A nurse is caring for a client who is receiving argatroban IV for HIT and requires urgent surgery. The nurse should stop the infusion at least how many hours before the surgery?
2 hours
4 hours
6 hours
8 hours.
The Correct Answer is B
Argatroban is a direct thrombin inhibitor (DTI) that is used as an alternative anticoagulant for patients with heparin-induced thrombocytopenia (HIT) who require urgent surgery. Argatroban has a half-life of about 40 to 50 minutes and is cleared by the liver. The infusion should be stopped at least 4 hours before the surgery to allow adequate time for the anticoagulant effect to wear off. The activated partial thromboplastin time (aPTT) should be monitored before and after the infusion to assess the degree of anticoagulation.
Choice A is wrong because 2 hours is not enough time to stop the argatroban infusion before surgery.
The patient may still have a high risk of bleeding if the aPTT is prolonged.
Choice C is wrong because 6 hours is longer than necessary to stop the argatroban infusion before surgery.
The patient may have a higher risk of thrombosis if the anticoagulation effect is too low.
Choice D is wrong because 8 hours is much longer than necessary to stop the argatroban infusion before surgery.
The patient may have a very low level of anticoagulation and a high risk of thrombosis if the infusion is stopped for too long.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is ["A","B","C"]
Explanation
Dabigatran etexilate mesylate (Pradaxa) is a medication that prevents blood clots and reduces the risk of stroke in patients with atrial fibrillation.
However, it can also cause bleeding as a side effect.
Therefore, the nurse should instruct the client to report any signs of unusual bleeding or bruising, blood in urine or stool, or abdominal pain or swelling immediately.These could indicate a serious complication such as gastrointestinal bleeding, hemorrhage, or internal organ damage.
Choice D, headache or dizziness, is not a correct answer.
Although these symptoms could be caused by dabigatran, they are not as serious or urgent as bleeding.
They could also be due to other factors such as dehydration, low blood pressure, or stress.The nurse should advise the client to monitor these symptoms and seek medical attention if they persist or worsen.
Choice E, shortness of breath, is not a correct answer.
Shortness of breath is not a common side effect of dabigatran.
However, it could be a symptom of atrial fibrillation or its complications such as heart failure or stroke.The nurse should educate the client about the signs and symptoms of these conditions and instruct them to call 911 if they experience chest pain, palpitations, fainting, or weakness.
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