A patient who is taking clopidogrel (Plavix) calls the nurse to ...

[formula1]

A patient who is taking clopidogrel (Plavix) calls the nurse to report black, tarry stools and coffee-ground emesis. The nurse will tell the patient to:
 
  a. ask the provider about using aspirin instead of clopidogrel.
  b. consume a diet high in vitamin K.
  c. continue taking the clopidogrel until talking to the provider.
  d. stop taking the clopidogrel immediately.

Question 2

A patient who takes warfarin (Coumadin) is brought to the emergency department after accidentally taking too much warfarin.
 
  The patient's heart rate is 78 beats per minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for:
  a. vitamin K (phytonadione).
  b. protamine sulfate.
  c. a PTT.
  d. a PT and an INR.

[mammy1697]

Answer to Question 1

ANS: C
Patients who experience bleeding should be warned not to stop taking the clopidogrel until the prescriber says they should, since abrupt withdrawal may precipitate a thrombotic event. Taking aspirin with an active GI bleed is contraindicated. Warfarin is a vitamin K inhibitor; consuming extra vitamin K will not reverse the effects of clopidogrel.

Answer to Question 2

ANS: D
This patient does not exhibit any signs of bleeding from a warfarin overdose. The vital signs are stable, there are no hematomas or petechiae, and the patient does not have pain. A PT and INR should be drawn to evaluate the anticoagulant effects. Vitamin K may be given if laboratory values indicate overdose. Protamine sulfate is given for heparin overdose. PTT evaluation is used to monitor heparin therapy.

[formula1]

Excellent

[emsimon14]

Gracias!