A nurse is caring for a client diagnosed with atrial fibrillation who is receiving continuous IV heparin. Which of the following findings is the nurse's priority?

The client has an INR of 2.

The client has an aPTT of 80 seconds.

The client experiences sudden weakness of one arm and leg.

The client's ECG tracing shows irregular heart rate without P waves.

Answer and Explanation

The Correct Answer is C

A. An INR of 2 is within the therapeutic range for anticoagulation but is more relevant for warfarin therapy rather than heparin.
B. An aPTT of 80 seconds is slightly elevated but not immediately life-threatening. The therapeutic range for heparin is typically 1.5 to 2.5 times the normal value (approximately 60-80 seconds).
C. Sudden weakness of one arm and leg suggests a possible embolic stroke, which is a serious complication of atrial fibrillation. This requires immediate assessment and intervention.
D. An irregular heart rate without P waves is characteristic of atrial fibrillation but is not the most urgent concern compared to potential stroke symptoms.

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Correct Answer is B

Explanation

A. Avoiding sick contacts is generally a good practice, but it is not the primary concern for a client with infective endocarditis. The focus is on preventing bacterial infections that could enter the bloodstream and affect the heart valves.
B. Prophylactic antibiotics are required before dental and invasive procedures to prevent bacterial endocarditis recurrence. The bacteria that cause infective endocarditis can enter the bloodstream through procedures that involve mucosal surfaces.
C. Discontinuing antibiotics when feeling better is incorrect. Infective endocarditis requires a full course of IV antibiotics, often lasting 4 to 6 weeks, to fully eradicate the infection and prevent complications.
D. Avoiding physical activity for six months is unnecessary unless the client has severe cardiac complications. However, clients should monitor for symptoms such as fatigue and consult their provider before engaging in strenuous activities.

A. Lanoxin increases the force of cardiac contractions. B. Lanoxin decreases the force of cardiac contractions. C. Lanoxin order should be questioned in this diagnosis. D. Lanoxin increases the heart rate.

Correct Answer is A

Explanation

A. Digoxin is a positive inotropic agent, meaning it increases the force of cardiac contractions. This helps improve cardiac output in patients with heart failure.
B. Digoxin does not decrease the force of contractions; instead, it strengthens them, making it beneficial for heart failure treatment.
C. Digoxin is commonly used in heart failure management, particularly in cases of systolic dysfunction or atrial fibrillation.
D. Digoxin decreases heart rate by slowing conduction through the atrioventricular (AV) node, making it useful in atrial fibrillation, but its primary benefit in heart failure is increasing contractility.

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A nurse is caring for a client diagnosed with atrial fibrillation who is receiving continuous IV heparin. Which of the following findings is the nurse's priority?

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Naxlex Comprehensive Predictor Exams

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