The following morning, the cardiologist came to consult on Lillian’s case and le
ID: 238237 • Letter: T
Question
The following morning, the cardiologist came to consult on Lillian’s case and left orders for anticoagulation because of Lillian’s chronic irregular heartbeat from atrial fibrillation. Dr. B left the following orders for anticoagulation.
Heparin 5,000 units SQ every 12 hours
Warfarin 2.5 mg po daily for a target INR of 2.5
aPTT, PT, and INR now and then every morning
Digoxin 0.25 mg po daily
1. What is the rationale for the cardiologist ordering heparin and warfarin at the same time?
2. What are some nursing implications when administrating digoxin?
Can you guys please give me something creative. Thanks!
Explanation / Answer
What is the rationale for the cardiologist ordering heparin and warfarin at the same time?
Heparin is quicker acting, as Warfarin takes two or three days to act. At first, the patient will be given heparin and warfarin together until his/her INR is in extend. Warfarin generally takes two or three days to achieve the right level, so he/she require the heparin to help treat the coagulation while the warfarin begins to act. Once the INR has been in the right range for no less than two days, the heparin can be halted.
What are some nursing implications when administrating digoxin?
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Implementation:
Patient/Family Teaching:
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