Clinical meaning
Anticoagulant medications prevent thrombus formation and propagation by interfering with the coagulation cascade. Heparin (unfractionated) acts by potentiating antithrombin III to inactivate thrombin and factor Xa. Low-molecular-weight heparins (enoxaparin) preferentially inhibit factor Xa. Warfarin inhibits vitamin K-dependent clotting factor synthesis (II, VII, IX, X). Direct oral anticoagulants (DOACs) directly inhibit thrombin (dabigatran) or factor Xa (rivaroxaban, apixaban). These medications carry significant bleeding risk. The nurse monitors for signs of bleeding, administers medications as ordered, and reports abnormal findings to the RN.
Exam relevance
Risk factors: - Deep vein thrombosis (DVT) - Pulmonary embolism (PE) - Atrial fibrillation - Mechanical heart valve - Post-surgical thromboprophylaxis - Stroke prevention - History of thromboembolism - Inherited thrombophilia
Diagnostics: - Monitor vital signs and report tachycardia or hypotension (may indicate bleeding) - Observe for signs of bleeding: bruising, petechiae, blood in urine/stool - Report dark or tarry stools (melena) immediately - Monitor for hematuria and report - Check for gum bleeding during oral care - Report headache, confusion, or vision changes (may indicate intracranial bleeding) - Monitor injection sites for excessive bruising or hematoma