Nokea
A nurse is conducting a seminar on thrombosis. What information would the nurse include about the cause of arterial thrombosis?
- A. Decreased blood flow
- B. Injury to the vessel wall
- C. Arrhythmias
- D. Altered blood coagulation
Correct Answer: C
Rationale: The nurse should mention that arterial thrombosis is caused by atherosclerosis and arrhythmias. Decreased blood flow, injury to the vessel wall, and altered blood flow are causes of venous thrombosis.
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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.
A nurse is caring for a client prescribed warfarin. The nurse would instruct the client that which of the following foods are high in vitamin K?
- A. Dairy products
- B. Root vegetables
- C. Green leafy vegetables
- D. Fruits and cereals
Correct Answer: C
Rationale: The nurse should inform the client that green leafy vegetables are high in vitamin K, which can affect warfarin's efficacy.
When reviewing the medical records of several clients, the nurse understands that the use of anticoagulants is contraindicated in clients with which of the following medical conditions? Select all that apply.
- A. Leukemia
- B. Hypotension
- C. Atrial fibrillation
- D. GI ulcers
- E. Tuberculosis
Correct Answer: A,D,E
Rationale: Anticoagulants are contraindicated in clients with known sensitivity to the drug, active bleeding, hemorrhagic disease, tuberculosis, leukemia, uncontrolled hypertension, GI ulcers, recent eye or CNS surgery, aneurysms, and severe renal and hepatic disease and during pregnancy and lactation.
A client is experiencing an overdosage of heparin. The nurse would expect to administer which of the following?
- A. Vitamin K1
- B. Protamine
- C. Ticlopidine
- D. Tenecteplase
Correct Answer: B
Rationale: Heparin overdosage is treated with protamine, which neutralizes heparin's anticoagulant effects.
When teaching a class about parenterally administered heparin, which of the following would the nurse include? Select all that apply.
- A. Onset of action is almost immediate.
- B. Maximum effect occurs within 10 minutes.
- C. It is preferably given intramuscularly.
- D. Clotting time returns to normal within 4 hours.
- E. It causes fewer adverse reactions than the oral form.
Correct Answer: A,B,D
Rationale: Parenteral heparin results in an almost immediate onset of action with a maximum effect within 10 minutes, but clotting returns to normal within 4 hours unless subsequent doses are given. It is preferably given subcutaneously or intravenously.