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This activity contains 10 questions.
The client develops blood loss due to a ruptured blood vessel in the leg. The coagulation process is initiated through:
The intrinsic pathway.
The extrinsic pathway.
The clotting cascade.
The platelet meshwork.
The nurse's understanding of the clotting mechanism is important in administering anticoagulant drugs. The nurse understands that which of the following clotting factors are formed after injury to the vessels?
Fibrin; vitamin K
The client receiving heparin therapy asks how the "blood thinner" works. The best response by the nurse would be:
"Heparin makes the blood less viscous."
"Heparin dissolves the clot."
"Heparin does not thin the blood, but prevents platelets from clumping."
"Heparin decreases the number of platelets, so that blood clots slower."
Nursing interventions for a client receiving enoxaparin (Lovenox) may include:
Teaching the client or family to give subcutaneous injections at home.
Monitoring multiple lab tests.
Teaching to observe for excessive bleeding.
Monitoring for development of deep vein thrombosis.
The nurse explains the action of pentoxifylline (Trental) to the client. The drug acts by:
Decreasing platelet aggregation.
Reducing the viscosity of red blood cells.
Increasing platelet production.
The nurse completes a physical assessment on the client receiving heparin therapy for DVT. The client complains of severe lumbar pain. The appropriate action by the nurse is to:
Reposition the client to promote comfort.
Document the finding, and report it to the next shift.
Administer pain medication.
Evaluate further; this could indicate a complication of drug therapy.
The nurse receives the client's lab values throughout Coumadin drug therapy. The expected therapeutic level is:
APTT 25-40 seconds.
APTT 1-2 times the client's baseline.
PT 1-2 times the client's baseline.
The client is prescribed enoxaparin (Lovenox). The initial dosage of the drug is determined by:
The client's weight.
Alteplase (Activase) is prescribed for a client with an acute myocardial infarction. Priority nursing action includes:
Monitoring PT, INR.
Monitoring level of consciousness (LOC).
Monitoring injection sites.
Warfarin (Coumadin) is prescribed to treat clotting following a surgery. Which of the following findings requires immediate nursing intervention?
INR of 3.0
Positive Homans' sign
Tylenol (acetaminophen) prescribed for headache
Urinary output 1,000 ml/day
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