Rivaroxaban

Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.

8. The order for the enoxaparin reads: Enoxaparin 70mg every 12 hours subcutaneous. L.J. is 5ft, 6in. and weighs 156lb. Is this dose appropriate?

Systemic and can quickly become life-threatening with organ failure, including reduced blood pressure and heart failure 1 2

Coumadin (non specific name: warfarin) is an anticoagulant, or blood diminishing drug, that is endorsed to numerous patients who are at danger for creating blood clusters that could bring about heart assaults or strokes. Warfarin is near the most astounding purpose recently and simultaneous investigations of medications that provoke ER visits and occurring an expansion in healing center based offices with the affirmation of patients. Anticoagulation treatment stances perils to patients and over and over prompts unfavorable solution events in light of complex dosing, fundamental ensuing watching, and clashing patient consistence. As a result, various patients who meet current evidence based principles for warfarin treatment are not being managed

In Kindred Rehabilitation, the patient had a total knee replacement due to osteoarthritis. Osteoarthritis causes degenerative changes, within the joints causing bone stiffening and reactive inflammation. My patient was admitted on 10/21/11 with osteoarthritis and a left total knee replacement. Her PT and INR were a concern because she had developed mild thrombocytopenia which resulted in the elevation and potential bleeding. The physician had to take her off of Lovenox and switch her to an oral anti-coagulant Xarelto at 10mg once daily. During her care I was educated by the interdisciplinary teams managing mobility, safety, and the more

In 1995, the FDA approved a miracle drug, which would aid in a person's ability to cope with the severe pain associated with cancer. Purdue Pharma L.P. of Stamford, Connecticut, introduced the wonder drug that would eventually be the demise of many. Oxycotin would, for several, lead to addiction, criminal behaviors, and, for some, their lives. The intent of releasing the drug was solely to treat patients suffering from chronic pain. Since the release of the drug, doctors are now prescribing the medicine for moderate pain as well. Patients have become extremely addicted and have gone to extreme lengths to obtain the "poor man's heroin," which may include criminal activities. Recovering addicts endure an

Thromboembolism the two primary complications include arterial thromboembolism and pump thrombosis. Thrombi forms due to low blood flow to certain areas (aortic valve, dilated ventricle) and infection this can lead to stroke. Hypotension can be an early sign of sepsis, hypovolemia, decreased cardiac output, filling pressure, hypovolemia, right ventricular failure, tamponade, arrhythmias, or device related complications. Hemorrhage or bleeding a major complication that can be caused either by underlying bleeding disorders

It is important to understand the adverse complications of NSAIDS which includes increased mortality, morbidity and increased health care cost. Providers should discuss potential adverse effects of NSAIDS to patients and also review medication list as some patients may be taking multiple NSAIDS without understanding the adverse effects of NSAIDS and recognize patients at risk for developing adverse events. It is one of the most preventable causes for hospital admissions in the elderly. Patients taking NSAIDS are more likely to be hospitalized versus those not taking

Annie Coffey is a 72 year old woman that has developed a deep vein thrombosis (DVT) due to reduced mobility while on bed rest. This assignment will discuss the signs, symptoms, prevention and management of a DVT and the use of warfarin as long term treatment. The assignment will explain what a DVT is and discuss its potential implications. The nurse’s role in the prevention of DVTs will be discussed in detail as well as the nursing management of Annie. The importance of patient education will be highlighted throughout the assignment and important discharge advice while on warfarin will be explained.

Venous Thromboembolism (VTE) is a disease that embodies both pulmonary embolism (PE) and deep vein thrombosis (DVT). On the side of research, VTE is the most common preventable cause of hospital-associated mortality and is both the second most common medical complication and cause of excess length of hospital stay (LOS). Furthermore, with appropriate evidence-based prophylactic measures, the occurrence of hospital-associated VTE (HA-VTE) can be reduced by as much as seventy percent. Subsequently, there are approximately between 200,000 and 300,000 VTE-related deaths annually, which is greater than the yearly rate of mortality for breast cancer,

For the collection of data, developed and verified NI surveillance was used. The NI surveillance was useful for measuring both the incidence and risk factors of VAP according to Katherason et al (2009). Demographical data, past medical history, medications, nutritional status, laboratory results, diagnosis, history of illness, etc were all included in the surveillance. The Acute Physiology and Chronic Health Evaluation III score measured the severity of the illness. The APCHE is comprised of the acute physiological score that entails the major physiological systems and the chronic health evaluation that incorporates the influence of co-morbid conditions on the patient’s current health (O'Keefe-McCarthy, Santiago, & Lau, 2008).

The risk factors associated with VTE are surgeries of general kind, orthopedic surgery, spinal cord injury, fracture caused in hips, long bones or pelvis, Trauma of multiple nature, malignancy, myocardial infarction, respiratory failure and congestive heart. In addition to this, another risk factor for the disease includes the past, age, immobility, pregnancy, puerperium and hereditary factor of the population. In order to avoid VTE, several preventive measures are

Enoxaparin is a low molecular weight heparin used to prevent thrombosis, particularly post surgery. Enoxaparin binds to antithrombin III which is responsible for inhibiting coagulation by acting on factor Xa. Enoxaparin accelerates the activity of antithrombin III therefore preventing clot formation (McKenna & Lim, 2014 p766). When a blood vessel is damaged, platelets in circulating blood stick to the site of injury and release chemicals that attract more platelets causing aggregation. There are both intrinsic and extrinsic pathways causing thrombi to form to maintain a closed cardiovascular system (Hollar, 2017). Immobility increases risk of thrombus formation as the blood becomes stagnant with gravity and decreased

The dabigatran etexilate (DE) is a prodrug that directly competes for the active site of thrombin.1 This direct inhibition inactivates both fibrin-bound and free form of thrombin. Because of its rapid onset and offset of action, there is no need for the initial parenteral anticoagulant treatment in patients with acute thrombosis.1 On the other hand, the enoxaparin indirectly inhibits factor Xa.2 It has a shorter duration of action (12h vs 24h) and a shorter half-life (4.5-7h vs 12-14h) in comparison to DE. The DE and the enoxaparin have no interaction with diet and alcohol. There is no routine monitoring required

Warfarin is a very common used drug worldwide. Warfarin is used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a heart attack, stroke, deep vein thrombosis or pulmonary embolism. Although warfarin is commonly used, its management is very challenging. First, it has a very narrow therapeutic index- increased anticoagulant effect puts the patients at a risk of bleeding, while decreased anticoagulant effect puts them at a risk of thromboembolic disorders such as heart attack and stroke. And second, the wide variation among patients in drug response. Therefore, it needs long time to determine the adequate dosage for each patient. Complications from inappropriate warfarin dosing are among the adverse events most frequently reported to the US