A nurse is caring for a client who is receiving heparin by continuous IV infusion for treatment of venous thrombosis. Which of the following laboratory values should the nurse monitor for in order to titrate the heparin dose?
Platelet function assay
aPTT
INR
Amylase
The Correct Answer is B
When caring for a client receiving heparin by continuous IV infusion for the treatment of venous thrombosis, the nurse should monitor the client's aPTT (Activated Partial Thromboplastin Time) to titrate the heparin dose.
Heparin is an anticoagulant medication used to prevent and treat blood clots. The aPTT is a coagulation test that measures the time it takes for the blood to clot when a specific activator is added. Monitoring the aPTT is a standard method for assessing the anticoagulant effect of heparin and ensuring that the client's blood remains within the desired therapeutic range.
The therapeutic range for aPTT while on heparin therapy varies depending on the indication and the client's condition but is generally maintained at a level that prolongs the clotting time enough to prevent and treat thrombosis while avoiding excessive bleeding risk.
Let's go through the other options:
A. Platelet function assay: While monitoring platelet function is essential for assessing overall hemostasis and platelet function, it is not specifically used for titrating heparin doses. Platelet function assays are more commonly used to assess the function of platelets in the context of platelet disorders or antiplatelet medication therapy.
C. INR (International Normalized Ratio): The INR is used to monitor the effect of vitamin K antagonist anticoagulants, such as warfarin, and is not the appropriate test for monitoring heparin therapy.
D. Amylase: Amylase is an enzyme produced by the pancreas and salivary glands and is not relevant for monitoring heparin therapy. Elevated amylase levels are typically associated with pancreatitis and not related to heparin treatment.
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Related Questions
Correct Answer is B
Explanation
A nurse who is caring for a preschooler should question a prescription for tetracycline. Tetracycline is contraindicated in children under 8 years of age due to its potential to cause permanent discoloration and damage to developing teeth and bones. This adverse effect is known as tooth staining or dental hypoplasia.
Let's go through the other options:
A. Azithromycin: Azithromycin is an appropriate antibiotic for use in preschool-age children and is commonly prescribed for various bacterial infections. It does not pose the same risk of tooth staining as tetracycline, making it a safe option for this age group.
C. Cefuroxime: Cefuroxime is another antibiotic that is safe for use in preschoolers. It belongs to the cephalosporin class of antibiotics and is commonly prescribed for respiratory tract infections, skin infections, and other bacterial infections.
D. Gentamicin: While gentamicin is an effective antibiotic, its use in preschool-age children should be carefully monitored. Gentamicin can have potential ototoxic and nephrotoxic effects (damage to the inner ear and kidneys, respectively). However, its use is not strictly contraindicated in this age group, and it can be prescribed when necessary with appropriate monitoring.
Correct Answer is ["A","C","D","E"]
Explanation
The nurse should plan to take the following actions:
A.Verify the prescription: Before administering any medication, the nurse must verify the prescription to ensure accuracy, appropriateness, and that it matches the provider's order.
Regarding option B, administering the medication at 1000, 1400, 1800, and 2200 may not be appropriate. The prescription states that ampicillin should be administered every 6 hours. The nurse should administer the medication at equally spaced intervals throughout the day. If the medication is prescribed every 6 hours, the appropriate administration times would be 0600, 1200, 1800, and 2400. However, the question does not provide sufficient information to determine the exact administration times, so option B cannot be definitively selected.
C. Assess the client for an allergy to penicillin: Since ampicillin is a penicillin-class antibiotic, it is essential for the nurse to assess the client for any history of allergies to penicillin or other beta-lactam antibiotics. A penicillin allergy could lead to a severe allergic reaction, so it is crucial to identify any potential allergies before administering the medication.
D. Document giving the medications: After administering the ampicillin, the nurse should document the administration in the client's medical record, including the time, dose, route, and any relevant observations or assessments.
E. Obtain a sputum for culture and sensitivity: The client's new prescription for ampicillin may be related to an infection. To ensure appropriate and effective treatment, obtaining a sputum specimen for culture and sensitivity is necessary. This will help identify the specific bacteria causing the respiratory infection and determine which antibiotics will be most effective in treating it.
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