A client has a prescription for heparin 5000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client’s medication drawer. Which action should the nurse implement?
Request a prescription to change the route of administration and use the available heparin.
Calculate and administer the equivalent dose of the available low molecular weight heparin.
Dilute the available heparin in 250 ml of normal saline solution prior to IV administration.
Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately.
The Correct Answer is D
Choice A reason:
Requesting a prescription to change the route of administration and use the available heparin is not appropriate. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable on a unit-for-unit basis. They have different pharmacokinetics and dosing requirements. Changing the route without proper guidance can lead to incorrect dosing and potential complications.
Choice B reason:
Calculating and administering the equivalent dose of the available low molecular weight heparin is incorrect. LMWH and UFH have different dosing protocols and are not directly interchangeable. Administering LMWH instead of UFH without proper conversion and guidance can result in inappropriate anticoagulation.
Choice C reason:
Diluting the available heparin in 250 ml of normal saline solution prior to IV administration is not appropriate. The prescription specifies heparin 5000 units IV STAT, which indicates an immediate need for intravenous administration. Diluting and administering it in this manner does not align with the urgency of the order.
Choice D reason:
Advising the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately is the correct action. This ensures that the client receives the prescribed medication in the correct form and dosage as ordered by the healthcare provider. It is crucial to follow the specific instructions for heparin administration to ensure patient safety and effective anticoagulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Applying warm compresses to the legs can help relieve muscle cramps, but it is not the most urgent intervention. Muscle cramps can be a sign of electrolyte imbalances, which are common side effects of furosemide. However, the presence of palpitations and tiredness suggests a more serious issue that needs immediate attention.
Choice B reason:
Monitoring intake and output is important for patients on furosemide to assess fluid balance and kidney function. However, this action does not address the immediate concern of potential cardiac issues indicated by palpitations and tiredness.
Choice C reason:
Raising the head of the bed can help alleviate respiratory symptoms such as a cough, but it does not address the potential cardiac complications. The presence of palpitations and tiredness suggests that cardiac monitoring is a higher priority.
Choice D reason:
Placing the client on cardiac monitoring is the most critical action. Furosemide can cause electrolyte imbalances, leading to arrhythmias and other cardiac issues. Given the symptoms of palpitations and tiredness, immediate cardiac monitoring is essential to detect and manage any potential life-threatening arrhythmias.
Correct Answer is A
Explanation
Choice A reason:
Measuring the client’s blood pressure is the most direct and effective way to assess the effectiveness of amlodipine. Amlodipine is a calcium channel blocker primarily used to treat hypertension and angina. Its main action is to relax the blood vessels, which lowers blood pressure. Regular monitoring of blood pressure helps determine if the medication is achieving its intended effect.
Choice B reason:
Monitoring the client’s serum electrolytes is important for overall health, but it is not the primary method to assess the effectiveness of amlodipine. Amlodipine does not significantly affect serum electrolyte levels, so this action would not provide specific information about the drug’s effectiveness.
Choice C reason:
Noting the client’s serum calcium levels is not necessary for assessing the effectiveness of amlodipine. Amlodipine does not alter serum calcium levels, as its mechanism of action involves blocking calcium channels in the blood vessels, not affecting calcium levels in the blood.
Choice D reason:
Reviewing the client’s intake and output can be useful for monitoring fluid balance and kidney function, but it is not the primary method to assess the effectiveness of amlodipine. This action does not directly measure the drug’s impact on blood pressure.
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