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Author Question: The physician decides not to administer an antidote, and M.M. is monitored closely. Four hours ... (Read 109 times)

mia

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on: Jun 25, 2018
The physician decides not to administer an antidote, and M.M. is monitored closely. Four hours later, the
  aPTT is 40 seconds.
  The next day the physician's orders read, Warfarin (Coumadin) 2.5 mg PO, PT/INR in am;
  D/C heparin.
 
   What is wrong with these orders?
  What will be an ideal response?

Question 2

What nutritional needs will H.K. have and why?
 
  What will be an ideal response?


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isabelt_18

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Reply #1 on: Jun 25, 2018
Answer to Question 1

It will take at least 3 days for warfarin (Coumadin) to reach therapeutic levels. The gold standard
for venous thromboembolism (VTE) treatment is to continue overlap therapy (parenteral and
oral anticoagulant therapy) for a minimum of 5 days. Then the parenteral anticoagulant can be
discontinued if the INR is above 2 . The PT/INR is usually drawn daily even though it might take
several days until it is in the therapeutic range. The heparin should be monitored by aPTT levels, and
the dose calculated according to results.

Answer to Question 2

 H.K. has had surgery, has a fracture, and has an infection.
 Surgery will increase his need for calcium; protein; vitamins A, C, E, and K; and zinc.
 Because of the fracture, he will need increased calories; protein; vitamins A, C, and D; zinc; and
calcium to heal.
 Infection will increase the need for calories and protein to fight infection.
 If his Hgb is low, he might need additional iron and folic acid.
 Smokers have an increased need for vitamin C.


mia

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Reply #2 on: Jun 25, 2018
Thank you


isabelt_18

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Reply #3 on: Jun 25, 2018
No problemo


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