Exam (elaborations)
Perfusion Questions (Ati and Saunders).
Perfusion Questions (Ati and Saunders).
[Show more]
Content preview
Perfusion Questions (Ati and Saunders)A client with atrial fibrillation is receiving a continuous heparin infusion at 1000
units/hr. The nurse would determine that the client is receiving the therapeutic
effect based on which of the following results?
1. Prothrombin time of 12.5 seconds
2. Activated partial thromboplastin time of 60 seconds
3. Activated partial thromboplastin time of 28 seconds
4. Activated partial thromboplastin time longer than 120 seconds - correct
answer-2. Activated partial thromboplastin time of 60 seconds
Common laboratory ranges for activated partial thromboplastin time (aPTT)
are 30 to 40 seconds. Because the aPTT should be 1.5 to 2.5 times the
normal value, the client's aPTT would be considered therapeutic if it was 60
seconds. Prothrombin time assesses the response to warfarin therapy.
The nurse provides discharge instructions to a client who is taking warfarin
sodium,. Which statement, by the client, reflects the *need for further
teaching*?
1. "I will avoid alcohol consumption"
2. "I will take my pills every day at the same time"
3. "I have already called my family to pick up a MedicAlert bracelet."
4. I will take coated aspirin for my headaches because it will coat my
stomach." - correct answer-4. I will take coated aspirin for my headaches
because it will coat my stomach."
Aspirin-containing products need to avoided when a client is taking this
medication. Alcohol consumption should be avoided by a client taking warfarin
sodium. Taking the prescribed medication at the same time each day
increases client compliance. The MedicAlert bracelet provided health care
personnel with emergency information.
A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L
(3 mmol/L) and is complaining of anorexia. The HCP prescribes a serum
digoxin level to be done. The nurse checks the results and should expect to
note which level that is outside of the therapeutic range?
,1. 0.3 ng/ml
2. 0.5 ng/ml
3. 0.8 ng/ml
4. 1.0 ng/ml - correct answer-4. 1.0 ng/dl
The optimal therapeutic range for digoxin is 0.5 to 0.8 ng/ml. If the client is
experiencing symptoms such as anorexia and is experiencing hypokalemia as
evidenced by a low potassium level, digoxin toxicity is a concern. Therefore,
option 4 is correct because it is outside of the therapeutic level and an
elevated level.
A client is being treated with procainamide for a cardiac dysrhythmia.
Following IV administration of the medication, the client complains of
dizziness. What interventions should the nurse take *first*?
1. Measure the heart rate on the rhythm strip.
2. Administer prescribed nitroglycerine tablets.
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client's apical pulse and obtain a blood pressure. - correct
answer-4. Auscultate the client's apical pulse and obtain a blood pressure.
Signs of toxicity from procainamide include confusion, dizziness, drowsiness,
decreased urination, nausea, vomiting, and tachydysrhythmias. If the client
complains of dizziness, the nurse should assess the vital signs first. Although
measuring the heart rate on the rhythm strip and obtaining a 12-lead
electrocardiogram ay be interventions, these would be done after the vital
signs are taken. Nitroglycerin is a vasodilator and will lower the blood
pressure.
The nurse is monitoring a client who is taking propranolol (Inderal LA). Which
assessment data indicates a potential adverse complication associated with
this medication?
1. The development of complaints of insomnia.
2. The development of auditory expiratory wheezes.
3. a baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mmHg after two doses of the medication.
4. A baseline resting heart rate of 88 beats/minute followed by a resting heart
rate of 72 beats/minute after two doses of the medication. - correct answer-2.
The development of auditory expiratory wheezes.
, Audible expiratory wheezes may indicate a serious adverse reaction,
bronchospasm. Beta blockers may induce this reaction, particularly in clients
with chronic obstructive pulmonary disease or asthma. Normal decreases in
blood pressure and hear rate are expected. Insomnia is a frequent mild side
effect and should be monitored.
A client with a clot in the right atrium is receiving a heparin sodium infusion at
1000 units/hour and warfarin sodium 7.5 mg at 5:00 pm daily. The morning
laboratory results are as follows: activated partial thromboplastin time (aPTT),
32 seconds; international normalized ratio (INR), 1.3. The nurse should take
which action based on the clients laboratory results?
1. Collaborate with the HCP to discontinue the heparin infusion and administer
the warfarin sodium as prescribed.
2. Collaborate with the HCP tp obtain a prescription to increase the heparin
infusion and administer the warfarin sodium as prescribed.
3. Collaborate with the HCP to withhold the warfarin sodium since the client is
receiving a heparin infusion and the aPTT is within the therapeutic range.
4. Collaborate withe the HCP to continue the heparin infusion at the same rate
and to discuss the use of dabigatran etexilate in place of warfarin sodium -
correct answer-2. Collaborate with the HCP tp obtain a prescription to
increase the heparin infusion and administer the warfarin sodium as
prescribed.
When a client is receiving warfarin for clot prevention due to atrial fibrillation,
an INR of 2 to 3 is appropriate for most clients. Until the INR has achieved a
therapeutic range, the client should be maintained on a continuous heparin
infusion with the aPTT ranging between 60 and 80 seconds. Therefore, the
nurse should collaborate withe the HCO to obtain a prescription to increase
the heparin infusion and to administer the warfarin as prescribed.
A client is diagnosed ST segment elevation myocardial infarction (STEMI) and
is receiving a tissue plasminogen activator, alteplase. Which action is a
*priority* nursing intervention?
1. Monitor for kidney failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller topgradesdr. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £6.36. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
82871 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy revision notes and other study material for 14 years now