A nurse has the order to begin administering warfarin sodium (Coumadin) to a client. While implementing this order, the nurse ensures that which of the following medications is available on the nursing unit as the antidote for Coumadin?
A. Vitamin K
B. Aminocaproic acid
C. Potassium chloride
D. Protamine sulfate
Correct Answer: A. Vitamin K
The antidote to warfarin (Coumadin) is Vitamin K and should be readily available for use if excessive bleeding or hemorrhage should occur. When managing warfarin toxicity, the initial step would be to discontinue warfarin and then administer vitamin K (phytonadione). The vitamin K may administration can be either via the oral, intravenous, or subcutaneous route. However, the initial administration of oral vitamin K is often preferable in patients without major bleeding or extremely elevated INR.
Option B: Aminocaproic acid has received approval from the Food and Drug Administration (FDA) for the therapeutic management of acute hemorrhages caused by elevated fibrinolytic activity leading to surgical complications after cardiac surgery, hematological disorders, hepatic cirrhosis, and neoplastic disease.
Option C: Potassium chloride is a medication used in the management and treatment of hypokalemia. It is in the electrolyte supplement class of medications. Regardless of the administration route, KCl is used to increase the potassium content of the body. Approximately 98% of all potassium in the body exists within cells, particularly skeletal muscle cells.
Option D: The antidote to heparin is protamine sulfate and should be readily available for use if excessive bleeding or hemorrhage should occur. Protamine is a medication used to reverse and neutralize the anticoagulant effects of heparin. Protamine is the specific antagonist that neutralizes heparin-induced anticoagulation. When appropriately dosed, this neutralization reduces the risk of postoperative bleeding.
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