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 C

Explanation

A. Holding all medications is not necessary; only certain medications that affect heart rate or blood pressure are held.
B. Keflex (Cephalexin) is an antibiotic and does not affect stress test results, so it should not be held.
C. Tenormin (Atenolol) is a beta-blocker that reduces heart rate and can interfere with the stress test by blunting the expected heart rate response. Beta-blockers are typically held before an exercise stress test.
D. Heparin is an anticoagulant and does not impact the stress test results.

A. NSTEMI B. Stable Angina C. Unstable Angina D. STEMI

Correct Answer is D

Explanation

A. NSTEMI (Non-ST Elevation Myocardial Infarction) does not present with ST-segment elevation on the ECG. Instead, it shows ST-segment depression or T-wave inversion and is diagnosed with elevated cardiac biomarkers.
B. Stable angina is predictable chest pain that occurs with exertion and is relieved by rest or nitroglycerin. It does not cause acute ECG changes.
C. Unstable angina is characterized by chest pain that occurs at rest or with minimal exertion and is not relieved by nitroglycerin. However, it does not show ST-segment elevation or myocardial infarction markers.
D. STEMI (ST-Elevation Myocardial Infarction) is diagnosed when there is ST-segment elevation in two or more contiguous ECG leads, indicating complete occlusion of a coronary artery and requiring immediate intervention such as percutaneous coronary intervention (PCI) or thrombolytic therapy.

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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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