(3) Since a patient who has once developed thrombophlebitis may have a
recurrence, he may be continued on an anticoagulant drug indefinitely as a prophylactic
b. Medical Considerations.
(1) Drug dosage is regulated very carefully by the physician, in relation to
the individual patient's prothrombin determination. (Prothrombin determination is a
special blood test.)
(2) Certain drugs should not be given with anticoagulants. Aspirin and
aspirin-like drugs increase the effect of the anticoagulant. Phenobarbital and
butazolidine decrease the effects.
c. Nursing Implications.
(1) Nursing personnel have a responsibility to recognize that any patient
receiving an anticoagulant drug must be closely observed for bleeding.
Bleeding may occur from the mouth, nose, urinary tract, or rectum.
(3) Patients receiving anticoagulant therapy should be encouraged to use a
soft bristle toothbrush and an electric razor instead of a blade.
(4) Local policy often dictates that only the RN may administer anticoagulant
drugs. This is due to the potential hazards and complicated dosage orders.
1-38. CARDIAC TAMPONADE
Bleeding into the pericardial sac, or accumulation of fluid in the pericardial sac,
results in compression of the heart. This compression reduces heart movement,
prevents adequate filling of the ventricles, and obstructs venous return to the heart.
This condition, called cardiac tamponade, is an emergency that requires prompt relief to
prevent death from circulatory failure.
a. Signs and Symptoms.
Distention of the neck veins.
Low pulse pressure.