A nurse is caring for a client who has a deep vein thrombosis, who received IV heparin for the past 5 days, and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?
"Heparin enhances the effects of the warfarin."
"Both heparin and warfarin work together to dissolve the clots."
"Heparin will be continued until the warfarin reaches a therapeutic level!"
"I will ask the charge nurse to call your provider and get an explanation"
The Correct Answer is C
A) "Heparin enhances the effects of the warfarin.": This statement is incorrect. Heparin and warfarin work through different mechanisms. Heparin acts quickly by inhibiting clot formation through antithrombin, while warfarin acts slower by inhibiting vitamin K-dependent clotting factors. They do not directly enhance each other's effects.
B) "Both heparin and warfarin work together to dissolve the clots.": This is inaccurate. Neither heparin nor warfarin dissolve existing clots; they prevent new clots from forming and existing clots from growing. The body's natural processes will eventually dissolve the clot.
C) "Heparin will be continued until the warfarin reaches a therapeutic level!": This is correct. Heparin is used initially because it acts quickly. Warfarin takes several days to reach therapeutic levels. Overlapping the two ensures continuous anticoagulation until warfarin is effective.
D) "I will ask the charge nurse to call your provider and get an explanation.": While involving the provider for further explanation can be helpful, it does not directly answer the client’s question. Providing accurate information about the overlapping use of heparin and warfarin is more appropriate in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Limit intake of Vitamin C while taking this medication:
Vitamin C enhances the absorption of iron from ferrous gluconate. Therefore, consuming foods rich in Vitamin C (such as citrus fruits or juices) alongside iron supplements can improve iron absorption. This instruction is incorrect because Vitamin C intake should be encouraged rather than limited.
B) Take this medication with milk:
Taking ferrous gluconate with milk or other dairy products is not recommended because calcium in dairy can inhibit iron absorption. It's preferable to take iron supplements with water or juice to maximize absorption.
C) Take this medication between meals:
Taking ferrous gluconate between meals enhances its absorption because the presence of food can reduce the absorption of iron. Taking it on an empty stomach (about 1 hour before meals or 2 hours after meals) is optimal for absorption.
D) Limit intake of whole grains while taking this medication:
Whole grains contain phytates that can inhibit iron absorption. Therefore, it is beneficial to avoid consuming whole grains at the same time as iron supplements. However, this instruction does not address the timing of medication intake, which is crucial for optimal absorption.
Correct Answer is B
Explanation
A) Peripheral edema:
Peripheral edema is not a common adverse effect of lactulose. Lactulose is typically used to treat constipation by increasing the water content and softening stools.
B) Diarrhea:
Diarrhea is a common adverse effect of lactulose due to its osmotic effect in the colon, which increases water retention and softens stools. Monitoring for diarrhea is important to prevent dehydration and electrolyte imbalances.
C) Dry mouth:
Dry mouth is not a common adverse effect of lactulose. Lactulose works by drawing water into the colon to soften stools, which does not typically affect salivary gland function or cause dry mouth.
D) Headache:
Headache is not a common adverse effect of lactulose. While rare, excessive diarrhea or dehydration resulting from lactulose use could potentially lead to headache, but it is not a direct effect of the medication itself.
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