08 Oct A client is receiving heparin by intravenous infusion for treatment of a deep vein thrombosis.

A client is receiving heparin by intravenous infusion for treatment of a deep vein thrombosis. What lab data would require the nurse to hold the infusion of heparin and notify the prescriber?

 

  Platelets 180,000/mcL

 

  aPTT 120 seconds

 

  INR 3.1

 

  PT 39.5 seconds

 

 

 

Question 2Match each medication with the appropriate antidote.

 

Heparin

 

Warfarin

 

Dabigatran

 

Alteplase

 

Question 3A client is being discharged home with a new prescription for warfarin. What information should the nurse provide in the discharge teaching concerning this medication? SELECT ALL THAT APPLY

 

  “Increase your intake of vitamin K in order to off-set the chance of bleeding with warfarin.”

 

  “Use a soft bristle toothbrush to help prevent bleeding from your gums.”

 

  “Report any excessive bruising or bleeding to your health care provider.”

 

  “Use an electric shaver to help prevent bleeding from cuts from shaving.”

 

  “Keep your blood work appointments every 2-4 weeks once the therapeutic level of warfarin is reached”

 

Question 4Prior to administering heparin 5,000 units subcutaneously, the nurse reviews the chart. Find the laboratory results in the table below. Based on this data, what actions should the nurse take? SELECT ALL THAT APPLY

 

Laboratory Tests              Monday               Tuesday

 

White Blood Cell Count 5.2          5.6

 

Red Blood Cell Count      4.5          3.9

 

Hemoglobin       16           12

 

Hematocrit         40%        30%

 

Platelet Count   400,000 180,000

 

aPTT      35           38

 

  Notify the pharmacy of the need to switch the client from heparin to argatroban

 

  Withhold the scheduled dose of heparin

 

  Administer protamine sulfate

 

  Assess the client for signs and symptoms of bleeding

 

  Notify the health care provider of lab results

 

Question 5A client is newly prescribed clopidogrel to prevent clots from forming on an implanted cardiac stent. What information should the nurse provide the patient concerning this medication? SELECT ALL THAT APPLY

 

  “Notify any surgeon or dentist that you are on clopidogrel prior to any procedure.”

 

  “Limit your intake of green leafy vegetables.”

 

  “You must go get lab work drawn every 2-4 weeks while on this medication.”

 

  “Report any dark, tarry stools to your health care provider.”

 

  “Avoid the use of ibuprofen and naproxen as this can increase the chance of bleeding.”

 

Question 6 What information about side effects of simvastatin should the nurse include in client teaching? SELECT ALL THAT APPLY

 

  “Muscle pain and tenderness can be a sign of muscle breakdown.”

 

  “Dark, tea colored urine can be a symptom of liver damage.”

 

  “Sudden weight loss and weakness can be a sign of muscle breakdown.”

 

  “Right upper quadrant pain and tenderness can be a symptom of liver damage.”

 

  “Periodically while on this medication, the health care provider will monitor your liver enzymes to assess for liver damage.”

 

Question 7 A client with symptoms of myocardial infarction has received alteplase within the needed time-frame. What nursing intervention should the nurse implement to help keep the client safe?

 

  Implement strict bed rest and pad the side rails

 

  Insert a foley catheter so client will not need to go to bathroom

 

  Place a fall precautions armband on the client

 

  If bleeding occurs at IV site, hold pressure 5 minutes.

 

Question 8Based on potential adverse effects of the “statin” drugs, what labs should the nurse be prepared to monitor in a client receiving any “statin” drug? SELECT ALL THAT APPLY

 

  ALT

 

  Creatininekinase

 

  Creatinine phosphokinase

 

  AST

 

  INR

 

  aPTT

 

Question 9While performing medication reconciliation at discharge, the nurse notes that the client takes simvastatin 20 mg PO as a current home medication and the hospital physician has written a prescription for gemfibrozil. What potential adverse reaction can happen as a results of taking these medications concurrently?

 

  Rhabdomyolysis

 

  Low blood pressure

 

  Bleeding

 

  Liver damage

 

Question 10When planning medication administration to a client on cholestyramine, the nurse should administer the cholestyramine either _________ hour(s) before other medications or __________ hour(s) after other medications. (Enter number or number range only)

 

Question 11A client will be starting on a transdermal patch for treatment of chronic stable angina.  What education should the nurse provide the client? SELECT ALL THAT APPLY

 

  Cleanse the previous patch site to prevent irritation

 

  Avoid saunas and hot tubs because these increase vasodilation

 

  Remove the old patch before applying the new patch

 

  Do not apply the patch to the same location every day.

 

  Apply the patch at the same time each day

 

  Acceptable application sites include the forearm area, calf area, along with the torso

 

Question 12What medication can cause a fatal drop in blood pressure if taken with nitroglycerin?

 

  Sildenafil

 

  Carvedilol

 

  Digoxin

 

  Amlodipine

 

Question 13A client is experiencing chest pain and 2 doses of nitroglycerin have been administered. Which assessment finding would require the nurse to hold the third dose of nitroglycerin?

 

  Systolic blood pressure 88 mm/Hg

 

  Unrelieved chest pain, radiating into the left arm and jaw

 

  Head ache rating at 10 on a 0-10 pain scale

 

  Tingling sensation under the tongue with each SL tablet

 

Question 14The nurse is reviewing the client’s medical record before providing discharge instructions. Find the information below:

 

Admitting Diagnosis

 

Dehydration

 

Past Medical Diagnosis:

 

Heart Failure, chronic stable angina, hypertension

 

Discharge Medication Orders:

 

digoxin 0.125 mg PO daily

 

furosemide 40 mg PO BID at 0900 and 1700

 

metoprolol 25 mg PO daily

 

isosorbide dinitrate 20 mg PO daily

 

nitroglycerin 0.4 mg SL PRN chest pain.

 

What information should the nurse include in the discharge instructions? SELECT ALL THAT APPLY

 

  Store the nitroglycerin in original container,keeping it away from heat and moisture.

 

  Call 9-1-1 if pain is not relieved within 3 minutes of your first dose of nitroglycerin.

 

  Smoking cessation will help with disease management.

 

  If experiencing chest pain, place 1 nitroglycerin tablet under your tongue and allow it to dissolve; you may repeat up to 5 times, 3 minute apart.

 

  Weigh yourself weekly to monitor for fluid retention and report a weight gain of more than 5 pounds.

 

  Rise slowly, in stages, because metoprolol and isosorbide dinitrate can cause low blood pressure upon standing.

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteDemy. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.