History of hypertension and obesity
Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.
Can Sandra be placed on Coumadin and Heparin at the same time? Explain your answer.
Develop 3 teaching points important for Sandra to know about her medications regimen.
What questions would you ask Sandra to verify that she understand the 3 teaching points?
Sample Solution
No. Coumadin and Heparin are both anticoagulants, which means that they thin the blood. Using both medications together can increase the risk of bleeding.
Teaching Points
1. Coumadin
- Coumadin is a blood thinner that takes several days to start working.
- You will need to take Coumadin at the same time each day to keep your blood levels consistent.
- Coumadin can interact with other medications, so it is important to tell your doctor about all the medications you are taking.
Full Answer Section
. Heparin
- Heparin is a blood thinner that works immediately.
- You will need to be given Heparin injections or have a Heparin drip started in the hospital.
- Heparin can cause side effects such as bleeding, bruising, and nausea.
- You will need to be monitored closely for side effects while you are on Heparin.
3. General Medication Instructions
- Take all of your medications as directed by your doctor.
- Do not stop taking any of your medications without first talking to your doctor.
- If you have any questions or concerns about your medications, talk to your doctor or pharmacist.
Questions to Verify Understanding
1. Coumadin
- Why is it important to take Coumadin at the same time each day?
- What are some of the medications that can interact with Coumadin?
- Why do you need to have your blood tested regularly while you are on Coumadin?
2. Heparin
- What are some of the side effects of Heparin?
- Why do you need to be monitored closely for side effects while you are on Heparin?
3. General Medication Instructions
- What should you do if you miss a dose of your medication?
- What should you do if you have any questions or concerns about your medications?
In addition to the above teaching points, it is also important to teach Sandra about the signs and symptoms of bleeding. She should know to contact her doctor immediately if she experiences any of the following:
- Heavy bleeding from a cut or wound
- Bleeding that does not stop after 10 minutes of pressure
- Bloody vomit or stool
- Red or dark urine
- Black or bloody stools
- Severe headache
- Dizziness or lightheadedness
- Weakness or fatigue
By providing Sandra with this information, you can help her to safely and effectively manage her medication regimen and reduce her risk of complications.