Clinical Medications Worksheets

Generic Name phytonadione Peak 3-6 hr Trade Name Vitamin K Onset 1-2 hr Classification Dose fat-soluble vitamins, 10mg Antifibrinolytic Agents Duration Normal dosage range 12-14 hr 10 mg daily Route SQ Time/frequency daily

Why is your patient getting this medication Hypoprothrombinemia due to Vitamin K Deficiency Mechanism of action and indications (Why med ordered) Required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, and X

For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, Hypersensitivity or intolerance to benzyl alcohol (injection only), use cautiously in impaired liver function Common side effects No known common side effects for this drug

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) No known interactions for this patient

Nursing Process- Assessment (Pre-administration assessment) Monitor for frank and occult bleeding (guaiac stools, Hematest urine, and emesis). Monitor pulse and blood pressure frequently; notify physician immediately if symptoms of internal bleeding or hypovolemic shock develop. Inform all personnel of patient's bleeding tendency to prevent further trauma. Apply pressure to all venipuncture sites for at least 5 min; avoid unnecessary IM injections

Lab value alterations caused by medicine Prothrombin time (PT) should be monitored prior to and throughout vitamin K therapy to determine response to and need for further therapy Be sure to teach the patient the following about this medication Instruct patient to take this medication as ordered. If a dose is missed, take as soon as remembered unless almost time for next dose. Notify health care professional of missed doses. Cooking does not destroy substantial amounts of vitamin K. Patient should not drastically alter diet while taking vitamin K. Caution patient to avoid IM injections and activities leading to injury. Use a soft toothbrush, do not floss, and shave with an electric razor until coagulation defect is corrected. Advise patient to report any symptoms of unusual bleeding or bruising (bleeding gums; nosebleed; black, tarry stools; hematuria). Patients receiving vitamin K therapy should be cautioned not to take OTC medications without advice of health care professional. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Advise patient to carry identification at all times describing disease process. Emphasize the importance of frequent lab tests to monitor coagulation factors. Assessment Evaluation Why would you hold or not give this med? Check after giving Toxicity (hemolytic anemia, brain damage), Prevention of spontaneous clot formation (e.g., DVT, pulmonary emboli) bleeding or cessation of bleeding in patients with hypoprothrombinemia secondary to impaired intestinal absorption or oral anticoagulant, salicylate, or anti-infective therapy.

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