A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis?
Warfarin PO
Enoxaparin subcutaneous
Aspirin PO
Heparin infusion
The Correct Answer is B
Choice A reason: Warfarin PO is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a slow onset of action and requires frequent monitoring of the INR (international normalized ratio). Warfarin may be used for long-term anticoagulation, but it is not effective for preventing the formation of new clots.
Choice B reason: Enoxaparin subcutaneous is a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a rapid onset of action and does not require frequent monitoring of the coagulation status. Enoxaparin is a low-molecular-weight heparin that inhibits the formation of thrombin and prevents the growth of existing clots.
Choice C reason: Aspirin PO is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a weak anticoagulant effect and may increase the risk of bleeding. Aspirin is an antiplatelet agent that inhibits the aggregation of platelets and prevents the formation of arterial clots, but it is not effective for preventing venous clots.
Choice D reason: Heparin infusion is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it requires continuous intravenous administration and frequent monitoring of the aPTT (activated partial thromboplastin time). Heparin is an unfractionated heparin that inhibits the formation of thrombin and prevents the growth of existing clots, but it has a narrow therapeutic window and a high risk of bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is: D. Apply heat to the knee.
Choice A reason:
Administering low dose aspirin is not appropriate for clients with hemophilia A because aspirin can inhibit platelet function and increase the risk of bleeding. Hemophilia A patients already have a deficiency in clotting factor VIII, and adding aspirin can exacerbate bleeding tendencies.
Choice B reason:
Preparing for an autologous blood transfusion is not a standard treatment for hemarthrosis in hemophilia A. The primary treatment involves factor replacement therapy to address the underlying clotting deficiency. Blood transfusions are generally reserved for severe cases of anemia or significant blood loss.
Choice C reason:
Obtaining a stool specimen is unnecessary because the client’s symptoms are localized to the knee rather than the gastrointestinal tract. This procedure is used to detect GI bleeding and does not address the acute hemarthrosis described. Focusing on a stool sample would delay the essential care needed to stop the joint hemorrhage. Priority must be placed on interventions that directly manage the active bleeding site.
Choice D reason:
Applying ice to the knee triggers vasoconstriction, which directly limits internal bleeding into the joint space. This action follows the RICE protocol to reduce inflammation and provide immediate pain relief. By cooling the area, the nurse helps stabilize the injury and prevents further swelling. It is a vital step in minimizing long-term damage to the joint's synovial tissue.
Correct Answer is C
Explanation
Choice A reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol is a beta-blocker that can reduce the workload of the heart and improve the symptoms of heart failure.
Choice B reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not have any significant interactions with antibiotics or other medications used to treat pneumonia.
Choice C reason: This is a problem for a client who has hypertension and a new prescription for metoprolol, as tadalafil is a phosphodiesterase-5 inhibitor that can lower the blood pressure and cause hypotension when taken with metoprolol. The nurse should investigate further and notify the provider of the potential interaction.
Choice D reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not affect the blood glucose levels or the management of diabetes.
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