When describing anticoagulants to a client, which of the fol...

When describing anticoagulants to a client, which of the following would the nurse expect to include? Select all that apply.

A. Anticoagulants prevent formation of a thrombus.
B. Anticoagulants prevent extension of a thrombus.
C. Anticoagulants dissolve existing thrombi.
D. Anticoagulants thin the blood.
E. Anticoagulants can reverse the damage caused by a thrombus.

Correct Answer: A,B

Rationale: Anticoagulants can prevent the formation and extension of a thrombus but have no direct effect on an existing thrombus and do not reverse any of the damage from that thrombus. Although clients often refer to anticoagulants as blood thinners, they do not actually thin the blood.

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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 female client is receiving an anticoagulant to prevent the formation and extension of blood clots. What instruction should the nurse include in the teaching plan for the client?

A. Avoid caffeinated drinks.
B. Take the drug on an empty stomach.
C. Use a reliable contraceptive.
D. Take the drug with a glass of milk.

Correct Answer: C

Rationale: The nurse should instruct the female client to use a reliable contraceptive to prevent pregnancy, as anticoagulants can pose risks during pregnancy.

Which assessment would the nurse obtain before administering an anticoagulant to a client with DVT? Select all that apply.

A. Test for a positive Homans' sign.
B. Examine extremity for skin temperature.
C. Assess pain.
D. Assess blood pressure.
E. Check for pedal pulse.

Correct Answer: A,B,C,E

Rationale: Preadministration assessment for a client with a DVT should include checking for a pedal pulse, examining the extremity for color and skin temperature, assessing for pain, and checking for a positive Homans' sign.

Protamine is used to treat overdose of which of the following medications? Select all that apply.

A. Clopidogrel (Plavix)
B. Heparin
C. Enoxaparin (Lovenox)
D. Alreplase (Activase)
E. Warfarin (Coumadin)

Correct Answer: B,C

Rationale: Protamine is used to treat overdose of heparin and low-molecular-weight heparins (LMWHs).

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.