A client who was recently started on the anticoagulant warfarin ...

[codyclark]

A client who was recently started on the anticoagulant warfarin (Coumadin) asks about adverse reactions. The nurse explains that adverse effects may occur because the drug is highly bound with only ____ available to reach the target cells.
 
  Fill in the blank with the appropriate word.

Question 2

The nurse checks a newly ordered medication and finds it to be 92 protein bound. How much of the medication will be readily available to the client once the nurse administers the medication?
 
  1. 100.
  2. 8.
  3. 50.
  4. 92.

[jesse.fleming]

Answer to Question 1

Correct Answer: 1
Rationale: When giving a medication that is highly bound, the nurse should carefully monitor for adverse effects. The anticoagulant warfarin (Coumadin) is highly bound; 99 of the drug in the plasma exists in drugprotein complexes and only 1 exists as a free drug available to reach target cells.
Global Rationale: When giving a medication that is highly bound, the nurse should carefully monitor for adverse effects. The anticoagulant warfarin (Coumadin), is highly bound; 99 of the drug in the plasma exists in drug-protein complexes and only 1 exists as a free drug available to reach target cells.

Answer to Question 2

Correct Answer: 2
Rationale 1: If 100 of the drug were available to the client, none of it would be protein bound.
Rationale 2: The percentage of drug that is unbound is free and able to reach target tissue. If a drug is 92 protein bound, then 8 is free and available to tissues.
Rationale 3: If 50 of the drug is available to the client, then 50 is protein bound.
Rationale 4: The percentage of drug that is unbound is free and able to reach target tissue.
Global Rationale: The percentage of drug that is unbound is free and able to reach target tissue. If a drug is 92 protein bound, then 8 is free and available to tissues. If 100 of the drug were available to the client, none of it would be protein bound. If 50 of the drug is available to the client, then 50 is protein bound. The percentage of drug that is unbound is free and able to reach target tissue.

[codyclark]

Gracias!

[kusterl]

Excellent