Nokea
The nurse is providing discharge teaching for a patient who developed a pulmonary embolism after total knee surgery. The patient has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client?
- A. Coumadin will continue to break up the clot over a period of weeks
- B. Coumadin must be taken concurrent with ASA to achieve anticoagulation
- C. Anticoagulant therapy usually lasts between 3 and 6 months
- D. He should take a vitamin supplement containing vitamin K
Correct Answer: C
Rationale: Anticoagulant therapy prevents further clot formation, but cannot be used to dissolve a clot. The therapy continues for approximately 3 to 6 months and is not combined with ASA. Vitamin K reverses the effect of anticoagulant therapy and normally should not be taken.
You may also like to solve these questions
A patient who was involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this patients care?
- A. Facilitation of long-term intubation
- B. Restoration of adequate gas exchange
- C. Attainment of effective coping
- D. Self-management of oxygen therapy
Correct Answer: B
Rationale: The objectives of treatment are to correct the underlying cause of respiratory failure and to restore adequate gas exchange in the lung. This is priority over coping and self-care. Long-term ventilation may or may not be indicated.
The nurse is caring for a patient who has been in a motor vehicle accident and the care team suspects that the patient has developed pleurisy. Which of the nurses assessment findings would best corroborate this diagnosis?
- A. The patient is experiencing painless hemoptysis
- B. The patients arterial blood gases (ABGs) are normal, but he demonstrates increased work of breathing
- C. The patients oxygen saturation level is below 88%, but he denies shortness of breath
- D. The patients pain intensifies when he coughs or takes a deep breath
Correct Answer: D
Rationale: The key characteristic of pleuritic pain is its relationship to respiratory movement. Taking a deep breath, coughing, or sneezing worsens the pain. The patients ABGs would most likely be abnormal and shortness of breath would be expected.
When assessing for substances that are known to harm workers lungs, the occupational health nurse should assess their potential exposure to which of the following?
- A. Organic acids
- B. Propane
- C. Asbestos
- D. Gypsum
Correct Answer: C
Rationale: Asbestos is among the more common causes of pneumoconiosis. Organic acids, propane, and gypsum do not have this effect.
The nurse is caring for an 82-year-old patient with a diagnosis of tracheobronchitis. The patient begins complaining of right-sided chest pain that gets worse when he coughs or breathes deeply. Vital signs are within normal limits. What would you suspect this patient is experiencing?
- A. Traumatic pneumothorax
- B. Empyema
- C. Pleuritic pain
- D. Myocardial infarction
Correct Answer: C
Rationale: The key characteristic of pleuritic pain is its relationship to respiratory movement. Taking a deep breath, coughing, or sneezing worsens the pain. Pleuritic pain is limited in distribution rather than diffuse; it usually occurs only on one side. The pain may become minimal or absent when the breath is held. It may be localized or radiate to the shoulder or abdomen. Later, as pleural fluid develops, the pain decreases. The scenario does not indicate any trauma to the patient, so a traumatic pneumothorax is implausible. Empyema is unlikely as there is no fever indicative of infection. Myocardial infarction would affect the patients vital signs profoundly.
The nurse is caring for a patient at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis?
- A. Incentive spirometry
- B. Intermittent positive-pressure breathing (IPPB)
- C. Positive end-expiratory pressure (PEEP)
- D. Bronchoscopy
Correct Answer: A
Rationale: Strategies to prevent atelectasis, which include frequent turning, early ambulation, lung-volume expansion maneuvers (deep breathing exercises, incentive spirometry), and coughing, serve as the first-line measures to minimize or treat atelectasis by improving ventilation. In patients who do not respond to first-line measures or who cannot perform deep-breathing exercises, other treatments such as positive end-expiratory pressure (PEEP), continuous or intermittent positive-pressure breathing (IPPB), or bronchoscopy may be used.