A nurse is educating a client about the action of aspirin during cardiac events. Which of the following statements by the nurse should be included in the teaching?

Rationale:

A. Heparin and warfarin do not work to lower blood pressure. Their primary action is to prevent blood clots, not to affect blood pressure.

B. While heparin can help prevent the extension of existing blood clots, it does not typically dissolve clots. Warfarin is used for long-term anticoagulation and works by inhibiting the synthesis of clotting factors.

C. Heparin is often used initially to rapidly anticoagulate a patient while waiting for the therapeutic effects of warfarin to take effect. Warfarin is then used long-term to prevent future clots from forming.

D. Heparin and warfarin are often given together initially, especially in certain clinical situations such as acute deep vein thrombosis or pulmonary embolism, to achieve rapid anticoagulation while waiting for the therapeutic effects of warfarin. However, careful monitoring is required to minimize the risk of hemorrhage.

Rationale:

A. Partial thromboplastin time (PTT) is used to monitor the effectiveness of heparin therapy, not warfarin.

B. Prothrombin time (PT) and international normalized ratio (INR) are used to monitor the therapeutic level of warfarin. INR is the preferred method as it standardizes the PT results across different laboratories.

C. D-dimer level is a marker of fibrin degradation and is used to assess for the presence of blood clots, not to monitor warfarin therapy.

D. Vitamin K level is not used to monitor warfarin therapy. However, administering vitamin K can reverse the effects of warfarin in cases of overdose or hemorrhage.