T.M., a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by bolus, was given. Following the IV bolus, heparin 5000 units given subQ q6h was prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were also prescribed.

How does heparin work and why was it prescribed?

What laboratory test(s) would be monitored for patients taking heparin? Explain your answer.

1. Explain the differences between heparin and enoxaparin. Are there advantages to either of these anticoagulants?
2. After 5 days of heparin therapy, T.M. was prescribed warfarin 5 mg PO daily.
3. Why was T.M changed to warfarin? What is the pharmacologic action of warfarin?

What laboratory test(s) would be monitored for patients taking warfarin? Explain your answer. 

Explain the half-life and protein-binding for warfarin. What additional concerns do you have? How does this knowledge impact teaching for patient’s taking warfarin? Explain.

1. What assessments should be performed before starting anticoagulant therapy?
2. Explain the nursing considerations and patient teaching for anticoagulant