Editing Pharmacology – RN Flashcards (section)

== Anticoagulation ==

;Heparin infusion: monitoring target, antidote, and the complication to watch for?
:Target aPTT is generally 1.5 to 2.5 times the control value, or an anti-Xa level per protocol; the antidote is protamine sulfate. Watch for heparin-induced thrombocytopenia, an immune-mediated fall in platelet count typically 5 to 10 days after exposure that paradoxically causes thrombosis. If suspected, stop all heparin including flushes and heparin-coated devices, notify the provider, and anticipate a nonheparin anticoagulant such as argatroban.

;Target INR ranges for warfarin?
:2.0 to 3.0 for atrial fibrillation and venous thromboembolism, and 2.5 to 3.5 for a mechanical mitral valve. Antidote is vitamin K, with prothrombin complex concentrate or fresh frozen plasma for urgent reversal.

;Key nursing points for subcutaneous enoxaparin administration?
:Give in the abdomen at least 2 inches from the umbilicus, do not expel the air bubble in the prefilled syringe, do not aspirate, and do not massage the site. Dose is reduced in renal impairment, and routine coagulation monitoring is usually not required.