A nurse is preparing to administer heparin to a client. Which of the following actions should the nurse plan to take?

Inject the medication into the abdomen above the level of the iliac crest.

Massage the injection site after administration of the medication.

Use a 1-inch needle to inject the medication.

Use a 22-gauge needle to inject the medication.

Answer and Explanation

The Correct Answer is A

Choice A reason: Injecting the medication into the abdomen above the level of the iliac crest is the correct action. This is the preferred site for heparin administration, as it has fewer blood vessels and nerves, and allows for better absorption of the medication. The nurse should avoid the area around the umbilicus, as it may have increased bleeding and bruising.

Choice B reason: Massaging the injection site after administration of the medication is not the correct action. This may cause hematoma formation, tissue irritation, and reduced effectiveness of the medication. The nurse should apply gentle pressure to the injection site for 1 to 2 minutes after administration.

Choice C reason: Using a 1-inch needle to inject the medication is not the correct action. This may cause pain, tissue damage, and bleeding. The nurse should use a 25- to 28-gauge needle that is 3/8 to 5/8 inch long to inject the medication.

Choice D reason: Using a 22-gauge needle to inject the medication is not the correct action. This may cause pain, tissue damage, and bleeding. The nurse should use a 25- to 28-gauge needle that is 3/8 to 5/8 inch long to inject the medication.

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Correct Answer is C

Explanation

Choice A reason: Migraines are not a contraindication for propranolol. In fact, propranolol is used as a prophylactic treatment for migraines, as it reduces the frequency and severity of migraine attacks.

Choice B reason: Glaucoma is not a contraindication for propranolol. Propranolol does not affect the intraocular pressure or the drainage of aqueous humor in the eye.

Choice C reason: Asthma is a contraindication for propranolol. Propranolol is a nonselective beta-blocker, which means it blocks both beta-1 and beta-2 receptors in the body. Beta-2 receptors are found in the bronchial smooth muscle, and when they are blocked, they cause bronchoconstriction and increased airway resistance. This can worsen the symptoms of asthma and cause a life-threatening asthma attack.

Choice D reason: Depression is not a contraindication for propranolol. Propranolol does not cause depression, although it may cause some side effects such as fatigue, insomnia, and sexual dysfunction. However, these side effects are usually mild and reversible.

A. Naloxone B. Protamine C. Calcium gluconate D. Flumazenil

Correct Answer is C

Explanation

Choice A reason: Naloxone is not the correct medication. Naloxone is an opioid antagonist that reverses the effects of opioid overdose, such as respiratory depression, sedation, and hypotension. Naloxone has no effect on magnesium sulfate, which is a mineral and electrolyte that is used to prevent seizures in clients with preeclampsia or eclampsia.

Choice B reason: Protamine is not the correct medication. Protamine is a heparin antagonist that reverses the effects of heparin overdose, such as bleeding, bruising, and thrombocytopenia. Protamine has no effect on magnesium sulfate, which is not an anticoagulant.

Choice C reason: Calcium gluconate is the correct medication. Calcium gluconate is a calcium salt that antagonizes the effects of magnesium sulfate overdose, such as hypotension, bradycardia, respiratory depression, and muscle weakness. Calcium gluconate is the antidote for magnesium sulfate toxicity, which can occur when the serum magnesium level is above 7.5 mEq/L. The nurse should monitor the client's vital signs, deep tendon reflexes, and urine output, and report any signs of toxicity to the provider.

Choice D reason: Flumazenil is not the correct medication. Flumazenil is a benzodiazepine antagonist that reverses the effects of benzodiazepine overdose, such as drowsiness, confusion, and coma. Flumazenil has no effect on magnesium sulfate, which is not a sedative.

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A nurse is preparing to administer heparin to a client. Which of the following actions should the nurse plan to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Correct Answer is C

Explanation

A client who is receiving magnesium sulfate has a urine output of 20 mL/hr. Which of the following medications should the nurse expect to administer?

Correct Answer is C

Explanation

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