The nurse notes hematuria and petechiae in a patient receiving ...

[soccerdreamer_17]

The nurse notes hematuria and petechiae in a patient receiving warfarin (Coumadin). Which of the following medications that the patient is receiving may be increasing the effectiveness of the warfarin? (Select all that apply.)
 
  a. Loratadine (Claritin)
  b. Amiodarone (Cordarone)
  c. Ampicillin (Amoxicillin)
  d. Cimetidine (Tagamet)
  e. Furosemide (Lasix)

Question 2

A patient has a PT of 40 seconds and an INR of 3.3 and is vomiting blood. Which of the following should the nurse anticipate administering?
 
  a. Protamine sulfate 20 mg orally
  b. Protamine sulfate 20 mg slowly IVP
  c. Phytonadione (vitamin K) 2.5 mg orally
  d. Phytonadione (vitamin K) 1 mg in 50 mL D5W infused over 1 hour

[cupcake16]

Answer to Question 1

B, D
Amiodarone and cimetidine can increase the effects of warfarin and therefore the patient's risk for bleeding tendencies.
Loratadine has no known drug-drug interaction with warfarin.
Ampicillin has no known drug-drug interaction with warfarin.
Furosemide has no known drug-drug interaction with warfarin.

Answer to Question 2

D
Although vitamin K can be given orally (2.5 mg) or intravenously (0.5 to 1 mg), the preferred route for this patient would be intravenous administration because the patient is vomiting blood.
Protamine sulfate is the antidote for heparin overdose and is administered intravenously, not orally.
Protamine sulfate is the antidote for heparin overdose.
Although vitamin K can be given orally, this route of administration is contraindicated in a pa-tient who is vomiting because the person would not receive the full effect of the medication.

[soccerdreamer_17]

Excellent

[dawsa925]

TYSM