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- Normal range 0.5 - 2.0
- Atrial Dysrhythmia w/ dig toxicity (A-Fib at 180)
- Signs of toxicity= N/ Anorexia/ Blurred vision
- Watch out for renal insufficiency
- Quinidine and Digoxin make Dig toxic
PT of patient 39, ctrl 27. Dose is too low. Target is 1.5-2.5 ctrl. So, titrate drip.
Patient report is 110, 2 hours later.
Now, too high. Protamine
Sulfate is antidote to Heparin.
She goes back on Coumadin bc she goes home with it. 3-5 days therapeutic. Target INR is 2-3. Stay on Coumadin for 6 mo atleast. Keep going on Heparin
till INR is at target. If stopped too soon, could dislodge clot. Hep is short half live, Coumadin is few days.
Follow up lab tests are PT/INR. Teach to watch for bruising/bleeding. Vit K foods maintain consistent consumptions. Spinach, greens. No high risk activities.
FFP for acute hemorrhage on Coumadin
Reverse coag w/ Vit K
Cardioverted Nursing Implications
- How long in A-fib?
- If longer than 48 hrs than need anticoagulating.
- hr control by Valsalva, Try BB, Carotid massage – if still
- tachy, cardiovert
- informed consent understanding,
- Turn sync switch on. No shocking on T wave
Test prior to compression of venous stasis ulcer
Complications from anterior MI
acute mitral regurge bc of capillary muscle rupture
assess before AceI admin
BP, BUN, creat, K and Na
Valv heart disease results in this cardiac complication?
L vent. Hypertrophy, LVH to HF
IVC filter for prevention of?
PE in DVT
3rd degree heart block needs?
mechanical Prosthetic heart valves need?
Anticoag, and Ab endocarditis prophy….target INR is 2.5-3.5 for mech. Valves
prolong survival of HF
ACEI and BB
assess therap effect of Warfarin (Coumadin)
TPN and CKMB
Aortic dissection from limbs
unequal perfusion of limbs
with A-Fib, at risk for?
congestion in lungs
Best indicator of renal perfusion after AAA
insulin resistance, hyperlipidemia, albinuria