A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin?
Activated partial thromboplastin time (APTT)
Bleeding time
Prothrombin time (PT)
Hemoglobin (Hgb)
The Correct Answer is C
warfarin inhibits vitamin K epoxide reductase interfering with the synthesis of vitamin K dependent clotting factors (II, VII, IX, and X). This prolongs the prothrombin time, expressed in the form of INR international normalized ratio. Monitoring of INR helps to ensure that the prescribed dosages are within the therapeutic levels without increasing the risk of bleeding. The target INR range is between 2.5 and 3.5.
A. Used to monitor heparin therapy
B, D- not used for monitoring
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Related Questions
Correct Answer is A
Explanation
Trough levels should be taken immediately to ensure that the drug levels are at the lowest. Peak levels are taken 30-45mins after the infusion as the drug levels rises rapidly reaching a peak level
B, D- The timings of measurement are closely related to the administration of the drug
C- Peak levels are taken after administration and trough levels after an d not vice versa
Correct Answer is D
Explanation
During the first week or last week of a 28-day cycle pack of oral contraceptives increases the risk of contraceptive failure. However, the client should take the missed dose as soon as they remember, even if it means taking two pills in one day. After taking the missed dose, the client should continue taking the remaining pills in the pack at the usual time, one pill per day. Due to increased risk of failure, client should use an emergency pill or condom for the next 7 days
A -stopping the pills and switching to a different contraceptive method is not necessary after missing one dose
B –missing a pill does not automatically indicate pregnancy. Testing can be considered in presence of typical signs and symptoms of pregnancy
C- abstaining from vaginal intercourse until after the next period is not necessary. Risk of pregnancy can be addressed by use of back up contraception like condoms.
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