Question 1

How would a nurse explain the action of pentoxifylline (Trental)to a client?

Accepted Answer

Pentoxifylline (Trental) reduces the viscosity of red blood cells by enhancing blood flow and oxygen delivery. It helps to improve circulation in people with peripheral vascular disease by making blood flow more easily through narrowed arteries.

Question 2

As the nurse is completing the physical assessment of a client receiving heparin therapy for deep vein thrombosis (DVT),the client complains of severe lumbar pain.Which is the nurse's priority action?

Accepted Answer

Severe lumbar pain is not a common side effect of heparin therapy, and it could indicate a complication such as bleeding or hematoma. Therefore, the nurse's priority action should be to further evaluate the client's condition and ensure that appropriate interventions are taken. Repositioning or administering pain medication may provide temporary relief, but they do not address the underlying issue. Documenting the finding and reporting it to the next shift are important steps, but they should not be the priority at this time.

Question 3

A client has lost 50 pounds by following a diet that allows 1200 calories each day.Today's laboratory results reveal a significant decrease in platelets.Which foods should the nurse recommend the client add to the daily diet?

Accepted Answer

Weight loss and a low-calorie diet may lead to a deficiency in nutrients such as folic acid, which can result in decreased platelet count. Therefore, the nurse should recommend that the client add foods rich in folic acid to their daily diet, such as leafy greens, lentils, beans, and fortified cereals. Moderate-carbohydrate and fiber-rich foods may be helpful for sustained weight loss and maintaining healthy blood sugar levels, but they are not specifically targeted to address a decrease in platelets. Vitamin C may improve platelet function, but it is not as important as folic acid in this scenario.

Question 4

Assessment for deep vein thrombosis (DVT)is a priority for which client?

Accepted Answer

Clients recovering from knee replacement surgery have an increased risk for DVT due to immobility and trauma to the leg. Therefore, assessment for DVT is a priority for this client. Clients with a gastric ulcer, hypertension, or pneumonia do not have an increased risk for DVT.

Question 5

The nurse is providing discharge instruction to a client who is going home after a knee replacement.Which information regarding symptoms of deep vein thrombosis (DVT)should the nurse include?

Accepted Answer

Increased tenderness in the lower legs is a common sign of DVT, and it should be reported immediately to the healthcare provider. The other options are not specific enough or incorrect. Clients may not always know they have a DVT, and paleness or coolness in the toes may indicate poor circulation rather than DVT. Swelling in the knee is common after knee replacement surgery, but it is not necessarily indicative of DVT.

Question 6

The nurse is planning care for a client prescribed enoxaparin (Lovenox).Which interventions should be included?
Select all that apply.

Accepted Answer

Enoxaparin is administered subcutaneously, so teaching the client or family to give injections is important. Monitoring for deep vein thrombosis is necessary as enoxaparin is used to prevent it. Educating the client on signs of excessive bleeding is crucial due to the anticoagulant effects of enoxaparin.

Question 7

Which class of drugs would the nurse expect to be prescribed to a client who is bleeding excessively at a surgical site?

Accepted Answer

The class of drugs that helps to control bleeding at a surgical site is the antifibrinolytics. These drugs work by preventing the breakdown of clots, which helps to stop bleeding. Examples of antifibrinolytics include aminocaproic acid (Amicar) and tranexamic acid (Cyklokapron). Thrombolytics, anticoagulants, and prothrombin activators would not be appropriate for this situation as they increase bleeding rather than control it.

Question 8

The nurse is addressing a group of clients who have experienced thromboembolic disorders.One of the clients states,My dad had a problem with clotting too much and so does my brother." Before responding to this comment,the nurse considers which information?

Accepted Answer

A genetic deficiency of protein C can produce hypercoagulability, which can cause an increased risk of thromboembolic disorders. This information is relevant to the client's statement about their family members' clotting issues. Familial eating habits and deficiencies in vitamin C or C peptide are not directly implicated in clotting disorders, and there is no evidence to suggest that a genetic tendency to decreased CRP levels enhances the clotting cascade.

Question 9

A client is prescribed intermittent intravenous heparin therapy to treat deep vein thrombosis (DVT).Which laboratory value should the nurse review prior to administering this medication?

Accepted Answer

The laboratory value that should be reviewed prior to administering heparin therapy is the activated partial thromboplastin time (APTT). This test measures the clotting ability of the blood and is used to determine the appropriate dosage of heparin. It is important to ensure that the APTT is within the therapeutic range before administering heparin to prevent the risk of bleeding or clotting complications.

Question 10

A nurse assessing a client on a heparin drip notes bloody drainage in the nasogastric tube and indwelling urinary catheter.A stat partial thromboplastin time (PTT)is drawn according to heparin protocol.The result is 224 seconds.Which action by the nurse is the most appropriate?

Accepted Answer

A PTT of 224 seconds indicates that the client is at high risk for bleeding due to excessive anticoagulation with heparin. The presence of bloody drainage in nasogastric tube and indwelling urinary catheter further supports this. The most appropriate action by the nurse is to notify the healthcare provider immediately and prepare to administer protamine sulfate, the antidote for heparin. Option B is incorrect because increasing the IV rate and administering aminocaproic acid is contraindicated in a client who is already at high risk for bleeding. Option C is incorrect because obtaining a unit of clotting factors is not the appropriate intervention for heparin overdose. Option D is incorrect as vitamin K is the antidote for warfarin, not heparin.

Question 11

Alteplase (Activase)is prescribed for a client with an acute myocardial infarction.Which is the priority nursing intervention for this client?

Accepted Answer

The priority nursing intervention for a client receiving alteplase for acute myocardial infarction is to monitor the level of consciousness as the medication can increase the risk of bleeding in the brain, leading to an intracerebral hemorrhage. Close monitoring of the client's neurological status is essential to identify any signs of bleeding promptly. While monitoring injection sites is important, it is not the priority intervention in this situation. Monitoring APTT and PT/INR levels may be necessary in other situations, but they are not directly related to the administration of alteplase for acute myocardial infarction.

Question 12

A client is maintained on warfarin (Coumadin)therapy secondary to refractory atrial fibrillation.Which statement by the client would alert the nurse to a possible problem with this therapy?

Accepted Answer

The answer of A client is maintained on warfarin (Coumadin)therapy...

Question 13

A clinic nurse is developing a teaching handout for clients who are prescribed warfarin (Coumadin)therapy.Which statements should be included in this information?
Select all that apply.

Accepted Answer

A) Clients taking warfarin need to inform their dentists before any procedure to manage the risk of bleeding.
C) Clients on warfarin should avoid strenuous activities or sports that may cause injury or bleeding. APTT testing is not necessary for warfarin therapy, and clients should not take NSAIDs as they can increase the risk of bleeding. Ice may not be effective for managing stinging or burning at the injection site.

Question 14

A hospitalized client is prescribed warfarin (Coumadin).The nurse teaches the client to avoid which food on the lunch selection menu?

Accepted Answer

Broccoli is high in vitamin K, which can counteract the effects of warfarin (Coumadin), a medication used to prevent blood clots. Warfarin works by inhibiting vitamin K-dependent clotting factors, so consuming foods high in vitamin K can decrease its effectiveness.

Question 15

A client with a newly placed prosthetic heart valve will be maintained on long-term anticoagulant therapy.Which medication does the nurse anticipate being used for this purpose?

Accepted Answer

Warfarin (Coumadin) is commonly used as long-term anticoagulant therapy for clients with prosthetic heart valves. Enoxaparin (Lovenox) and Dalteparin (Fragmin) are low molecular weight heparins typically used for short-term anticoagulant therapy. Heparin is also a short-term anticoagulant used for clients with acute thrombosis or embolism.

Question 16

The nurse is planning a teaching session for a client newly diagnosed with hemophilia A.Which information should be included?

Accepted Answer

Hemophilia A is a genetic disorder that occurs because of a deficiency in clotting factor VIII, which is necessary in the clotting process. Due to this deficiency, the client's blood takes longer to clot, leading to bleeding episodes. Therefore, it is important to educate the client about the missing substance.

Question 17

An adult client is brought to the emergency department (ED)and diagnosed with a thrombotic stroke.The team plans to administer alteplase (Activase).The client makes the following comments to a nurse.Which information is critical for the nurse to relay to the health care provider?

Accepted Answer

C) The information about the client falling and hitting their head last week is critical for the nurse to relay to the healthcare provider because alteplase (Activase) is a thrombolytic agent that dissolves blood clots and increases the risk of bleeding. A recent head injury could significantly increase the risk of intracranial hemorrhage if thrombolytic therapy is administered.

Question 18

A client is being treated for a thromboembolic disorder.If the goal is to prevent clot formation,the nurse anticipates the client will be treated with which classifications of drug?
Select all that apply.

Accepted Answer

Anticoagulants and antiplatelet agents are used to prevent clot formation in thromboembolic disorders. Hemostatics are used to promote clotting, thrombolytics are used to dissolve existing clots, and clotting factor concentrates are used to replace deficient clotting factors in bleeding disorders. Therefore, choices A, B, and E are not appropriate for preventing clot formation in this situation.

Question 19

The client states,"I've never had such trouble breathing.What is a pulmonary embolus anyway?" Which response by the nurse is the most appropriate?

Accepted Answer

A pulmonary embolus is when a portion of a blood clot breaks off from its original location (usually in the legs) and travels to the lung, causing a blockage in the blood vessels of the lung. Option A is incorrect because a pulmonary embolus is not stationary, but is moving. Option B is incorrect because an embolus is not a piece of an injured blood vessel, but is a foreign object, such as a blood clot or air bubble. Option D is incorrect because a pulmonary embolus does not cause necrosis of lung tissue but rather can cause areas of the lung to be deprived of oxygen.

Question 20

The client prescribed heparin therapy asks how the "blood thinner" works.Which response by the nurse is the most appropriate?

Accepted Answer

Heparin prevents the formation of blood clots by inhibiting the clotting factors thrombin and factor Xa. It does not dissolve existing clots, make blood less viscous, or decrease the number of platelets.

Quiz 38: Pharmacotherapy of Coagulation Disorders

How would a nurse explain the action of pentoxifylline (Trental) to a client?

As the nurse is completing the physical assessment of a client receiving heparin therapy for deep vein thrombosis (DVT) ,the client complains of severe lumbar pain.Which is the nurse's priority action?

A client has lost 50 pounds by following a diet that allows 1200 calories each day.Today's laboratory results reveal a significant decrease in platelets.Which foods should the nurse recommend the client add to the daily diet?

Assessment for deep vein thrombosis (DVT) is a priority for which client?

The nurse is providing discharge instruction to a client who is going home after a knee replacement.Which information regarding symptoms of deep vein thrombosis (DVT) should the nurse include?

The nurse is planning care for a client prescribed enoxaparin (Lovenox) .Which interventions should be included? Select all that apply.

Which class of drugs would the nurse expect to be prescribed to a client who is bleeding excessively at a surgical site?

The nurse is addressing a group of clients who have experienced thromboembolic disorders.One of the clients states,My dad had a problem with clotting too much and so does my brother." Before responding to this comment,the nurse considers which information?

A client is prescribed intermittent intravenous heparin therapy to treat deep vein thrombosis (DVT) .Which laboratory value should the nurse review prior to administering this medication?

A nurse assessing a client on a heparin drip notes bloody drainage in the nasogastric tube and indwelling urinary catheter.A stat partial thromboplastin time (PTT) is drawn according to heparin protocol.The result is 224 seconds.Which action by the nurse is the most appropriate?

Alteplase (Activase) is prescribed for a client with an acute myocardial infarction.Which is the priority nursing intervention for this client?

A client is maintained on warfarin (Coumadin) therapy secondary to refractory atrial fibrillation.Which statement by the client would alert the nurse to a possible problem with this therapy?

A clinic nurse is developing a teaching handout for clients who are prescribed warfarin (Coumadin) therapy.Which statements should be included in this information? Select all that apply.

A hospitalized client is prescribed warfarin (Coumadin) .The nurse teaches the client to avoid which food on the lunch selection menu?

A client with a newly placed prosthetic heart valve will be maintained on long-term anticoagulant therapy.Which medication does the nurse anticipate being used for this purpose?

The nurse is planning a teaching session for a client newly diagnosed with hemophilia A.Which information should be included?

An adult client is brought to the emergency department (ED) and diagnosed with a thrombotic stroke.The team plans to administer alteplase (Activase) .The client makes the following comments to a nurse.Which information is critical for the nurse to relay to the health care provider?

A client is being treated for a thromboembolic disorder.If the goal is to prevent clot formation,the nurse anticipates the client will be treated with which classifications of drug? Select all that apply.

The client states,"I've never had such trouble breathing.What is a pulmonary embolus anyway?" Which response by the nurse is the most appropriate?

The client prescribed heparin therapy asks how the "blood thinner" works.Which response by the nurse is the most appropriate?