A nurse is caring for a client who has a pulmonary embolism and has been on a heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
"Both heparin and warfarin work together to dissolve the clots."
"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."
"The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."
"I will call the provider to get a prescription for discontinuing the IV heparin today."
The Correct Answer is B
Choice A reason: Heparin and warfarin do not work together to dissolve clots. Heparin acts quickly to prevent further clotting, while warfarin is used for long-term anticoagulation.
Choice B reason: Warfarin's onset of action is slow, requiring several days to reach therapeutic levels. During this time, heparin is used to provide immediate anticoagulation to prevent new clot formation or the growth of existing clots.
Choice C reason: IV heparin does not increase the effects of warfarin. They are used concurrently because of the delay in warfarin's onset of action.
Choice D reason: It is not appropriate to discontinue heparin immediately after starting warfarin due to the delay in warfarin reaching therapeutic levels. The overlap is necessary to ensure continuous anticoagulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Dizziness and pallor are common vasomotor symptoms of early dumping syndrome. They result from the rapid shift of fluid into the intestine, leading to a decrease in blood volume and a temporary decrease in blood pressure.
Choice B reason: Abdominal cramping and pain are gastrointestinal symptoms of dumping syndrome but are not specifically vasomotor manifestations. They occur due to the rapid entry of hyperosmolar contents into the small intestine.
Choice C reason: Bradycardia is not typically a symptom of dumping syndrome. Instead, tachycardia is more commonly observed due to the body's response to the rapid changes in the gastrointestinal tract and blood volume.
Choice D reason: Double vision and chest pain are not typical symptoms of dumping syndrome. These symptoms may indicate other medical conditions and should be evaluated separately.
Correct Answer is D
Explanation
Choice A reason:Cardiac enzyme studies do not provide information about the heart's structure or the mobility of the heart valves; imaging studies are used for that purpose.
Choice B reason:While cardiac enzymes indicate damage to heart tissues, they do not pinpoint the exact location of an MI; imaging studies are needed for localization.
Choice C reason:Cardiac enzymes are not used to diagnose pulmonary congestion; they are specific markers for myocardial injury.
Choice D reason:Cardiac enzyme levels, such as troponin, rise when there is damage to the heart muscle, which is why they are used to assess the degree of damage after an MI.
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