Nokea
A female client is prescribed warfarin. The client also uses oral contraceptives. The nurse would assess the client closely for which of the following? Select all that apply.
- A. Bruising
- B. Blood in the stool
- C. Subtherapeutic INR
- D. Supratherapeutic INR
- E. Calf pain and warmth
Correct Answer: C,E
Rationale: Coadministration of warfarin and oral contraceptives can result in a decreased anticoagulant effect, leading to subtherapeutic INR and increased chance of clotting (signs and symptoms of DVT or PE).
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A nurse is conducting an in-service presentation about hemostasis. The nurse determines that the teaching was successful when the class identifies a thrombus as which of the following?
- A. Damage to a blood vessel
- B. Formation of a blood clot
- C. Cessation of bleeding
- D. Coagulation cascade
Correct Answer: B
Rationale: A thrombus refers to the formation of a blood clot, sometimes from damage, in a vessel that impedes blood flow.
A nurse is reviewing a journal article about antiplatelet agents. Which of the following would the nurse expect to be discussed? Select all that apply.
- A. Heparin
- B. Warfarin
- C. Abciximab
- D. Anagrelide
- E. Dipyridamole
Correct Answer: C,D,E
Rationale: Abciximab, anagrelide, and dipyridamole are antiplatelet agents. Heparin and warfarin are anticoagulants.
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 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.