A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer?
Warfarin
Vitamin K
Heparin
Ferrous sulfate
The Correct Answer is B
A. Warfarin:
Warfarin is an anticoagulant that works by inhibiting the synthesis of certain clotting factors, including factors II, VII, IX, and X. While it is used to prevent thromboembolic events, in a client with cirrhosis and an elevated PT, the priority is addressing the coagulation factor deficiency rather than adding an anticoagulant.
B. Vitamin K:
Vitamin K is the antidote for warfarin, and it helps in the synthesis of clotting factors. In cirrhosis, there can be impaired synthesis of clotting factors due to liver dysfunction. Administering vitamin K can aid in correcting coagulation abnormalities.
C. Heparin:
Heparin is another anticoagulant, but it does not reverse the effects of warfarin. It works by a different mechanism and is typically used in acute settings, such as deep vein thrombosis or pulmonary embolism. It is not the primary intervention for an elevated PT in cirrhosis.
D. Ferrous sulfate:
Ferrous sulfate is an iron supplement and is not indicated for the correction of an elevated PT. Iron supplements are typically used to address iron deficiency anemia.
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Related Questions
Correct Answer is C
Explanation
A. Calcium:
While calcium levels can be affected in pancreatitis, it is more commonly associated with a decrease in calcium levels due to fat necrosis and the formation of calcium soaps. However, the primary electrolyte disturbance is more likely to involve magnesium.
B. Magnesium:
Magnesium levels may be decreased in acute pancreatitis due to factors such as vomiting, malabsorption, and poor oral intake. Hypomagnesemia is a possible consequence, but it's not as specific to pancreatitis as the elevation of amylase.
C. Amylase:
Elevated amylase levels are a hallmark of acute pancreatitis. Amylase is an enzyme released by the pancreas, and its elevation in the blood is a key diagnostic marker for pancreatitis.
D. RBC count:
Acute pancreatitis does not typically result in a significant impact on the red blood cell (RBC) count. The elevation of amylase and lipase levels, along with imaging studies, is more indicative of pancreatitis.
Correct Answer is A
Explanation
A. Regular insulin:
Regular insulin, also known as short-acting insulin, is commonly used in the initial management of diabetic ketoacidosis. It has a relatively rapid onset of action, making it suitable for addressing the acute and severe nature of DKA.
B. Insulin detemir:
Insulin detemir is a long-acting insulin analog. It is not the preferred choice for addressing the acute insulin needs in DKA; instead, it is used for basal insulin requirements in the maintenance phase of diabetes management.
C. Insulin glargine:
Insulin glargine is a long-acting insulin analog used for basal insulin coverage. Like insulin detemir, it is not the first choice for addressing the acute insulin needs in the initial treatment of DKA.
D. NPH insulin:
NPH (Neutral Protamine Hagedorn) insulin is an intermediate-acting insulin. While it has a role in diabetes management, it is not the preferred choice for the initial treatment of DKA. NPH insulin has a slower onset and longer duration compared to regular insulin.
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