A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:
Petechiae
Slowing pulse rate
Confusion
Pruritus
The Correct Answer is A
Rationale:
A. Petechiae are small, pinpoint red or purple spots on the skin that may indicate bleeding or thrombocytopenia, which can be a side effect of heparin therapy.
B. Slowing pulse rate is not typically associated with heparin therapy.
C. Confusion is not typically associated with heparin therapy.
D. Pruritus (itching) is not typically associated with heparin therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Tenormin (Atenolol) is a beta-blocker that reduces the heart rate and may affect the results of the stress test. Therefore, it should be held the morning of the test.
B. Heparin is an anticoagulant and is not typically held before a stress test.
C. Keflex (Cephalexin) is an antibiotic and is not typically held before a stress test.
D. Holding all medications is not necessary for a stress test, but specific medications that may interfere with the test, such as beta-blockers, should be held.
Correct Answer is C
Explanation
Rationale:
A. This is wrong because the ECG leads show ST segment elevation.
B. Stable angina may present with ST segment depression in an ECG unlike in the strip shown above which depicts an ST segment elevation.
C. This is correct because of the ST segment elevation.
D. Unstable angina may have hyperacute T wave, flattening of the T waves, inverted T waves or an ST depression unlike in the above ECG strip.
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