Learn more about Clinical Skills today! Standardize education and management competency among nurses, therapists and other health professionals to ensure knowledge and skills are current and reflect best practices and the latest clinical guidelines.
If bleeding cannot be stopped, continue to apply pressure to the injury and contact emergency medical services.
Anticoagulant therapy is used to manage and reduce the incidence of venous thromboembolism (VTE), pulmonary embolism (PE), stroke in patients with atrial fibrillation (AF), and for short-term therapy for some postoperative patients.undefined#ref2">2 The use of anticoagulant therapy can be complex, with benefits, such as reduced risk for thrombus extension, stroke, or fatal PE, usually outweighing the risk for life-threatening bleeding complications.3
Vitamin K antagonists, such as warfarin, unfractionated heparin, and low-molecular-weight heparin (LMWH) are recommended for patients with mechanical heart valves and valvular AF and can be initiated and managed in an outpatient setting. Direct oral anticoagulants are recommended for treatment of non–cancer-associated VTE, whereas LMWH is recommended for cancer-associated VTE. LMWH is provided via a subcutaneous injection and does not require laboratory monitoring. Oral vitamin K antagonists require monitoring for a targeted international normalized ratio (INR).
Oral factor Xa inhibitors, such as rivaroxaban, apixaban, and others, are approved for prevention of strokes in patients with nonvalvular AF, postoperative thromboprophylaxis with knee and hip replacement surgery, and treatment of deep vein thrombosis (DVT) and PE.1 These medications do not require routine laboratory monitoring. The advantages of Xa inhibitors are their efficacy in preventing stroke, a lower incidence of bleeding, less drug and food interactions, and no requirements for laboratory monitoring. These benefits make it a more favorable choice with practitioners for home care patients.
A diet that includes food high in vitamin K (e.g., green leafy vegetables, kale, swiss chard, collard greens, spinach, beef liver) may decrease the INR of a patient using warfarin for anticoagulant therapy. Explain that the patient should continue eating the foods he or she normally eats but should not increase intake of vitamin K rich foods.
Cookies are used by this site. To decline or learn more, visit our cookies page.