A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?
A serum sodium (Na)
A radiological examination of the chest
A blood urea nitrogen (BUN)
An international normalized ratio (INR)
The Correct Answer is D
A. Serum sodium levels are typically assessed to evaluate electrolyte balance and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
B. This could be ordered for various reasons such as assessing lung status or identifying any abnormalities in the chest. It is not directly related to monitoring warfarin therapy.
C. BUN levels are measured to assess kidney function and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
D. The INR is a standardized measurement of the blood's ability to clot. Warfarin works by inhibiting vitamin K-dependent clotting factors, thereby prolonging the time it takes for blood to clot. The INR is used to monitor and adjust warfarin dosage to maintain therapeutic anticoagulation levels, especially in patients with conditions like atrial fibrillation who are at risk of blood clots.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hemoglobin levels are important for assessing oxygen-carrying capacity of the blood. While anemia can affect tissue oxygenation and exacerbate symptoms in heart failure, it is not directly related to the risk of digoxin toxicity.
B. Creatinine levels are used to assess kidney function. Impaired kidney function can affect the clearance of digoxin from the body, potentially increasing the risk of toxicity. However, potassium levels have a more direct impact on the risk of digoxin toxicity.
C. BUN levels are also used to assess kidney function. Similar to creatinine, impaired kidney function can affect digoxin clearance, but potassium levels are more directly related to the risk of digoxin toxicity.
D. Potassium levels are critical because hypokalemia (low potassium) can predispose the client to digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in cardiac cells. When potassium levels are low, digoxin can bind more readily to these pumps, leading to increased toxicity and potentially life-threatening arrhythmias such as ventricular tachycardia or ventricular fibrillation.
Correct Answer is B
Explanation
A. It is particularly sensitive to deficiencies in clotting factors, but it does not measure the deficiencies themselves
B. The activated partial thromboplastin time (aPTT) test measures the effectiveness of the intrinsic and common pathways of the coagulation cascade.
C. There is no need to skip breakfast or alter diet for an aPTT test. It is not affected by food intake or fasting status.
D. While aPTT is used to monitor heparin therapy, it is not typically used to monitor warfarin (a vitamin K antagonist) therapy. Warfarin therapy is usually monitored using the prothrombin time (PT) and international normalized ratio (INR) tests.
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