A nurse is caring for a client who has been taking warfarin and has a prothrombin time of 30 seconds and an INR of 7. Which of the following medications should the nurse anticipate the provider to prescribe?

A. Prayer: Prayer and meditation are practices that focus on the mind-body connection and can be used for relaxation, stress reduction, and promoting inner peace. These practices are often included in CAM approaches.

B. Yoga: Yoga combines physical postures, breathing exercises, and meditation. It can improve flexibility, strength, balance, and overall well-being, making it a popular CAM therapy.

C. Massage: Massage therapy involves manipulating the soft tissues of the body to promote relaxation, pain relief, and improved circulation. It's a widely used CAM therapy.

D. Meditation: Meditation involves focusing your attention and quieting the mind. It can promote relaxation, reduce stress, and improve emotional well-being, aligning with CAM principles.

E. Ointments with a steroid base: Steroid creams are medications typically prescribed by doctors for specific skin conditions. While some natural remedies might be used topically in CAM, ointments with a steroid base wouldn't be considered a CAM therapy itself.

A. Use a 22-gauge needle to inject the medication.

This is inappropriate. Subcutaneous injections typically require a smaller gauge needle, usually between 25 to 30 gauge, to minimize tissue damage and discomfort. A 22-gauge needle is too large for subcutaneous injections and is more appropriate for intramuscular injections.

B. Inject the medication into the abdomen above the level of the iliac crest.

This is appropriate. The preferred site for subcutaneous heparin injection is the abdomen, avoiding areas near the umbilicus by at least 2 inches. Injecting above the level of the iliac crest is appropriate as it ensures the medication is administered into the subcutaneous tissue where it can be properly absorbed. The abdomen is chosen due to its ample subcutaneous tissue and relatively few large blood vessels, reducing the risk of bleeding and bruising.

C. Massage the injection site after administration of the medication.

This is inappropriate. Massaging the injection site after administering heparin is not recommended as it can cause bruising and increase the risk of bleeding. Heparin is an anticoagulant, and massaging the site can disrupt the tissue and lead to complications.

D. Use a 1-inch needle to inject the medication.

This is inappropriate. A 1-inch needle is generally used for intramuscular injections, not subcutaneous injections. For subcutaneous injections, a shorter needle (usually 3/8 to 5/8 inch) is sufficient to reach the subcutaneous tissue without penetrating too deeply into muscle tissue.