Care Plan

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|Student Name: p |Age: 89 | |Course number: Basic Skills & Concepts of Nursing | | |Health care agency: c |Developmental State: Ego vs. Integrity: Patient expresses satisfaction with her life and enjoys sharing stories from her past. | |Date of Care: 11/09/11 |Expresses contentment with the results of her child rearing by talking of her professional lawyer son and accountant daughter as | |Patient’s initials: AH |well as successful grandchildren. Also expresses concern that relinquishing her home which she still lives in independently to a| |Patient’s room: 521-D |nursing home facility will make her feel like a failure. | | | | | |Instructor: Professor | | | |

Medical diagnosis: Coumadin Toxicity: Warfarin (Coumadin) is an oral anticoagulant prescribed to inhibit clot formation. Anticoagulants are prescribed for people that have venous and arterial disorders, including deep vein thrombosis (DVT), pulmonary embolism (PE), and coronary thrombosis (myocardial infarction – MI) that are at a high risk for clot formation. Oral anticoagulants prolong clotting time and are monitored by the prothrombian time (PT), a lab test that measures the time it takes blood to clot in the presence of certain factors. The International Normalized Ratio or INR was created to account for the variability that can occur by using different factors in the PT lab tests. Monitoring INR is extremely important for the duration of drug therapy. Warfarin (Coumadin) has a long half-life and very long duration. Drug accumulation can occur and cause internal and external bleeding. In the event of an overdose or uncontrollable bleeding as a result of Warfarin (Coumadin), Vitamin K, an antagonist an Warfarin, is used. Usually 1 to 10mg of Vitamin K is administered immediately to control bleeding. If the Vitamin K fails to reverse the effects, fresh whole blood or fresh-frozen plasma or platelets are given.

Explain significance of operative procedure, lab data, and/or special diagnostic test or procedures: Glucose: 124 (High): blood sugar concentration; high reading indicates hyperglycemia. BUN: 23 (High): blood urea nitrogen; elevated level indicates renal dysfunction. Bun/Cr Ratio: 26 (High): Bun/creatinine ratio: elevated level can...
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