Question

Case Scenario:

            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.

            After 5 days of heparin therapy, TM was prescribed warfarin (Coumadin) 5 mg PO daily. An INR test was ordered.

Questions:

1. Why was an aPTT and INR ordered? How would you determine whether TM is within the desired range? Explain your answer.

2. What patient teaching interventions should the nurse include? List at least three interventions.

Answer 1

PTT means Partial thromboplastin  Time

PTT is performed to asses the amount and function of protiens called coagulation factors that are important part of proper blood clot formation. often PT and PTT are performed together.In above mentioned case PTT is performed to evaluate the patient's response to heparin therapy.

INR means International normalized ratio

PT(prothrombin time ) is a test used to detect any bleeding disorders or excessive clotting disorder,

INR is calculated from a PT result and is used to monitor how well the blood thinning medication (anticoagulant) is working to prevent blood clot.

As warfarin is prescribed INR is performed.

PATIENT TEACHING INTERVENTIONS

Include explaining patient about

1.Importance of taking warfarin on a schedule.

2.Increased risk of bleeding and  measures to be take to avoid that.

3.Effect of alcohol consumption .

4.Importance of wearing medical identification.

5.warfarrin intreraction with other medications.

6. Warfarin and food restrictions