Buy a Nursing essay from nursingessays.us

Left your Nursing Assignment to the last minute? Let a qualified expert do your Nursing essay for you and deliver it before your deadline!

9.8
Buy Nursing essay Papers
Calculate your paper price
Pages (550 words)
Approximate price: -

warfarin sodium Nursing Considerations & Management

Drug Name
Generic Name : warfarin sodium Nursing Brand Name:  Apo-Warfarin (CAN), Coumadin, Gen-Warfarin (CAN) Classification: Oral anticoagulant, Coumarin derivative Pregnancy Category X 
Dosage & Route
Available forms :Tablets—1, 2, 2.5, 3, 4, 5, 6, 7.5, 10 mg; powder for injection—5.4 mg reconstitutes to 2 mg/mL Dosages :Adjust dosage according to the one-stage PT to achieve and maintain 1.5–2.5 times the control value or prothrombin activity 20%–30% of normal; PT ratio of 1.3–1.5 or INR of 2–3. IV use is reserved for situations in which oral warfarin is not feasible. Dosages are the same for oral and IV forms.
ADULTS
  • Initially, 2–5 mg/day PO. Adjust dose according to PT response. For maintenance, 2–10 mg/day PO based on PT ratio or INR.
GERIATRIC PATIENTS
  • Lower doses are usually needed; begin with smaller doses than those recommended for adults and closely monitor PT ratio or INR.
Therapeutic actions
  • Warfarin inhibits synthesis of vit K-dependent coagulation factors VII, IX, X and II and anticoagulant protein C and its cofactor protein S. No effects on established thrombus but further extension of the clot can be prevented. Secondary embolic phenomena are avoided.
Indications
  • Venous thrombosis and its extension, treatment, and prophylaxis
  • Treatment of thromboembolic complications of atrial fibrillation with embolization, and cardiac valve replacement
  • Pulmonary embolism, treatment, and prophylaxis
  • Prophylaxis of systemic embolization after acute MI
  • Unlabeled uses: Prevention of recurrent TIAs, prevention of recurrent MI, adjunct to therapy in small-cell carcinoma of the lung
Adverse effects
  • Hypersensitivity, rash, alopecia, diarrhea, drop in hematocrit, purple toes syndrome, skin necrosis, jaundice, nausea, vomiting, hepatic dysfunction, pancreatitis, increased LFT.
  • Potentially Fatal: Hemorrhage.
Contraindications
  • Hypersensitivity; hemorrhagic tendencies or blood dyscrasia; recent surgery; peptic ulcer; severe hypertension; bacterial endocarditis; cerebrovascular disorders; psychosis; senility; aneurysms; pericarditis; pericardial effusion; eclampsia; pre-eclampsia; threatened abortion; alcoholism; severe renal and hepatic impairment; pregnancy.
warfarin sodium Nursing considerations
Assessment
  • History: Allergy to warfarin; SBE; hemorrhagic disorders; TB; hepatic diseases; GI ulcers; renal disease; indwelling catheters, spinal puncture; aneurysm; diabetes; visceral carcinoma; uncontrolled hypertension; severe trauma; threatened abortion, menometrorrhagia; pregnancy; lactation; CHF, diarrhea, fever; thyrotoxicosis; senile, psychotic or depressed patients
  • Physical: Skin lesions, color, T; orientation, reflexes, affect; P, BP, peripheral perfusion, baseline ECG; R, adventitious sounds; liver evaluation, bowel sounds, normal output; CBC, urinalysis, guaiac stools, PT, LFTs, renal function tests
Interventions
  • Do not use drug if patient is pregnant (heparin is anticoagulant of choice); advise patient to use contraceptives.
  • Monitor PT ratio or INR regularly to adjust dosage.
  • Administer IV form to patients stabilized on Coumadin who are not able to take oral drug. Dosages are the same. Return to oral form as soon as feasible.
  • Do not change brand names once stabilized; bioavailability may be a problem.
  • WARNING: Evaluate patient regularly for signs of blood loss (petechiae, bleeding gums, bruises, dark stools, dark urine). Maintain PT ratio of 1.3–1.5, 1.5–2 with mechanical prosthetic valves or recurrent systemic embolism; INR ratio of 2–3, 3–4.5 with mechanical prosthetic valves or recurrent systemic emboli.
  • Do not give patient any IM injections.
  • WARNING: Double check all drugs ordered for potential drug interactions; dosage of both drugs may need to be adjusted.
  • Use caution when discontinuing other drugs; warfarin dosage may need to be adjusted; carefully monitor PT values.
  • Keep vitamin K readily available in case of overdose.
  • Arrange for frequent follow-up, including blood tests to evaluate drug effects.
  • WARNING: Evaluate for therapeutic effects: INR within therapeutic range.
Teaching points
  • Many factors may change your body’s response to this drug—fever, change of diet, change of environment, other medications. Your dosage may have to be changed repeatedly. Write down changes that are prescribed.
  • Do not start or stop taking any medication without consulting your health care provider. Other drugs can affect your anticoagulant; starting or stopping another drug can cause excessive bleeding or interfere with the desired drug effects.
  • Carry or wear a medical ID tag to alert emergency medical personnel that you are taking this drug.
  • Avoid situations in which you could be easily injured (contact sports, shaving with a straight razor).
  • Have periodic blood tests to check on the drug action. These tests are important.
  • Use contraception; do not become pregnant while taking this drug.
  • You may experience these side effects: Stomach bloating, cramps (transient); loss of hair, rash; orange-red discoloration to the urine (if upsetting, add vinegar to your urine and the color should disappear).
  • Report unusual bleeding (from brushing your teeth, excessive bleeding from injuries, excessive bruising), black or bloody stools, cloudy or dark urine, sore throat, fever, chills, severe headaches, dizziness, suspected pregnancy.

Questions?

Ask our team

Want to contact us directly? No problem. We are always here for you.

Frequently Asked Buy a Nursing essay Questions

See all
Is your service confidential?

When you place an order with our company, we ask you to provide us with such personal information as your name, phone number, and email address. We need this data to keep you updated on the important things related to your order or account, and never share it with any third parties. We also don’t use your contact details for spamming you.

Please note that our support team may contact you using only the phone number(s) stated on our website, such +1 (248) 599-2414 and/+44 (151) 528-2636. In order to secure our mutual cooperation, please do not communicate with those who introduce themselves as essaypapers support staff and reach you from different phone numbers.

Also, remember that we never ask you to provide your credit card information via phone conversations. You should enter this information only on PayPal or Gate2Shop billing forms when making an online payment on our website. The essaypapers support administrator will send a confirmation letter to your personal order page when your payment is received.

We also use a secure encrypted connection and do not store your private data if we do not need it anymore. For more details about how we ensure your confidentiality, check our Privacy Policy, which completely complies with the GDPR.

We offer original model papers that can be used legally in a number of ways if properly referenced:

  • As a source of arguments or ideas for your own research
  • As a source of additional understanding of the subject
  • Direct citing

Nonetheless, check your college’s/university’s policies, including their definition of plagiarism and paraphrasing before using our services. Make conscious decisions in regards to your education.

How do I order a paper from essaypapers?

We take care not only of your academic success, but also of your experience with us. That’s why we have made the process of placing your order as easy and fast as possible—usually, it takes no more than 2-3 minutes.

Let’s have a closer look at the simple steps you need to go through for submitting your order:

Fill in the order form.

Be sure to include specific instructions regarding your paper and to upload any of the required materials. If you have any questions while specifying your paper’s information, just click on the info sign at the end of every field name and you will see a detailed tip on what exact information is required.

Proceed with the payment.

After you are through with the order form, you will need to make a payment via a preferable system. Right after that, you will be automatically provided with your personal order page where you can track your order’s progress, provide additional requirements, and send messages to your writer or support manager.

A personal writer is assigned to your order.

Our qualified staff will choose the most suitable writer whose skills and experience match your field of study and paper’s details. In case the writer must have any particular software or literature in order to get the Nursing Assignment done, please do not forget to mention this in your initial instructions.

Your paper is completed and delivered to your personal order page.

When the writer finishes your paper, it is delivered to your personal order page as a PDF document, available for preview only. You will be able to download an editable MS Word version of the order right after you click the “Approve” button in the “Files” tab of your personal order page. If any changes are to be applied to the paper, you are always welcome to request a free revision with a new deadline for the writer (be sure to check more information about this in our revision policy).

You can check how easy the process is by going to the order page and submitting your paper details right now.

Is there a money-back guarantee? If yes, how can I receive a refund?

You can get more details about possible types and terms of refunds on our official money-back guarantee page.

How will I receive a completed paper?

You will get the first version of your paper in a non-editable PDF format within the deadline. You are welcome to check it and inform us if any changes are needed. If everything is okay, and no amendments are necessary, you can approve the order and download the .doc file. If there are any issues you want to change, you can apply for a free revision and the writer will amend the paper according to your instructions.

If there happen to be any problems with downloading your paper, please contact our support team.

What if I’m not satisfied with my order?

If your paper needs some changes, you can apply for a free revision that is available for 7 days after your paper is approved. To use this option, you have a “Revision” button on your personal page.

After the 7-day period, you cannot apply for a free revision, though you still can use a paid revision option. The price of such a revision will differ depending on the number of amendments needed to be done. Please contact our support team to find out how we can help you with the amendments to your paper.

If you think our writer didn’t manage to follow your instructions, and as a result, your paper is of poor quality, please contact us and we will do our best to solve the problem.

If the revisions didn’t give the desired result, you can apply for a refund. Our dispute department will process your inquiry to find out what kind of refund we can give you. To find out more, please visit our money-back guarantee page.

How do I request a refund?

You can’t apply for a refund on certain stages of your order, like when the order is not finished by the writer yet.

When the paper is delivered, the “Refund” button on your personal order page becomes clickable.

On the relevant tab of your personal order page, you will also be able to choose the type of refund you’re demanding and the reason why you applying for it. As soon as you do that, our dispute department will start working on your inquiry. All kinds of refunds concerning the quality or the lateness of your paper should be requested within 14 days from the time the paper was delivered, as in 14 days your paper, will be automatically approved.

Your inquiry should be submitted by clicking the “Refund” button on your personal order page only.

Order your essay today and save 15% with the discount code NURSINGHELP