A patient with a vein thromboembolism is to be started on oral ...

[evelyn o bentley]

A patient with a vein thromboembolism is to be started on oral warfarin (Coumadin) while still receiving intravenous heparin. What is the nurse's best action?
 
  a. Administer the drugs as prescribed.
  b. Remind the prescriber that two anticoagulants should not be administered con-currently.
  c. Hold the dose of warfarin until the patient's activated partial thromboplastin time is the same as the control value.
  d. Monitor the patient for clinical manifestations of internal or external bleeding at least every 2 hours.

Question 2

A 78-year-old man has been taking diphenhydramine (Benadryl) for seasonal allergies. Which new symptom would the nurse report to the prescriber?
 
  a. Decreased urination
  b. Drowsiness
  c. Dry mouth
  d. Cough

[bassamabas]

Answer to Question 1

A
Although both heparin and warfarin are anticoagulants, they have different mechanisms of action and onsets of action. Because warfarin has such a slow onset, it must be started while the patient is still receiving heparin.

Answer to Question 2

A
Diphenhydramine is an antihistamine with anticholinergic actions that include dry mouth, drowsiness, and urinary retention. An enlarged prostate is common among older men and causes difficulty urinating. This problem can be made much worse when taking a drug that can cause urinary retention.