A child is prescribed warfarin (Coumadin). Which laboratory ...

[vHAUNG6011]

A child is prescribed warfarin (Coumadin). Which laboratory values does the nurse monitor? (Select all that apply.)
 
  A.
  Electrolytes
  B.
  Hematocrit (Hct)
  C.
  International normalized ratio (INR)
  D.
  Partial thromboplastin time (PTT)
  E.
  Prothrombin time (PT)

Question 2

A nurse is teaching a group of parents about bacterial endocarditis (BE) and follow-up care. Which parents should be instructed to obtain prophylactic antibiotics prior to dental cleaning? (Select all that apply.)
 
  A.
  Child after complete repair via catheter for 1 year
  B.
  Child after transplant, no residual defect, for 6 months
  C.
  Child with congenital repair with residual defect, for life
  D.
  Child with one prior episode of bacterial endocarditis
  E.
  Child with prosthetic mitral valve for the first 6 months

[pratush dev]

Answer to Question 1

ANS: C, D
Coumadin is monitored using the PT and INR. Electrolytes and hematocrit are important laboratory values but are not specific for this drug. The PTT is used to monitor heparin therapy.

Answer to Question 2

ANS: B, C, D
Guidelines for who needs prophylaxis prior to invasive procedures were updated in 2007. They include children post-cardiac transplantation who do not have residual valve problems for 6 months post-transplant, any child with a residual defect after a surgical repair for the remainder of his or her life, and children who have already had one (or more) episode of BE. Prophylaxis after complete repairs is for 6 months. Prophylaxis after valve replacement is lifelong.

[vHAUNG6011]

TYSM

[dantucker]

Gracias!