A client is receiving heparin sodium 1000 units per hour via an infusion and warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg.
The nurse educates the client that heparin and warfarin are prescribed together because:
Smaller doses of both drugs can be used with this method.
This combination facilitates the thrombolysis more quickly.
The heparin provides anticoagulation until the warfarin becomes effective.
This combination provides immediate anticoagulation.
The Correct Answer is C
Choice A rationale
While it might seem that smaller doses of both drugs could be used when they are prescribed together, this is not the primary reason for using heparin and warfarin together. Both drugs have different mechanisms of action and are used for their unique therapeutic effects.
Choice B rationale
The combination of heparin and warfarin does not facilitate thrombolysis more quickly. Thrombolysis is the process of breaking down clots, and while these medications can prevent the formation of new clots, they do not actively break down existing ones.
Choice C rationale
Heparin and warfarin are often used together in the treatment of thrombophlebitis because they provide different benefits. Heparin acts quickly to prevent further clotting and allows the body to naturally break down existing clots. Warfarin, on the other hand, takes several days to become effective. Therefore, heparin is used to provide immediate anticoagulation until the warfarin becomes effective.
Choice D rationale
While it’s true that the combination of heparin and warfarin provides immediate anticoagulation, this is primarily due to the action of heparin. Warfarin takes several days to become effective, so it does not contribute to the immediate anticoagulant effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
55-year-old woman with coronary artery disease. While patients with coronary artery disease often have multiple comorbidities and may be on medications that could interact with Penicillin G, there is no specific increased risk of adverse reactions to Penicillin G in this population.
Choice B rationale
21-year-old college senior who is being treated for Streptococcus. Penicillin G is often used to treat Streptococcus infections. There is no specific increased risk of adverse reactions in this population unless the patient has a known allergy to penicillins.
Choice C rationale
23-year-old woman who recently delivered and has mastitis. Penicillin G can be used to treat mastitis, an infection of the breast tissue that results in breast pain, swelling, warmth, and redness. There is no specific increased risk of adverse reactions in this population unless the patient has a known allergy to penicillins.
Choice D rationale
65-year-old man with dehydration. Dehydration can affect kidney function, and Penicillin G is excreted by the kidneys. Therefore, patients with dehydration or any other condition that reduces kidney function are at a higher risk of adverse reactions to Penicillin G3.
Correct Answer is B
Explanation
Choice A rationale
Administering the PRN antianxiety medication is not the most appropriate next step. The client’s symptoms—shortness of breath, anxiety, restlessness, tachycardia, tachypnea, hypotension, and decreased oxygen saturation—are indicative of a potential pulmonary embolism, a life-threatening complication of deep vein thrombosis. While anxiety can be a symptom of a pulmonary embolism, treating it without addressing the underlying cause could delay necessary medical intervention.
Choice B rationale
Calling the rapid response team is the most appropriate next step. The client’s symptoms suggest a potential pulmonary embolism, a serious and life-threatening condition that requires immediate medical intervention. The rapid response team can provide the necessary urgent care.
Choice C rationale
Increasing the intravenous infusion rate is not the most appropriate next step. While hydration is important, it would not address the immediate life-threatening situation. The client’s symptoms suggest a potential pulmonary embolism, which requires immediate medical intervention.
Choice D rationale
Preparing for mechanical ventilation is not the most appropriate next step. While the client’s decreased oxygen saturation and increased respiratory rate suggest respiratory distress, the priority should be to address the potential pulmonary embolism. Mechanical ventilation may be necessary later depending on the client’s response to treatment.
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