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Cardiac Subspecialty Certification (CSC) Exam

Category - Free CSC Practice Test Questions

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A patient was planning to undergo Mitral valve replacement surgery. He was on warfarin therapy for Atrial Fibrillation. What modification should the nurse do with the anticoagulant medication?
  1. Stop warfarin on the day of surgery
  2. Stop warfarin 4-5 days before surgery
  3. Stop warfarin 4-5 days prior to surgery; admit and start on IV heparin; stop IV heparin 2-3 hours pre-op
  4. Continue warfarin therapy
Explanation
Answer: C - For patients taking anticoagulants like warfarin, stop 4-5 days prior to surgery; admit and start on IV heparin if high risk of thrombosis (large left atrium, atrial fibrillation, mitral valve prosthesis). IV heparin should be stopped 2-3 hours pre-op (unless on intra-aortic balloon pump (IABP) support).
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