A client is receiving IV heparin and oral warfarin after a pulmonary embolism (PE). The nurse determines the client's activated partial prothromboplastin time (APTT) value is two times the control value; the prothrombin time (PT) level is the same as the control, and the international normalized ratio (INR) is 1. Which protocol prescription should the nurse implement?

Reference Range:

Activated Partial Prothromboplastin Time (APTT) [Anticoagulant therapy: 1.5 to 2 times the control value in seconds.] Prothromboplastin Time (PT) [Anticoagulant therapy: greater than 1.5 to 2 times the control value.] International Normalized Ratio (INR) [0.8 to 1.1]

The client is a 32-year-old multigravida at 28 weeks' gestation, who presents to the obstetrician's office for a routine prenatal visit. Obstetrical history reveals she has given birth three times; once at 35 weeks (twins), once at 38 weeks (singleton), and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks' gestation. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation.

The client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dl (9.1 mmol/L). Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 mg/dL (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L).

The nurse reviews nurses' notes to determine what the client's obstetric history reveals in the form of GTPAL.

Choose the most likely option for the information missing from the statement by selecting from the list of options provided.

Based on the client's obstetrical history, the client's G-T-P-A-L designation is

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) performing oral hygiene on an unconscious client who is lying in a flat side-lying position with an emesis basin on the bedside table near the chin. Which action should the PN take?

Review H and P, nurse's notes, laboratory results, orders, and imaging studies.

The child is showing only minor signs of impact from the submersion injury and will likely be discharged in the morning. The nurse would like to give some education to the parents before discharge.

What should the nurse include in pre-discharge education for this child's parents? Select all that apply.

The charge nurse brings a #18 urinary catheter with a 30 mL balloon to the practical nurse (PN) who is preparing to insert a catheter in a female client who weighs 50 kg. Which action should the PN take first?

An older female adult who was admited to a long-term care facility yesterday is confused about what day of the week it is. Her history does not indicate that she was confused prior to admission. What action should the practical nurse (PN) take?

Patient Data

Which are the nurse's best responses? Select all that apply.

The nurse identifies an electrolyte imbalance, elevated blood pressure, and exhibited changes in mental status for a client with chronic kidney disease. Which is the most important action for the nurse to take?

The birth weight of an infant delivered by a woman with gestational diabetes is 10.1 pounds (4,581 grams). The infant is jitery and has a heel stick glucose level of 40 mg/dL (2.2 mmol/L) 30 minutes after birth. Based on this information, which intervention should the practical nurse (PN) implement first?

Reference range:

Blood glucose neonate: [30 to 60 mg/dL or 1.7 to 3.3 mmol/L]

When conducting diet teaching for a client who is on a postoperative full-liquid diet, which food(s) should the nurse encourage the client to eat? (Select all that apply.)

Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important
for the practical nurse (PN) to review?