The nurse administers Heparin BD subcutaneously for a patient in cardiogenic shock. The drug is expected to e… - JODHPUR AIIMS SNO-2018

JODHPUR AIIMS SNO-2018

Pharmacology

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

Heparin is classified as an anticoagulant, a drug that prevents the formation of blood clots.
It acts indirectly by potentiating the action of antithrombin III, which in turn inactivates key clotting factors like thrombin (IIa) and factor Xa.
In cardiogenic shock, blood flow is slow, increasing the risk of clot formation. Heparin is given prophylactically to prevent complications like deep vein thrombosis (DVT) and pulmonary embolism (PE).
The subcutaneous route is typically used for prophylactic (low-dose) anticoagulation.

Option B: Anti-dysrhythmic drugs are used to treat irregular heartbeats. Heparin has no effect on the heart's electrical conduction system or rhythm.
Option C: Inotropes are drugs that alter the force or energy of muscular contractions. Positive inotropes increase the strength of heart contractions. Heparin does not have any inotropic effects.
Option D: Vasopressin is a hormone and drug that causes vasoconstriction (narrowing of blood vessels) to raise blood pressure. Heparin is an anticoagulant and does not have vasopressor properties.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Pharmacological action and clinical use of Heparin in acute care settings.
Nurses administering heparin must be vigilant in monitoring for signs of bleeding, which is the primary adverse effect. This includes checking for hematuria, melena, epistaxis, and excessive bruising.
For therapeutic intravenous heparin, monitoring the activated partial thromboplastin time (aPTT) is crucial. However, for low-dose subcutaneous heparin used for prophylaxis, routine aPTT monitoring is not typically required.
It is essential to differentiate between the prophylactic use of heparin (preventing clots) and its therapeutic use (treating existing clots), as the dosing and monitoring protocols differ significantly.

How to Approach the Question

First, identify the core subject of the question: the pharmacological action of a specific drug, Heparin.
Recall or look up the primary drug class for Heparin. You should recognize it as an anticoagulant.
Analyze the clinical context provided: a patient in cardiogenic shock. Consider why this specific drug class would be used in this situation. The risk of thrombosis due to immobility and poor circulation is a key link.
Evaluate each option against the known action of Heparin. 'Anticoagulant' directly describes its primary function.
Systematically eliminate the other options by defining their actions. Anti-dysrhythmics treat rhythm, inotropes affect contractility, and vasopressors affect blood vessel tone. None of these match Heparin's mechanism.
Confirm that the use of an anticoagulant is a standard and logical intervention for a patient in cardiogenic shock to prevent secondary complications.

Concept Tested & Keywords

Concept Tested: Pharmacological action and clinical use of Heparin.
Stem keywords: Heparin, cardiogenic shock, subcutaneously, drug action
Lead-in keywords: expected to exhibit action
Clinical cues: Patient in cardiogenic shock, indicating a state of high risk for thromboembolism due to poor circulation.
Negative lead-in flag: false

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