Coagulation Modifiers - General

Question 1

Blood vessel injury

Answer 1

1. Local vasoconstriction seals off small injury
2. Platelet aggregation forms a platelet plug
3. Hageman factor is activated
4. Intrinsic pathway converts prothrombin to thrombin to seal system
5. Extrinsic pathway clots the blood that has leaked out of the vascular system

Question 2

Considerations for children

Answer 2

• Injury prevention
• Safety precautions
• What to do if bleeding begins
• Drugs should be based on weight and age
• Warfarin used for cardiac surgery
• Xaban should not be used
• Low-molecular weight heparins: unknown safety

Question 3

Considerations for adults

Answer 3

• Injury prevention: electric razor, soft-bristled toothbrush, no contact sports
• What to do if bleeding occurs: constant, firm pressure, call provider
• Caution with other meds
• Medicalert bracelet
• Extreme caution in pregancy and lactation
• Periodic blood tests

Question 4

Considerations for older adults

Answer 4

• Drug-Drug interactions
• Impaired liver and kidney fx: get labs done
• Start low, go slow
• Safety

Question 5

Thromboembolic disorder

Answer 5

-Conditions that predispose a person to the formation of clots and emboli

Question 6

Hemorrhagic disorder

Answer 6

-Disorder in which excess bleeding occurs

Question 7

Antiplatelets

Answer 7

-Alter the formation of the platelet plug

Question 8

Anticoagulants

Answer 8

-Interfere with the clotting cascade and thrombin formation

Question 9

Thrombolytics

Answer 9

-Break down the thrombus that has been formed by stimulating the plasmin system

Question 10

Anticoagulant adjuncts

Answer 10

• Lepirudin
• Protamine sulfate (Heparin antidote)
• Vitamin K (warfarin antidote)

Question 11

Bleeding disorders treated with clotting factors

Answer 11

• Hemophilia
• Liver disease
• Bone marrow disease