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: Administering oxygen therapy is the first and immediate intervention for a client with a pulmonary embolism to address hypoxemia.
Choice B reason: Starting an IV infusion of Lactated Ringer's is important for fluid resuscitation but is not the first intervention for pulmonary embolism.
Choice C reason: Initiating cardiac monitoring is important for observing the client's heart function but comes after ensuring the client is receiving adequate oxygen.
Choice D reason: Giving morphine IV may be used for pain management in pulmonary embolism but is not the first-line intervention.
Correct Answer is A
Explanation
Choice A reason: Frequent nosebleeds and bruising are indicative of coagulopathy, a common complication in advanced cirrhosis due to the liver's impaired ability to synthesize clotting factors. This can lead to an increased tendency to bleed.
Choice B reason: Urinary retention is not typically associated with cirrhosis. Instead, cirrhosis can lead to renal dysfunction known as hepatorenal syndrome, characterized by the failure of the kidneys to filter waste from the blood².
Choice C reason: While constipation can occur in cirrhosis, no bowel movement in three days is not a direct complication of cirrhosis. However, it could be related to the overall health status of the patient or medications used.
Choice D reason: Increased blood glucose is not a direct complication of cirrhosis. Cirrhosis primarily affects the metabolism of proteins and fats and does not directly cause hyperglycemia unless there is concurrent diabetes or metabolic syndrome.
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