Question

The health care provider has prescribed a client sodium warfarin (Coumadin) while he is still receiving intravenous heparin. Which is the nurse's best action?

a. Administer both heparin and warfarin as prescribed.
b. Turn off the heparin before administering the warfarin.
c. Clarify the warfarin order with the nursing supervisor.
d. Hold the warfarin dose until the heparin is discontinued.

Answer 1

The nurse should administer both heparin and warfarin as prescribed. Pharmacogenomics is utilized to tailor the dosage of Coumadin to the patient's genetic profile, potentially reducing the risk of overdose and enhancing treatment effectiveness.

Step-by-step explanation:

The best action for the nurse when a client is prescribed both heparin and warfarin is to administer both heparin and warfarin as prescribed. It is a common practice to overlap heparin therapy with warfarin for a short period because warfarin takes a few days to reach therapeutic levels. During this overlap, blood levels can be monitored, and the dosage adjusted as necessary.

With regards to pharmacogenomics and its role in assisting patients prescribed Coumadin (warfarin), pharmacogenomics could be beneficial in determining the appropriate dose for individual patients. Because warfarin dosing is influenced by genetic factors affecting its metabolism and sensitivity, pharmacogenomics can help tailor the dosage to a patient's genetic profile. This personalized approach helps minimize the risk of overdose or under-dose, leading to more effective and safer treatment for preventing blood clots without the increased risk of bleeding.

While pharmacogenomics may lead to development of counter-acting drugs in the future, it is currently used to adjust the existing medication dosage to prevent overdose and adverse effects based on individual genetic variations.