Question

a nurse is caring for a client who has a deep - vein thrombosis (dvt) and has been taking unfractionated heparin for 1 week. two days ago, the provider also prescribed warfarin. the client asks the nurse about receiving both heparin and warfarin at the same time. which of the following statements should the nurse make? a \i will remind your provider that you are already receiving heparin.\ b \your laboratory findings indicated that two anticoagulants were needed.\ c \it takes 3 to 4 days before the therapeutic effects of warfarin are achieved, and then the heparin can be discontinued.\ d \only one of these medications is being given to treat your deep - vein thrombosis.\

Explanation:

Warfarin is a vitamin K antagonist. It inhibits the synthesis of vitamin K - dependent clotting factors (II, VII, IX, X). However, it takes 3 - 4 days for warfarin to reach its therapeutic effect because the half - lives of the clotting factors it affects vary. Heparin acts rapidly by potentiating antithrombin III, which inactivates thrombin and factor Xa. So, heparin is continued until warfarin reaches its therapeutic level (usually when the INR is in the therapeutic range, around 2 - 3 for DVT treatment).

Answer:

C. "It takes 3 to 4 days before the therapeutic effects of warfarin are achieved, and then the heparin can be discontinued."