Nokea
A client with intermittent claudication is prescribed cilostazol by the primary health care provider. The nurse would expect to administer this drug cautiously if the client's history reveals which of the following?
- A. Intermittent claudication
- B. Pulmonary emboli
- C. Myocardial infarction
- D. Pancytopenia
Correct Answer: D
Rationale: The nurse should administer cilostazol with caution to clients with pancytopenia. Anticoagulants are used for the prevention and treatment of pulmonary emboli, the adjuvant treatment of myocardial infarction, and the treatment of intermittent claudication.
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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.
A client is receiving heparin by continuous IV infusion. Which of the following would be most appropriate for the nurse to do?
- A. Perform a complete blood count.
- B. Perform baseline PT/INR.
- C. Perform APTT test 4 to 6 hours after injection.
- D. Perform blood coagulation tests every 4 hours.
Correct Answer: D
Rationale: The nurse should perform blood coagulation tests every 4 hours for the client receiving heparin by continuous IV infusion.
A client is prescribed an anticoagulant. In which of the following situations would the nurse hold the drug and notify the physician? Select all that apply.
- A. PT exceeds 1.5 times the control value.
- B. PT is less than 1.5 times the control value.
- C. There is evidence of bleeding.
- D. INR is less than 3.0.
- E. INR is greater than 3.0.
Correct Answer: A,C,E
Rationale: The nurse should withhold the drug and contact the physician if any of the following occur: the PT exceeds 1.5 times the control value, there is evidence of bleeding, or the INR is greater than 3.0.
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 client is receiving a heparin infusion. The nurse should check the needle site for the heparin infusion for signs of which of the following? Select all that apply.
- A. Inflammation
- B. Pain
- C. Tenderness
- D. Clot formation
- E. Itching
Correct Answer: A,B,C
Rationale: The nurse inspects the needle site for signs of inflammation, pain, and tenderness along the pathway of the vein. If these occur the infusion is discontinued and restarted in another vein.