A nurse is caring for a client who has an overdose of dabigatran and is experiencing life-threatening bleeding. Which of the following drugs should the nurse anticipate administering as an antidote?

Dabigatran is an anticoagulant that prevents blood clots and stroke.It can cause bleeding as a side effect, so the client should report any signs of bleeding, such as bruising, hematuria, or melena.The client should also use a soft toothbrush and an electric razor to prevent injury and bleeding.Dabigatran should be stored in its original container to maintain potency and protect it from moisture.

Choice A is wrong because dabigatran does not need to be taken with food to prevent gastrointestinal upset.It can be taken with or without food.

Choice E is wrong because dabigatran does not require regular blood tests to monitor the drug level.Unlike warfarin, dabigatran has a predictable anticoagulant effect and does not need frequent dose adjustments.

Lepirudin is a direct thrombin inhibitor that is used as an anticoagulant in patients with heparin-induced thrombocytopenia (HIT).It is administered as an initial intravenous bolus dose followed by a continuous intravenous infusion for 2-10 days or longer if clinically needed.The infusion rate should be adjusted to the activated partial thromboplastin time (aPTT), which is a measure of the blood’s clotting ability. An infusion pump can ensure a constant and accurate delivery of the drug at the desired rate.

Choice A is wrong because flushing the IV line with heparin before and after giving lepirudin can increase the risk of bleeding and worsening HIT.Heparin is the cause of HIT and should be avoided in patients with this condition.

Choice C is wrong because administering lepirudin as a bolus injection over 15 seconds can result in a rapid and excessive anticoagulation effect, which can increase the risk of bleeding and hemorrhage.Lepirudin should be given as a bolus injection over 15-20 minutes, followed by a continuous infusion.

Choice D is wrong because monitoring the client’s platelet count daily is not sufficient to assess the efficacy and safety of lepirudin therapy.The platelet count is not affected by lepirudin and does not reflect its anticoagulant activity.The aPTT should be monitored at least once daily and more frequently in patients with renal impairment or increased bleeding risk.The normal platelet count range is 150,000 to 450,000 platelets per microliter of blood.