A nurse is caring for a client who is receiving warfarin therapy to prevent deep vein thrombosis. Which of the following medications should the nurse have available in the event of an overdose?
Epinephrine
Vitamin K
Atropine
Protamine
The Correct Answer is B
Choice A reason : Epinephrine is an adrenergic agonist primarily used in the management of cardiac arrest, anaphylaxis, and severe asthma attacks. It is not used to reverse the effects of warfarin overdose. Warfarin acts as an anticoagulant by inhibiting vitamin K-dependent clotting factors, and epinephrine has no role in this mechanism.
Choice B reason : Vitamin K is the antidote for warfarin toxicity. Warfarin works by inhibiting the vitamin K-dependent clotting factors II, VII, IX, and X. In the event of an overdose, vitamin K is administered to reverse the anticoagulant effects of warfarin and restore the clotting factor levels to normal. The administration can be oral or intravenous, depending on the severity of the overdose and the urgency of the situation.
Choice C reason : Atropine is an anticholinergic drug used to treat bradycardia (slow heart rate) and as an antidote for organophosphate poisoning. It does not have a role in reversing warfarin overdose as it does not affect the clotting cascade or vitamin K metabolism.
Choice D reason : Protamine is used to reverse the effects of heparin, another anticoagulant, but not warfarin. Protamine sulfate binds to heparin, forming a stable complex and neutralizing its anticoagulant effects. Since warfarin's mechanism of action is different from heparin's, protamine is not effective in reversing warfarin toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason : Keeping the client in a high-Fowler's position for 6 hours post-cardiac catheterization is not recommended. After a femoral approach, it's important to keep the leg straight and the patient flat or with the head slightly elevated to prevent bleeding from the catheter insertion site. High-Fowler's position could increase the risk of bleeding and is not conducive to maintaining pressure at the arterial access site.
Choice B reason : Allowing the patient to ambulate around the room immediately after the procedure is contraindicated. The patient is typically required to remain on bed rest with the affected leg straight to prevent bleeding and ensure proper healing of the arterial puncture site. Ambulation is usually restricted for several hours post-procedure.
Choice C reason : Checking pedal pulses every 15 minutes is a critical action following cardiac catheterization via the femoral artery. It ensures that there is adequate blood flow to the extremity and helps to identify any complications such as occlusion or bleeding early. Adequate perfusion is indicated by strong and equal pedal pulses.
Choice D reason : Performing passive range-of-motion exercises for the affected extremity immediately after cardiac catheterization is not recommended. The affected leg should remain straight without bending at the hip to prevent bleeding from the catheter site. Passive range-of-motion could disrupt the vascular integrity at the puncture site and increase the risk of bleeding.
Correct Answer is C
Explanation
Choice A reason : Advising a client with PVD not to go barefoot is correct. Going barefoot can increase the risk of injury to the feet, which can be particularly dangerous in individuals with PVD due to poor circulation. Any injuries to the feet may heal poorly and can lead to complications such as ulcers or infections.
Choice B reason : Using a thermometer to check the temperature of bath water is a recommended practice for clients with PVD. Due to potential nerve damage and reduced sensation in the extremities, clients may not accurately gauge water temperature, leading to burns. Therefore, using a thermometer helps prevent thermal injury.
Choice C reason : Wearing stockings with elastic tops is not recommended for clients with PVD. Elastic tops can constrict blood flow in the legs, exacerbating circulation problems. Instead, clients should wear non-constricting, well-fitting socks or stockings that promote blood flow.
Choice D reason : Avoiding crossing legs at the knees is good advice for clients with PVD. Crossing the legs can restrict blood flow to the lower extremities, which is already compromised in PVD. Keeping the legs uncrossed and elevating them when possible can help improve circulation.
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