A patient with a history of deep venous thrombosis is prescribed ...

[MirandaLo]

A patient with a history of deep venous thrombosis is prescribed dabigatran (Pradaxa). What should the nurse instruct the patient about this medication?
 
  Select all that apply.
 
  1. Use a straight razor to shave if necessary.
  2. Limited amounts of alcohol are permitted.
  3. A reversal agent for this medication is not available.
  4. The cost of this medication is higher than for warfarin.
  5. Laboratory test monitoring is not necessary for this medication.

Question 2

A patient with a history of recurrent venous micro emboli is scheduled for an insertion of a Greenfield filter. What should the nurse explain to the patient about this procedure?
 
  Select all that apply.
 
  1. The filter can be inserted under fluoroscopy.
  2. Mortality from the insertion of the filter is low.
  3. The filter will need to be replaced every 6 months.
  4. The patient may only need local anesthesia for the procedure.
  5. The filter traps emboli while maintaining the patency of the vena cava.

[Galvarado142]

Answer to Question 1

Correct Answer: 3, 4, 5
Rivaroxaban (Xarelto) acts as a selective factor X inhibitor, inactivating the cascade of coagulation. It does not require monitoring like warfarin does, however, there is no reversal agent available for this drug. The cost is significantly higher for this drug when compared to warfarin. The patient should be instructed to prevent injury and bleeding. A straight razor would be contraindicated. Alcohol should be avoided while taking this medication.

Answer to Question 2

Correct Answer: 1, 2, 4, 5
The Greenfield filter is widely used for its ability to trap emboli within its apex while maintaining patency of the vena cava. The filter can be inserted under fluoroscopy with local anesthesia. Mortality associated with the filter is very low. There is no information to support the frequency in which the filter needs to be replaced.