A nurse is discussing the use of docusate sodium (Colace) with a client who is recovering from a non-ST elevation myocardial infarction (NSTEMI). What is the rationale for administering this medication during the recovery from a myocardial infarction?

Treats hyperlipidemia to reduce the risk of new plaques

Prevents the formation of clots to reduce the risk of stroke

Prevents vagal stimulation to reduce e risk of dysrhythmias

Removes excess sodium to reduce the risk of hypertension

Answer and Explanation

The Correct Answer is C

A.   This statement refers to medications like statins (e.g., rosuvastatin, atorvastatin) which are used to lower cholesterol levels and reduce the risk of atherosclerosis progression. Docusate sodium does not treat hyperlipidemia or affect plaque formation directly.
B.   This refers to anticoagulant medications (e.g., heparin, warfarin, direct oral anticoagulants) which are used to prevent clot formation and reduce the risk of thromboembolic events such as stroke. Docusate sodium does not have anticoagulant properties.
C.   After a myocardial infarction (MI), especially in the early recovery phase, vagal stimulation can exacerbate bradycardia or contribute to dysrhythmias. Stool softeners like docusate sodium help prevent constipation, which can stimulate the vagus nerve during straining, potentially leading to vagally mediated dysrhythmias such as bradycardia or atrioventricular blocks.
D.   Diuretics (e.g., furosemide, hydrochlorothiazide) are used to reduce fluid retention and lower blood pressure by increasing urine output. Docusate sodium does not remove excess sodium or affect blood pressure regulation.

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Correct Answer is C

Explanation

A. Involves the use of physical force that may result in bodily injury, pain, or impairment. This option does not fit the scenario described because it does not involve direct physical harm.
B. Involves behaviors such as intimidation, threats, humiliation, and isolation that cause mental or emotional distress. While similar to neglect in some aspects, neglect specifically refers to the failure to provide essential care rather than actively causing psychological harm.
C. Neglect refers to the failure of a caregiver or responsible person to provide the necessary care, assistance, or supervision that is essential to maintain the health and well-being of an elderly person.
D. Involves unauthorized or improper use of an elderly person's financial resources. This option does not apply to the scenario described as it involves financial exploitation rather than the physical or emotional neglect of the resident.

A. Platelet factor 4 (PF4) bound with heparin forming a PF4-heparin complex. B. Abnormally long von Willebrand factor. C. A deficiency of the enzyme ADAMTS13. D. Platelets which are coated with antibodies.

Correct Answer is D

Explanation

A. This option describes a phenomenon seen in heparin-induced thrombocytopenia (HIT), not in immune thrombocytopenic purpura (ITP). In HIT, antibodies against the PF4-heparin complex can cause platelet activation and aggregation, leading to thrombocytopenia. However, this is not characteristic of ITP.
B. Abnormally long von Willebrand factor is seen in von Willebrand disease (VWD), not in ITP. VWD is a bleeding disorder caused by deficiency or dysfunction of von Willebrand factor, which plays a key role in platelet adhesion and aggregation. It is not typically associated with ITP.

C. ADAMTS13 deficiency is characteristic of thrombotic thrombocytopenic purpura (TTP), not ITP. TTP is a rare blood disorder where small blood clots form in blood vessels throughout the body, leading to thrombocytopenia (low platelet count) and other complications. It is distinct from ITP.
D. In immune thrombocytopenic purpura (ITP), the immune system mistakenly attacks and destroys platelets, leading to a low platelet count. Antibodies, particularly anti-platelet antibodies such as anti-GP IIb/IIIa or anti-GP Ib/IX, coat the surface of platelets. These antibody-coated platelets are recognized and destroyed by macrophages in the spleen and liver, contributing to thrombocytopenia.

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A nurse is discussing the use of docusate sodium (Colace) with a client who is recovering from a non-ST elevation myocardial infarction (NSTEMI). What is the rationale for administering this medication during the recovery from a myocardial infarction?

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Explanation

A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). When reviewing the results of the client's peripheral blood smear, what would the nurse expect to find?

Correct Answer is D

Explanation

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