Anticoagulation Therapy

Anticoagulants do not dissolve an established clot. They slow clot propagation and reduce the chance that thrombus will embolize while the body gradually removes it. The same reduction in thrombin formation that protects against stroke or pulmonary embolism also makes bleeding more difficult to stop. The safest nursing assessment begins with the indication: atrial fibrillation, venous thromboembolism, a mechanical valve, postoperative prevention, or another high-risk state. Then identify the agent, the time and dose of the last administration, renal and hepatic function, interacting medicines, and any evidence of bleeding. A new severe headache, focal neurological change, gastrointestinal blood loss, hypotension, falling haemoglobin, or bleeding after head trauma changes the priority from routine monitoring to urgent assessment and reversal planning.