Mainly when a patient is inactive or bedridden for long periods of time, surgery can damage a blood vessel so a clot can form, or even cancer can cause DVT to form. Treatments for DVT are drugs called anticoagulants that can prevent the blood from clotting thus preventing the adverse effects from a clot. Low molecular weight heparin works by binding to a substance called antithrombin III (which is the major inhibitor of thrombin in the blood). The overall effect of heparin is that it turns off the coagulation pathway and prevents clots from forming.
It can be used as a subcutaneous injection which can be given in an outpatient setting with no increased risk of recurrent thromboembolism or bleeding complications. Since most patients with DVT require one or more diagnostic tests, treatment with intravenous heparin and a three to seven day hospital stay thus making low molecular weight heparin a better alternative. (aafp. org1999) However, with low molecular weight heparin, being a subcutaneous injection makes the process easier for the patient since they do not have to spend all that extra time in the hospital.
The ultimate consequence of a blood clot can be stroke or heart attack so prevention of these events is the consequence of this drug. Unfortunately, just like many other drugs there are some serious side effects to taking LMWHs. They are contraindicated with patients with an indwelling epidural catheter; they can be given two hours after the epidural is removed. If it is given before the epidural is taken out then they have found it to be associated with epidural hematoma. Bleeding is the main concern when taking anticoagulation therapy.
Some of the other common adverse effects to heparin are hematoma, nausea, anemia, thrombocytopenia, fever, and edema. There is a low chance for side effects with monitoring and patient awareness. When evaluating a patient on anticoagulants the nurse needs to ensure patients know the side effects to be aware of and arrange follow up care. Cranberry juice should be avoided since it can affect the INR results. Patients should seek emergency medical care for injuries, particularly a head injury, due to the hemorrhage risk.
As a nurse you need to monitor your patient while on these drugs because of the bleeding factor. (nursingtimes. net2012) References Gee, Emma. (2011) How to look after a patient on anticoagulant therapy. January 22, 2011 Retreived from www. nursingnet. net on July 2012 Lilley, Rainforth Collins, Harrington, Snyder. (2011) Pharmacology and the Nursing Process Copyright 2011 Mosby Inc. Rydberg, J Eric MD. (1999) Low Molecular Weight Heparin in Prevention and Treating DVT Retrieved from www. aafp. org