A nurse is caring for a client who has atrial fibrillation and is receiving warfarin therapy to prevent thromboembolism formation. The nurse should monitor which of the following laboratory values to determine the effectiveness of the medication?
Activated partial thromboplastin time (aPTT)
Prothrombin time (PT)
International normalized ratio (INR)
Platelet count.
The Correct Answer is C
Warfarin is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors. The INR is a standardized measure of the prothrombin time (PT), which reflects the degree of anticoagulation. The therapeutic range for INR is 2 to 3 for most conditions, and higher for some mechanical heart valves.
Choice A) Activated partial thromboplastin time (aPTT) is wrong because it is used to monitor heparin therapy, not warfarin therapy.
Heparin is another anticoagulant that works by activating antithrombin III, which inhibits thrombin and factor Xa. The therapeutic range for aPTT is 1.5 to 2.5 times the normal value, which is 30 to 40 seconds.
Choice B) Prothrombin time (PT) is wrong because it is not a standardized measure of the warfarin effect.
The PT can vary depending on the reagents and methods used by different laboratories. The INR was developed to eliminate this variability and provide a consistent measure of the warfarin effect.
Choice D) Platelet count is wrong because it is not affected by warfarin therapy.
Warfarin does not affect the number or function of platelets, only the clotting factors. Platelet count can be used to monitor other conditions that affect hemostasis, such as thrombocytopenia or thrombocytosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend acetaminophen, which is the safest pain reliever while taking warfarin.Acetaminophen does not interfere with the anticoagulant effect of warfarin and does not increase the risk of bleeding.
Choice A is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can enhance the anticoagulant effect of warfarin and increase the likelihood of harmful bleeding.
NSAIDs can also cause stomach ulcers, kidney damage, and high blood pressure.
Choice B is wrong because naproxen is another NSAID that has the same risks as ibuprofen.
Naproxen should be avoided by patients taking warfarin.
Choice D is wrong because aspirin is also an anticoagulant that can increase the risk of bleeding when taken with warfarin.
Aspirin can also cause stomach irritation, ulcers, and allergic reactions.
The normal range for INR is 2 to 3 for patients with atrial fibrillation who are taking warfarin.
An INR of 2.5 indicates that the patient’s blood is taking longer to clot than normal, but not too long.
The patient should have regular blood tests to monitor their INR and adjust their warfarin dose if needed.
Correct Answer is ["A","C","E"]
Explanation
Apixaban (Eliquis) is a blood thinner that prevents blood clots from forming or growing larger.
It is used to treat or prevent deep vein thrombosis (DVT), a condition in which a blood clot forms in a vein deep in the body, usually in the legs.
It can also prevent pulmonary embolism (PE), a condition in which a blood clot breaks off and travels to the lungs, blocking blood flow and causing breathing problems.
Patients taking apixaban should follow these instructions:
• Avoid activities that may cause injury.
Apixaban can increase the risk of bleeding, so patients should be careful not to cut or bruise themselves.
They should use a soft toothbrush, an electric razor, and avoid contact sports or other activities that may cause bleeding.They should also wear a medical alert bracelet or carry an identification card that states they are taking apixaban.
• Report signs and symptoms of bleeding immediately.Patients should notify their doctor or seek emergency care if they have any signs of bleeding, such as unusual bruising, red or black stools, blood in the urine, coughing up blood, vomiting blood, nosebleeds, heavy menstrual bleeding, headaches, dizziness, weakness, or swelling.
• Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).
These drugs can also increase the risk of bleeding and interfere with the effects of apixaban.
Patients should avoid taking aspirin, ibuprofen, naproxen, or other NSAIDs unless prescribed by their doctor.They should also check the labels of any over-the-counter medications or supplements they use and avoid those that contain aspirin or NSAIDs.
Choice B and D are wrong because:
• Take medication with food.Apixaban can be taken with or without food.Taking it with food does not affect its absorption or efficacy.
Therefore, this instruction is not necessary for patients taking apixaban.
• Monitor vital signs regularly.Apixaban does not affect blood pressure, heart rate, or oxygen saturation.
Therefore, monitoring vital signs regularly is not required for patients taking apixaban.However, patients should still follow their doctor’s advice on how often to check their blood tests, such as hemoglobin, hematocrit, and platelets.
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