In the event of major bleeding, heparin should be stopped, and, if necessary, protamine sulfate may be administered. Undiagnosed and uncontrolled bleeding may lead to cardiovascular collapse or cardiac tamponade. Monitoring includes thorough head-to-toe patient assessments for potential side effects, and laboratory monitoring.īleeding is the most common side effect, and may present in a variety of ways: epistaxis, gum bleeding, hemoptysis, hematuria, melena or hemorrhage. Heparin requires close monitoring because of its narrow therapeutic index, increased risk for bleeding, and potential for heparin-induced thrombocytopenia (HIT). While the NPSG applies to all anticoagulants, this educational offering will focus on the most commonly used anticoagulants: unfractionated heparin (UFH), low molecular weight heparin (LMWH), and warfarin.

This Goal, with an implementation date of January 2009, required organizations to develop and implement standardized practices in order to reduce harm. In 2008, The Joint Commission published a new National Patient Safety Goal (NPSG) to address high-risk anticoagulation drugs used for treatment.

Discuss patient/family educational needs related to anticoagulantsĪuthors: Dana Moore, MS, RN, CSHA Regina Hendrix, MSN, MPA, RN-BC Deena Conti, BSN, RN Felix Guzman, BSN, RNĪnticoagulation medications are high-risk drugs.1 There is a very small window for therapeutic dosing: too much of a drug can cause bleeding, and too little may lead to clotting.

Consider important safety implications to help prevent complications.

Identify common indications for use of anticoagulants.

After reading this article, you will be able to: The goal of this CE activity is to provide nurses and nurse practitioners with knowledge and skills to manage patients on anticoagulant drugs.

Antidote for warfarin and heparin