Question

In: Nursing

TM is a 57 year old male. He has been admitted into the hospital thromobophlebitis in the right lower leg. He was given a IV Heparin 5000 unit bolus.

TM is a 57 year old male. He has been admitted into the hospital thromobophlebitis in the right lower leg. He was given a IV Heparin 5000 unit bolus. Following the IV bolus, heparin 5000 units was given subcutaneously every 6 hours as prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were prescribed, and a aPTT test was ordered.

1.Was TM's heparing order within the safe daily dosage range? Explain.

2. What are the various methods for administering heparin?

3. Why was a aPTT test ordered? How would you determine whether TM is withing the desired therapeutic range? Explain your answer.

After 5 days of heparin therapy, TM is prescribed oral warfarin 5mg daily. An INR test was ordered.

4. What is the pharmacologic action of warfarin? Is the warfarin dose within the safe daily dose range? Explain your answer.

Expert Solution

1. Yes, the heparin order within the safe daily dosage range.

The recommended dose is 5000 units bolus and 250 units per kg 12 hourly.(Approx 60 kg person can administered 30,000 units per day.)

The patient has given an IV Heparin 5000 unit bolus. Following the IV bolus, heparin 5000 units were given subcutaneously every 6 hours. So, it is in a safe range.

2.

Heparin can be administered intravenously (Bolus, periodically or as a continuous infusion)

Or in the subcutaneous route periodically.

It can also be administered by indwelling catheters.

3.

Partial thromboplastin time (PTT) is used to measure the effects of Heparin in the body which helps in the adjustment of dose. The normal range of PTT is 25 to 35 seconds.

Heparin increases the PTT value. PTT range from 60 to 100 seconds tells the therapeutic dose of Heparin in the body.

4.

Warfarin is a class of drugs called an anticoagulant, It blocks the actions of clotting factors and stops the clot formation in the body.

Yes, the dose is safe, The Patient can take up to 10 mg of warfarin daily.

According to INR value, the dose can be modified, Therapeutic INR value for warfarin is 2 to 3.

Nightingale answered 2 years ago

TM, a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by...

TM, a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by bolus, was given. Following the IV bolus, heparin 5000 units given subQ q6h was prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were also prescribed. An aPTT test was ordered. 1. Was TM's heparin order within the safe daily dosage range? 2. What are the various methods for administering heparin?

T.M., a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by...

T.M., a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by bolus, was given. Following the IV bolus, heparin 5000 units given subQ q6h was prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were also prescribed. How does heparin work and why was it prescribed? What laboratory test(s) would be monitored for patients taking heparin? Explain your answer. Explain the differences between heparin and enoxaparin. Are there advantages to either of...

MN, a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by...

MN, a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by bolus, was given. Following the IV bolus, heparin 5000 units given subcutaneously every 6 hours was prescribed. An aPTT was ordered. Use the drug cards you created and your textbook to respond to the following questions: Was MN's heparin within the safe daily dosage range? ( answer please) Why was an aPTT ordered( answer please) After 5 days, MN was prescribed warfarin 5 mg...

TM is a 38 year old male with ulcerative colitis admitted to the medical unit at...

TM is a 38 year old male with ulcerative colitis admitted to the medical unit at the hospital for acute exacerbation of the disease. This is his second admission in the last six months. TM says he is frustrated with this disease. In the last week TM has had 15-20 diarrhea episodes a day. He needs to hurry to the bathroom often throughout the day and night. He reports sleeping only an hour at a time at night and trouble...

A 65-year-old male admitted to the unit with a severe asthma attack. He has been experiencing...

A 65-year-old male admitted to the unit with a severe asthma attack. He has been experiencing shortness of breath since admission several hours ago. An ABG is ordered with these results: Patient: Test Patient 1 Date: April 10, 2007 1000 pH 7.20 PaCO2 58 HCO3- 24 pH PCO2 HCO3- Patient is in _____________________________________ Interventions may include: ________________________________________________

Mr Balram a 49-year-old male, has been admitted to hospital in the late evening for a...

Mr Balram a 49-year-old male, has been admitted to hospital in the late evening for a case of unstable angina. Presenting complaints include left-sided chest pain which was less severe than that of his previous admission and localized pain during rest. Other symptoms are profuse sweating as well as nausea and vomiting, orthopnea and paroxysmal nocturnal dyspnea, cough and fever. Patient’s past medical history includes diabetes mellitus and hypertension diagnosed 6 years ago, ischemic heart disease (IHD) since 3 years...

A 40-year-old woman has been admitted with possible embolism. Her symptoms are chest pain, right leg...

A 40-year-old woman has been admitted with possible embolism. Her symptoms are chest pain, right leg temperature warmer than left, delivery of a baby by C-section three weeks ago, and fatigue and shortness of breath. 1. Question: Explain the clotting cascade and the relevance to the symptoms described

Jason is a 7-year-old who has been admitted to the general pediatric unit for IV antibiotics...

Jason is a 7-year-old who has been admitted to the general pediatric unit for IV antibiotics because of a severe spider bite that has become infected despite treatment at home with oral antibiotics. His mother is very upset that Jason has to be in the hospital. She voices frustration that the antibiotics have not worked and questions why he needs a different drug. a) What actions would you expect to take as the nurse to ensure that Jason receives the...

PANCREATITIS, A 44 year old male patient has been admitted to the medical surgical unit of...

PANCREATITIS, A 44 year old male patient has been admitted to the medical surgical unit of the hospital for after seeking treatment for nausea, vomiting, and intense pain in the right upper quadrant the evening before and waited for a few hours before seeking treatment. He has a history of substance abuse and has been in rehabilitation for both alcoho and methamphetamines, despite previous. Following diagnosis and continued administration of the pain medication, the patient still complaing of pain. the...

Jordan James is a 25-year-old male. Jordan has been admitted to hospital with a five day...

Jordan James is a 25-year-old male. Jordan has been admitted to hospital with a five day history of right lower abdominal cramping pain, a feeling of abdominal bloating, nausea and bilious vomiting, and an increased amount of abdominal gurgling and rumbling. Jordan stated that over recent weeks, he has experienced persistent diarrhoea, lower right abdominal pain and tenderness, fatigue and malaise. Jordan stated he has not been able to keep up with his work demands and is not getting quality...