Nokea
A client is being discharged on warfarin therapy. Which of the following would the nurse include in the teaching plan for the client? Select all that apply.
- A. Be consistent with your intake of foods containing vitamin K.
- B. Do not change brands of warfarin without consulting the physician.
- C. Take the drug at the same time every evening.
- D. Do not take or stop taking other medications except on the advice of the physician.
- E. Inform the dentist of therapy with warfarin prior to any treatment or procedure.
Correct Answer: A,B,C,D,E
Rationale: Instructions would include being consistent with intake of foods containing vitamin K, not changing brands of the drug, taking the drug at the same time each evening, not taking or stopping other medications, and informing the dentist about the use of warfarin.
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A client is prescribed warfarin. The client also takes a diuretic for the treatment of cardiac problems. The nurse would anticipate which of the following?
- A. Decreased effectiveness of the anticoagulant
- B. Increased effectiveness of the diuretic
- C. Increased absorption of the anticoagulant
- D. Increased absorption of the diuretic
Correct Answer: A
Rationale: The nurse should monitor for decreased effectiveness of warfarin as an effect of the interaction between the anticoagulant and the diuretic.
A nurse is caring for a client receiving the anticoagulant drug warfarin. Which assessment would be most appropriate before administering the drug?
- A. Observe for signs of thrombus formation.
- B. Assess prothrombin time (PT) and INR.
- C. Assess for signs of bleeding.
- D. Monitor for hypersensitivity reaction.
Correct Answer: B
Rationale: The nurse should assess the prothrombin time (PT) and INR before administering the anticoagulant drug warfarin to the client.
A client is receiving streptokinase. The nurse understands that which of the following would occur? Select all that apply.
- A. Breakdown of existing thrombi
- B. Reopening of occluded blood vessels
- C. Prevention of tissue necrosis
- D. Decreased risk of internal bleeding
- E. Prevention of formation of a thrombus
Correct Answer: A,B,C
Rationale: Streptokinase is a thrombolytic drug. Thrombolytic drugs break down existing thrombi, reopen blood vessels after occlusion, and prevent tissue necrosis.
When teaching a client how to inject heparin subcutaneously, which of the following would the nurse include? Select all that apply.
- A. Holding the needle at a 45-degree angle
- B. Pinching a fold of skin
- C. Aspirating before injecting the drug
- D. Applying firm pressure after injection
- E. Changing sites for each dose
Correct Answer: B,D,E
Rationale: When administering a subcutaneous dose of heparin, the nurse picks a site that has not been used previously, pinches a fold of skin, holds the needle at a 90-degree angle, does not aspirate before injecting, and then applies firm pressure to the area after injection.
After teaching a group of nursing students about heparins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a low-molecular-weight heparin (LMWH)? Select all that apply.
- A. Dalteparin
- B. Streptokinase
- C. Enoxaparin
- D. Warfarin
- E. Tinzaparin
Correct Answer: A,C,E
Rationale: Dalteparin, enoxaparin, and tinzaparin are all examples of LMWHs. Streptokinase is a thrombolytic; warfarin is an oral anticoagulant.