A nurse is caring for a client diagnosed with atrial fibrillation and is receiving heparin. Which of the following findings is the nurse's priority?
The client experiences sudden weakness of one arm and leg
The client's ECG tracing shows irregular heart rate without P waves.
The client's urine output is cloudy and odorous.
The client has an aPTT of 80 seconds.
The Correct Answer is A
Rationale:
A. Sudden weakness of one arm and leg may indicate a stroke, which is a potential complication of atrial fibrillation.
B. An irregular heart rate without P waves is characteristic of atrial fibrillation and is expected.
C. Cloudy and odorous urine may indicate a urinary tract infection but is not the priority in this case.
D. An aPTT of 80 seconds is within the therapeutic range for heparin therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Hypocalcemia is a decreased level of calcium in the blood and is not associated with furosemide use.
B. Hypernatremia is an increased level of sodium in the blood and is not associated with furosemide use.
C. Hyperkalemia is an increased level of potassium in the blood and is not associated with furosemide use.
D. Hypokalemia is a decreased level of potassium in the blood and is a major adverse effect of furosemide use.
Correct Answer is D
Explanation
A. Radiofrequency catheter ablation is a long-term treatment for recurrent VT, not an immediate intervention.
B. CPR is indicated for pulseless VT, but this client has a carotid pulse.
C. Defibrillation is used for pulseless VT or ventricular fibrillation, but this client is still perfusing.
D. Synchronized cardioversion is the appropriate treatment for unstable VT with a pulse, as it delivers a timed shock to restore normal rhythm.
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