6 Perfusion: Coagulation Disorders and Anticoagulants Medications
6 Perfusion: Coagulation Disorders and Anticoagulants Medications
This chapter covers the concepts of perfusion, focusing on coagulation and its pharmacologic principles. These are essential concepts that professional nurses must apply in various healthcare settings. Understanding the pathophysiology of coagulation disorders is crucial for the pharmacologic management and nursing care of affected patients.
Learning Objectives
- Understand the etiology, pathophysiology, and clinical manifestations of hemostasis and coagulation.
- Discuss non-pharmacologic measures to control clotting disorders and interventions to increase therapeutic effects.
- Explain the mechanism of action, indications for use, adverse effects, and implications of the nursing process for anticoagulants, antiplatelet, direct thrombin inhibitors, and thrombolytic agents.
- Compare heparins and warfarin in terms of indications of use, onset, and duration of action, route of administration, and laboratory tests used to monitor effects.
- Describe systemic hemostatic agents for treating overdoses of anticoagulant and thrombolytic medications.
I. Perfusion Overview
Perfusion is the heart’s ability to circulate oxygen and nutrients throughout the body to support cellular functions. It operates cyclically, removing cellular wastes and by-products as cells receive oxygen and nutrients. This chapter reviews the body systems that maintain adequate perfusion, including the cardiovascular and renal systems, to ensure survival.
The Heart
Did you know that the average adult human heart contracts approximately 108,000 times a day, over 39 million times a year, and nearly 3 billion times over a 75-year lifespan? Each heartbeat ejects about 70 mL of blood, producing 5.25 liters per minute and around 14,000 liters daily. This equates to over 2.6 million gallons of blood annually through approximately 60,000 miles of vessels in the adult body. No wonder the heart is the body’s most important muscle! This chapter reviews key concepts and disorders related to the heart and cardiovascular system, followed by standard medication classes. Understanding these medications is crucial for nurses to provide safe and effective patient care.
Main Function of the Heart
Oxygenating and Nourishing Organs and Tissues
- The heart circulates oxygenated blood, nutrients, and hormones to organs and tissues, enabling essential processes that sustain life. Without proper blood flow, cells risk oxygen deprivation, impairment, and death.
Removing Waste Products from Organs and Tissues
- The heart also circulates deoxygenated blood and metabolic wastes away from the body for excretion. This allows blood to be re-oxygenated and the cycle to continue.
II. Hemostasis and Coagulation: Etiology, Pathophysiology, and Clinical Manifications
Etiology
Hemostasis is the physiological process that stops bleeding at the site of an injury while maintaining normal blood flow elsewhere in the circulation.
Coagulation is a key component