NCLEX RN Practice Question # 921

NCLEX Examination.

Practice Question # 921.

 

nclex examination

 

Heparin Pharmacological Review

Generic Name

  • Heparin

Trade Name

  • Hep-Lock

Properties of Heparins and warfarin.

Property

Heparins

Warfarin

Structure

Large acidic polysaccharide polymers

Small lipid-soluble molecule

Route of administration

Parenteral

Oral

Site of action

Blood

Liver

Onset of action

Rapid (minutes)

Slow (days); limited by half-lives of preexisting normal

factors

Mechanism of action

Activates antithrombin III, which proteolyzes

coagulation factors including thrombin and factor Xa

Impairs post-translational modification of factors II, VII,

IX and X

Monitoring

aPTT for unfractionated heparin but not LMW heparins

Prothrombin time

Antidote

Protamine for unfractionated heparin; protamine

reversal of LMW heparins is incomplete

Vitamin K1, plasma, prothrombin complex concentrates

Use

Mostly acute, over days

Chronic, over weeks to months

Use in pregnancy

Yes

No

 

Indication

  • Venous thromboembolism prophylaxis and treatment, low dose used to ensure patency of IV catheters

Action

  • Increases the inhibitory effect of antithrombin on factor Xa

Therapeutic Class

  • Anticoagulant

Pharmacologic Class

  • Antithrombotic

Nursing Considerations

  • Monitor for signs of bleeding
  • Monitor platelet count
  • May cause hyperkalemia
  • Have patient report any signs of bleeding

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