Nokea
Which of the following may be ordered periodically during therapy with anticoagulants? Select all that apply.
- A. Urinalysis
- B. Platelet count
- C. Blood count
- D. Stool analysis
- E. Ultrasound
Correct Answer: B,C,D
Rationale: A complete blood count, platelet count, and stool analysis for occult blood may be ordered periodically throughout anticoagulant therapy.
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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.
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 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.
After teaching a group of nursing students about heparins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a low-molecular-weight heparin (LMWH)? Select all that apply.
- A. Dalteparin
- B. Streptokinase
- C. Enoxaparin
- D. Warfarin
- E. Tinzaparin
Correct Answer: A,C,E
Rationale: Dalteparin, enoxaparin, and tinzaparin are all examples of LMWHs. Streptokinase is a thrombolytic; warfarin is an oral anticoagulant.
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.