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1-37. ANTICOAGULANT DRUG THERAPY IN THROMBOPHLEBITIS AND EMBOLISM
a. General. Anticoagulant drugs such as heparin sodium and coumadin compounds lessen the tendency of blood to clot. They are frequently ordered as a part of the medical management of patients who have developed thrombophlebitis or who have survived an embolism.
(1) These drugs do not dissolve thrombi that have already formed, but are an important treatment measure to prevent extension of a clot within a blood vessel or to prevent further intravascular clot formation.
(2) Anticoagulant drugs act by prolonging the clotting time of blood.
(3) Since a patient who has once developed thrombophlebitis may have a recurrence, he may be continued on an anticoagulant drug indefinitely as a prophylactic measure.
b. Medical Considerations.
(1) Drug dosage is regulated very carefully by the physician, in relation to the individual patient's prothrombin determination. (Prothrombin determination is a special blood test.)
(2) Certain drugs should not be given with anticoagulants. Aspirin and aspirin-like drugs increase the effect of the anticoagulant. Phenobarbital and butazolidine decrease the effects.
c. Nursing Implications.
(1) Nursing personnel have a responsibility to recognize that any patient receiving an anticoagulant drug must be closely observed for bleeding.
(2) Bleeding may occur from the mouth, nose, urinary tract, or rectum.
(3) Patients receiving anticoagulant therapy should be encouraged to use a soft bristle toothbrush and an electric razor instead of a blade.
(4) Local policy often dictates that only the RN may administer anticoagulant drugs. This is due to the potential hazards and complicated dosage orders.
