A patient is at 12 weeks' gestation with her first baby. She has cardiac disease, class III. She states that she had been taking sodium warfarin (Coumadin), but her physician changed her to heparin. She asks the nurse why this was done
The nurse's response should be: 1. "Heparin may be given by mouth, while Coumadin must be injected."
2. "Heparin is safer because it does not cross the placenta."
3. "They are the same drug, but heparin is less expensive."
4. "Coumadin interferes with iron absorption in the intestines."
2
Rationale 1: Heparin is an injectable and Coumadin is a pill.
Rationale 2: Heparin is safest for the patient to take because it does not cross the placental barrier.
Rationale 3: Heparin does not cost less than Coumadin.
Rationale 4: Coumadin does not interfere with iron absorption in the intestines.
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