyme) Inhibitors
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)
Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Adjunct Neuro Assessments
Admissions, Discharges, and Transfers
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Advance Directives
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Airway Suctioning
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Alteplase (tPA, Activase) Nursing Considerations
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Amputation
Amputation Concept Map
Anemia for Progressive Care Certified Nurse (PCCN)
Anesthetic Agents
Anesthetic Agents
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Anti-Infective – Antitubercular
Anti-Platelet Aggregate
Anticonvulsants
Antidiabetic Agents
Antimetabolites
Antineoplastics
Antinuclear Antibody Lab Values
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
ASA (Aspirin) Nursing Considerations
Aspiration for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Asthma for Certified Emergency Nursing (CEN)
At Risk for Gout Nursing Mnemonic (MALE)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
Azithromycin (Zithromax) Nursing Considerations
Barriers to Health Assessment
Blood Flow Through The Heart
Blunt Chest Trauma
Bowel Obstruction Concept Map