Question

A nurse is caring for a client who has a DVT and has been taking unfractionated heparin for 1 week. Two days ago, the provider also prescribed warfarin. The client asks the nurse about receiving both heparin and warfarin at the same time. Which of the following statements should the nurse give?

A. "I will remind your provider that you are already receiving heparin."
B. "Your lab findings indicated that tow anticoagulants were needed."
C. "It takes 3-4 days before the therapeutic effects of warfarin are achieved, and then the heparin can be discontinued."
D. "Only one of these medications is being given to treat your DVT."

Answer 1

The nurse should inform the client that heparin and warfarin are given together until the warfarin reaches therapeutic levels, after which heparin is discontinued. Pharmacogenomics offers personalized medication dosing based on genetic factors, which could enhance the safety and efficacy of warfarin treatment.

Step-by-step explanation:

The nurse should explain to the client why both heparin and warfarin are being administered concurrently. The best response would be: "It takes 3-4 days before the therapeutic effects of warfarin are achieved, and then the heparin can be discontinued." This is because warfarin has a slow onset of action and requires some time for its anticoagulant effects to reach therapeutic levels. During this interim period, heparin is used because it acts immediately, providing anticoagulation until warfarin is effective. Eventually, once stable warfarin levels are achieved and confirmed via lab tests targeting the INR (International Normalized Ratio), heparin can be safely stopped.

Regarding pharmacogenomics, it could be used to adjust the dosing of Coumadin (warfarin) based on a patient's genetic makeup. This is crucial because patients have varying responses to drugs like warfarin due to differences in liver function influenced by genetics. By utilizing pharmacogenomics, healthcare providers can personalize medication plans to minimize the risk of overdose and ensure effective anticoagulation.