NUR 326 Lecture Notes - Lecture 5: Protamine Sulfate, Anticoagulant, Dalteparin Sodium
Document Summary
Active major bleeding, history of heparin induced thrombocytopenia (hit) Inhibits effect of antithrombin on factor xa and thrombin. Pe, evolving stroke, disseminated intravascular coagulation (dic) s t n a l u g a o c i t n. Inactivated xa factor but less able to inhibit thrombin. Contra: stroke, peptic ulcer, blood anomalies, platelet count. Not to be given to pts. having eye surgery, brain, or spinal surgery. Never given orally bc poor absorption in gi track. Monitor platelet count q3-4 days; mild hit may occur on 4th day. Effect: chamomile, garlic, ginger, ginkgo, ginseng, high-dose vitamin e aptt (activated partial thromboplastin time) reference range = 30-40 seconds. Monitor for indication of bleeding (bruised gums, abdominal pain, coffee-ground emesis, tarry stools. Provide instruction for self- administration do not expel air bubble (purpose: to make sure full dose is delivered to pt. ) Inhibit thrombin, preventing a thrombus forming, prevents strokes, embolism in patient w/ afib.
