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.

Answer and Explanation

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.

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Correct Answer is ["A","D"]

Explanation

A patient with a high aPTT result is at risk for bleeding, so assessing for signs and symptoms of bleeding is important.

Holding heparin therapy per protocol is also appropriate, as heparin is the cause of the prolonged aPTT.

The other choices are wrong because:

• Choice B is wrong because continuing heparin therapy at the current rate will increase the risk of bleeding and further prolong the aPTT.

• Choice C is wrong because decreasing heparin therapy per protocol is not enough to reverse the effects of heparin.

Heparin should be stopped until the aPTT returns to the therapeutic range.

• Choice E is wrong because increasing heparin therapy per protocol will worsen the situation and cause more bleeding and coagulation problems.

The normal range for aPTT is 25 to 35 seconds, and the therapeutic range for heparin therapy is 60 to 80 seconds.A result of 90 seconds indicates excessive anticoagulation and increased bleeding risk.

A. Unusual bleeding or bruising B. Blood in urine or stool C. Abdominal pain or swelling D. Headache or dizziness E. Shortness of breath.

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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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The patient has been receiving heparin therapy for deep vein thrombosis (DVT). The patient’s activated partial thromboplastin time (aPTT) result is 90 seconds (therapeutic range: 60-80 seconds). What will be included in patient care? (Select all that apply.).

Correct Answer is ["A","D"]

Explanation

A client who has atrial fibrillation is prescribed dabigatran etexilate mesylate (Pradaxa). The nurse should instruct the client to report which of the following findings immediately? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

A nurse is caring for a patient who has been prescribed apixaban (Eliquis) for deep vein thrombosis (DVT). Which instructions should be included in patient teaching? Select all that apply.

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?

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