A clinic nurse is preparing to teach student nurses about care of clients with viral pharyngitis. Which information should the nurse include in the teaching plan? Select all that apply.

A. Client develops ecchymosis at the venipuncture site. Minor bruising at venipuncture sites is a common and expected side effect of heparin therapy due to its anticoagulant effect. While the nurse should monitor for increased bruising, isolated ecchymosis at an IV site does not necessarily indicate excessive anticoagulation or require immediate provider notification.
B. PTT 70 seconds (control 25-40). Heparin therapy is adjusted based on the activated partial thromboplastin time (aPTT). The therapeutic range is typically 1.5 to 2.5 times the control value, which in this case would be approximately 60-100 seconds. A PTT of 70 seconds is within the therapeutic range, so it does not require urgent intervention.
C. Client develops hematuria. Hematuria is a sign of potential excessive anticoagulation or internal bleeding, which can be a serious complication of heparin therapy. This finding suggests that the client's coagulation status may need immediate reassessment, and the heparin infusion may require adjustment or reversal with protamine sulfate if necessary. The healthcare provider should be notified promptly.
D. Order for Coumadin 2.5 mg to begin today. It is common practice to start warfarin (Coumadin) while a client is on heparin therapy because warfarin takes several days to reach therapeutic levels. Heparin is typically continued until the INR reaches a therapeutic range. Therefore, this order does not require provider notification.

A. Vanilla ice cream: While ice cream may be soothing for a sore throat, it is not the most nutritious option for a client with bacterial pharyngitis. Although it provides calories and can help with throat discomfort, it lacks essential nutrients that support recovery and may not help with hydration, which is critical during illness.
B. Chicken noodle soup: This option can be beneficial due to its warm temperature and potential nutritional value, including protein and hydration. However, the heat of the soup may irritate a sore throat further, especially if it is too hot. It can be a good option, but care should be taken to ensure it is at a comfortable temperature for the client.
C. Hot herbal tea: While herbal tea can provide hydration and soothing effects, it may also irritate a sore throat if served too hot. The temperature of the tea is a consideration, as consuming very hot liquids can exacerbate throat discomfort. Therefore, while it can be helpful, it may not be the best option for promoting comfort.
D. Fruit-flavored popsicles: This is the most recommended option for promoting nutrition during treatment for bacterial pharyngitis. Popsicles are cold, which can soothe a sore throat and reduce inflammation. They are also hydrating, easy to swallow, and can provide some calories, making them a good choice for maintaining nutrition and comfort during recovery. This option balances soothing relief with hydration and nutrition effectively.