hey guys nurse Mike here and welcome to simplenursing.com before we get today's lecture started please remember click here to check out our brand new app-based enclex product loaded with the highest quality en click style practice questions and complete with detailed video rationals that break down the question for you so finally master all those darn select Al that apply questions plus all our enclex memberships come included with our entire library of over a th000 videos and study guides and cheat sheets come see why over a 100,000 students have trusted their future to simplenursing.com click here to get started for free now for blood thinners generally they come in three sizes small medium and large so by comparison think of antiplatelets like aspirin and cigil like water gun these are the small guys and anti-coagulants like heprin warrin like a bazooka the semi big guns those are the medium and then thrombolytics the clot Busters like TPA and Ela Pace Guys these are the atomic bombs the most deadly since they have the highest bleed risk so first up let's cover anti-platelets like clil and aspirin AKA solic late now guys let the name help you here antiplatelets are just that they're antiplatelet they low lower platelet aggregation so we have a less chance of them sticking together and clogging the arteries so just think AC for aspirin and cigal brand named Plavix like AC for anti-logging of the arteries preventing platelets from forming clots now the indication is mainly for clot prophylaxis basically meaning clot prevention so guys in heart and brain clot like an MI or CVA prevention narrowed arteries like ACS in the heart or a TIA in the brain or even pad in the extremities or even prevention after a stent or bypass preventing the reocclusion of that artery there now the hessie key term we use post PCI that percutaneous coronary intervention fancy words for cath lab to clear the clot again guys AC is aspirin an citril AC for anti-clot now the mechanism of action guys it's very simple they prevent the platelets from aggregating together or clumping up sort of like spreading them out like a bunch of plates now the key points before giving we always assess so the key numbers here is hemoglobin levels so anything less than seven just think you might be sending your patient to Heaven huge bleed risk there and also platelets normally between 150 to 400 so just think anything less than 150 is very iffy always notify the hcp but less than 50 is very risky these Med should not be decreasing platelet levels guys this is known as thrombocytopenia basically meaning a huge risk for bleeding so common questions on exams they'll give you a scenario of a plat link count about 75,000 or less than 40 guys what's the priority nursing action always the priority is to hold the drug and Quest question the prescription and then notify the hcp and guys don't let the an click trick you aspirin and compil think platelets not INR not PTT that's for anti-coagulants in our next section now hessie had an exit question about aspirin they were asking about contraindication for patients with hypoprothrombinemia that's just fancy words for low clotting factors so we just hold the aspirin now as far as aspirin toxicity this is a big focus on safety so hessie and ATI exit exams had a few questions on this so activated charcoal was the number one drug for aspirin toxicity now the key term here is initial treatment of cicil or aspirin toxicity it binds with Aspirin to block the absorption by the small intestine and the key signs of aspirin toxicity is number one tentis the ringing of the ears and also hyperventilation so guys we notify the hcp immediately now Kaplan mentioned this as a priority finding given a scenario about a patient on aspirin who is hyperventilating indicating it could be a cicil poisoning or aspirin poisoning and ATI question about long-term aspirin Administration priority assessment is assess for tentis and a very last side note here tacac cardia and hypotension are not signs of toxicity this could actually indicate a bleed so just be careful now for glycoprotein or GP receptor Inhibitors we have elmab also an antiplatelet given for prevention of platelet aggregation but guys here's the big difference it's mainly used after cardiac procedures like a heart cath or coronary stent placement where we want to prevent vessel reocclusion now adverse effects guys just like aspirin but way more severe so we still thrombocytopenia and bleeding now the big nursing care common exam questions ask actions the nurse should Implement so key terms to write down here number one is assessment of hemoglobin and platelets again hemoglobin below seven sends your patient to heaven and platelets below 150 is very iffy but anything less than 50 guys is very risky always question any prescription or or order for any blood thinner with playlets that low and guys we assess for bleeding here thanks for watching for our full 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