Rivaroxaban Assignment Scenario After Graduating From Nursin

Rivaroxaban Assignment Scenario After graduating from nursing school and passing your boards, you accepted a position as an RN in the emergency center at Rasmussen General Hospital (RGH). In the weeks ahead, your emergency center plans to implement a new initiative where clients diagnosed with low-risk deep vein thrombosis (DVT) will be sent home on 3 months of oral anticoagulation therapy with rivaroxaban. Historically, clients diagnosed with DVTs in the emergency center were admitted to the hospital's observation unit. However, when surveyed about their experiences, many clients reported that this was costly, time-consuming, and inconvenient. Under RGH's new program, emergency center nurses will be responsible for educating clients about their new medication and administering the first dose to the client before discharge. As part of this new initiative, all emergency center nurses at RGH must be trained to properly educate these clients on all aspects of their new medication regimen. Because you have demonstrated a keen interest in pharmacology, your manager has asked you to develop the educational tools that will be used to train the nurses at RGH. It's worth noting that the standard dosing for all low-risk DVTs is as follows: 15 mg BID, 12 hours apart, for 21 days After 21 days, use 20 mg once per day After 90 days, the client will follow up in the thrombosis clinic to evaluate if they meet criteria for discontinuing the medication Assignment Instructions Your manager explained that all of the emergency center nurses at RGH will be educated in small groups through a short, in-service training session. You have been asked to develop a professional-looking PowerPoint presentation that the trainers will use to guide the in-service sessions. Your PowerPoint will need to: Be professional-looking, have a title slide, and 10-15 content slides . Use the Speaker Notes feature in PowerPoint to reduce the amount of text that appears on the content slides. The Speaker Notes for each slide will contain the text that will guide what the trainer will say while presenting the slides during the in-service. The content slides themselves should be clear and easy to understand; they serve as an outline so the audience can follow along with what is being presented. Be written using proper spelling/grammar and at a level that would be appropriate for the audience. Remember the purpose of the training is to help nurses learn to educate their clients about the use of a medication. With that in mind, it may be helpful to provide examples of how to explain the information to a client in an easy to understand way without complicated, technical terms. Include APA formatted in-text citations for at least 3 scholarly references and present the sources in APA format on a References slide. Contain content addressing the items below. Pharmacotherapeutics State the drug name and its therapeutic category. Pharmacodynamics - how does this drug work to achieve its intended response? Pharmacokinetics - how is this drug absorbed, distributed, metabolized, and excreted? Discuss dosage, scheduling, route, and length of therapy. Describe what clients can expect regarding their therapeutic response and when it should develop. Introduce nondrug measures that clients can do to enhance their therapeutic response (e.g., specific diet to follow, exercise requirements, substances to avoid, special precautions to take, etc.). Side Effects, Adverse Effects, and Interactions Explain the symptoms of common side effects, and what clients can do to minimize any discomfort. Explain the symptoms of any major adverse effects, and what clients should do if they experience them. List the major adverse drug-drug interactions and drug-food interactions that clients need to be made aware of. Follow-up Care Provide information regarding when clients should call their doctor for advice (e.g., questions, non-urgent symptoms, unpleasant side effects, etc.). Note: When developing a professional-looking presentation, it's important to be mindful of how you layout your content. The slides should present key points, arranged in a logical manner, without extraneous information contributing to a cluttered look. Using the Speaker Notes feature in PowerPoint is a great way to include relevant details without overloading the slides. For information about creating PowerPoint presentations or adding Speaker Notes, consult the resources below. Writing Guide: PowerPoints How do I add Speaker Notes to my PowerPoint presentation slides? PowerPoint FAQ PowerPoint & APA: citing sources and creating reference lists in PPT presentations

Paper For Above instruction

Introduction

The adoption of new anticoagulation therapies, such as rivaroxaban, aims to improve patient outcomes and streamline care for low-risk deep vein thrombosis (DVT). As an RN at Rasmussen General Hospital (RGH), understanding how to effectively educate patients about this medication is essential. This presentation provides a comprehensive overview of rivaroxaban, covering its pharmacology, administration, side effects, and follow-up care, empowering nurses to deliver accurate and clear patient education.

Pharmacotherapeutics: Rivaroxaban and Its Therapeutic Use

Rivaroxaban is an oral anticoagulant classified as a direct factor Xa inhibitor. It works by selectively blocking the activity of Factor Xa, a key component in the coagulation cascade, thereby preventing clot formation (O’Connell et al., 2020). This makes rivaroxaban effective in treating and preventing venous thromboembolism, including DVT and pulmonary embolism.

Pharmacodynamics

Rivaroxaban inhibits Factor Xa, reducing thrombin generation and clot development. Its targeted action results in a predictable anticoagulant effect without the need for routine laboratory monitoring. Patients can expect a decreased risk of thrombus extension and embolization as the drug works within hours of administration.

Pharmacokinetics

Rivaroxaban is absorbed in the gastrointestinal tract, with peak plasma concentrations occurring approximately 2-4 hours after oral intake (Mueck et al., 2018). It is extensively distributed throughout the body, binding to plasma proteins. The drug is metabolized primarily in the liver via CYP3A4 enzymes and is excreted through renal and fecal pathways. The dosing schedule involves 15 mg twice daily for 21 days, then 20 mg once daily afterward. The standard duration of therapy for DVT is typically three months, but this may vary based on individual patient assessment.

Patients should expect to see an effective reduction in clot formation within a few days, with maximum therapeutic effect developing within one to two weeks of consistent use.

Client Education: Enhancing Therapeutic Response

Patients should be instructed to maintain a healthy diet high in omega-3 fatty acids and to stay physically active to promote circulation (Lip et al., 2021). They should avoid substances known to increase bleeding risk, such as alcohol and NSAIDs. Encouraging adherence to the prescribed medication schedule and regular follow-up appointments enhances effectiveness.

Side Effects and Common Adverse Effects

Common side effects include bleeding, bruising, and gastrointestinal discomfort. To minimize bleeding risk, patients should be advised to use caution when using sharp objects or participating in activities with a risk of injury. If they experience unusual bleeding—such as bleeding gums, blood in urine or stool—they should notify their healthcare provider immediately.

Major adverse effects include severe bleeding episodes, which require prompt emergency care. Signs include sudden weakness, dizziness, or blood loss evident through vomiting blood or passing large clots.

Drug Interactions

Rivaroxaban interacts with other medications that affect bleeding or influence its metabolism, such as certain antibiotics, antifungals, and antiplatelet drugs. Patients should inform providers about all medications and supplements they use. Food interactions are minimal, but grapefruit juice should be avoided as it can affect drug metabolism (Shim et al., 2020).

Follow-up and Emergency Warning Signs

Clients need to attend regular follow-up appointments to monitor for signs of bleeding or clot recurrence. They should contact their healthcare provider if they experience non-urgent symptoms such as mild bleeding, bruising, or gastrointestinal upset. Immediate medical attention is necessary if symptoms of major bleeding occur—such as uncontrolled bleeding, dizziness, or loss of consciousness.

Educating patients on when to seek emergency care ensures timely intervention and safe medication use, vital for successful anticoagulation therapy.

Conclusion

Effective nurse-led patient education on rivaroxaban can significantly improve adherence, minimize adverse effects, and promote optimal outcomes in clients with DVT. Ensuring clarity and simplicity during communication enhances patient understanding and safety.

References

• O’Connell, C. M., et al. (2020). Pharmacology and management of rivaroxaban. Journal of Thrombosis and Haemostasis, 18(4), 973–985.
• Mueck, W., et al. (2018). Pharmacokinetics of rivaroxaban: A comprehensive review. International Journal of Clinical Pharmacology, 60(1), 15–23.
• Lip, G. Y., et al. (2021). Lifestyle modifications to reduce thrombosis risk. Vascular Health and Risk Management, 17, 127–135.
• Shim, J., et al. (2020). Drug interactions with oral anticoagulants: A review. Clinical Pharmacology & Therapeutics, 107(3), 620–629.