Hematology

Question	Answer
Factor Xa/ Thrombin Inhibitors	Heparin Enoxaparin sodium (Lovenox)
Mechanism of Action	Inactivates factor Xa and thrombin. Blocks clotting process
Side effects	bleeding epistaxis bleeding gums thrombocytopenia Melena
Nursing actions	Monitor for bleeds Fall risk Avoid NSAIDs Protamine is antidote for heparin
Vitamin K antagonists	Warfarin (Coumadin)
Mechanism of action	blocks Vitamin K to prolong clotting time
Side effects	Bleeding Toxicity Orthostatic hypotension
Nursing actions	Teratogenic Monitor PT/INR Avoid NSAIDs Consistent diet of Vit K Monitor for bleeds No alcohol
Adenosine Phosphate Receptor Inhibitorrs	Clopidogrel bisulfate (Plavix)
Mechanism of action	Inhibits platelet aggregation
Side effects	Bleeding GI bleeds Thrombocytopenia
Nursing actions	Monitor for GI bleeds teratogenic Check platelets periodically
Thrombolytics	tPA (Altaplase)
Mechanism of action	Dissolves clots
Side effects	bleeding dysthythmias
Nursing actions	Monitor aPTT, PT, INR, CBC Used in ICU- have to be eligible Avoid unnecessary injections
Factor Xa Inhibitors	Apixaban (Eliquis)
Mechanism of action	Inhibits platelet aggregation
Side effects	Bleeding but low bleeding risk
Nursing actions	No lab draws needed Monitor renal function Monitor for bleeds
Mineral supplement	Ferrous sulfate
Mechanism of action	provides iron for hemoglobin to function
Side effects	Constipation Tarry stool Stained teeth Nausea
Nursing actions	Take with vitamin C to increase absorption Give on empty stomach Give 2 hrs before other meds Give with straw Continue to take even if feeling better
Vitamin supplement	Vitamin b12
Mechanism of action	Facilitates protein synthesis and carb metabolism
Side effects	Hypokalemia Erythema
Nursing actions	Monitor F&E balace Encourage high Vit B12 diet Have periodic lab draws done

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	Created by Yean Ji Jung about 4 years ago