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A patient is receiving an IV infusion of a thrombolytic drug during treatment for an acute MI. The nurse notices that there is a slight amount of bleeding from the antecubital area where venous lab work was drawn. What will the nurse do first?
- A. Monitor the site for further bleeding.
- B. Apply pressure to the site with a gauze pa
- D. Slow the rate of infusion of the thrombolytic drug.
Correct Answer: B
Rationale: Applying pressure to the site with a gauze pad is the first action the nurse should take when noticing bleeding from the antecubital area. This will help control the bleeding and prevent further blood loss. Monitoring the site for further bleeding is important, but immediate intervention by applying pressure is necessary to address the issue. Slowing the rate of infusion of the thrombolytic drug or stopping the infusion should be considered if bleeding continues despite applying pressure or if there are signs of significant bleeding or hemorrhage.
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A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?
- A. Vitamin E
- B. Vitamin K
- C. Protamine sulfate
- D. Potassium chloride
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin (Coumadin) toxicity. Warfarin is a vitamin K antagonist that inhibits the synthesis of vitamin K-dependent coagulation factors (II, VII, IX, X) in the liver. In cases of excessive anticoagulation and bleeding, administering vitamin K can help reverse the effects of warfarin by replenishing the depleted vitamin K-dependent clotting factors. Vitamin K helps the liver produce clotting factors, thereby promoting the clotting process and reversing the excessive anticoagulant effects of warfarin. Other options mentioned, such as Vitamin E, Protamine sulfate, and Potassium chloride, are not appropriate antidotes for warfarin toxicity.
The patient accidentally takes too much of the prescribed warfarin (Coumadin) and is readmitted to the hospital with bleeding. Which drug can the nurse anticipates administrating?
- A. Protamine sulfate
- B. Alteplase (Activase, Cathflo Activas
- D. Reteplase (Retavas
Correct Answer: D
Rationale: Warfarin, also known as Coumadin, is an anticoagulant medication that works by inhibiting the production of clotting factors in the liver, specifically factors II, VII, IX, and X. In the event of warfarin overdose, which can lead to excessive bleeding, the antidote is vitamin K. Vitamin K promotes the production of these clotting factors and helps reverse the effects of warfarin. Therefore, in this situation, the nurse can anticipate administering vitamin K to the patient to help stop the bleeding caused by the excess warfarin in the system.
A nurse is caring for a patient who is taking Digoxin. The nurse should instruct the patient to monitor and report which of the following adverse e昀昀ects? ( select all the apply)
- A. Fatigue
- B. Constipation
- C. Anorexia
- D. Rash
Correct Answer: A
Rationale: A. Fatigue: Digoxin, a medication commonly used to treat heart conditions, can cause side effects such as fatigue. Patients taking Digoxin should monitor and report any unusual fatigue or weakness to their healthcare provider.
Serious adverse effects of oral contraceptives include:
- A. Increase in skin oil followed by acne.
- B. Headache and dizziness.
- C. Early or mid-cycle bleeding.
- D. Thromboembolic complications.
Correct Answer: D
Rationale: Thromboembolic complications, such as deep vein thrombosis and pulmonary embolism, are serious adverse effects of oral contraceptives. These occur due to the estrogen component, which increases the risk of blood clots. While headaches, dizziness, and breakthrough bleeding are common side effects, they are not as severe as thromboembolic events.
Which patient-teaching instructions are appropriate for a patient taking an antidysrhythmic drug? (Select all that apply.)
- A. Do not chew or crush extende
- B. release forms of medication.
- C. Take the medication with food if gastrointestinal distress occurs.
- D. If a dose is missed, the missed dose should be taken along with the next dose that is due to be taken.
Correct Answer: A
Rationale: A. Do not chew or crush extended-release forms of medication. This is an appropriate instruction because chewing or crushing extended-release forms of medication can alter their intended time-release action, leading to an overdose or underdose.