A nurse is reinforcing teaching about warfarin with a client who has a new onset of atrial fibrillation. Which of the following statements should the nurse include in the teaching?

"Warfarin dissolves clots in the bloodstream."

"This medication slows the response of the ventricles to the fast atrial impulses."

"Warfarin helps prevent strokes in clients who have atrial fibrillation."

"This medication will help maintain a normal heart rhythm."

Answer and Explanation

The Correct Answer is C

Choice A reason : The statement that warfarin dissolves clots in the bloodstream is incorrect. Warfarin does not dissolve existing clots. Instead, it is an anticoagulant that works by decreasing the production of certain clotting factors in the blood, which helps prevent the formation of new clots.

Choice B reason : This statement is not accurate regarding the action of warfarin. Warfarin does not affect the electrical impulses of the heart. Medications that slow the response of the ventricles to fast atrial impulses are typically antiarrhythmic drugs, not anticoagulants like warfarin.

Choice C reason : This is the correct statement. Warfarin is prescribed for clients with atrial fibrillation to reduce the risk of stroke. Atrial fibrillation increases the risk of forming blood clots in the heart, which can then travel to the brain, causing a stroke. Warfarin's anticoagulant effect helps to prevent these clots from forming.

Choice D reason : Warfarin does not help maintain a normal heart rhythm. It is not an antiarrhythmic drug but an anticoagulant. The purpose of warfarin in atrial fibrillation is to prevent stroke by reducing the risk of clot formation, not to correct the heart rhythm.

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Correct Answer is B

Explanation

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.

A. Hemoglobin (Hgb) : 16 g/dL B. Prothrombin Time (PT) : 45 seconds C. Activated Partial Thromboplastin Time (aPTT) : 36 seconds D. Platelets : 190,000/mm

Correct Answer is B

Explanation

Choice A reason : A hemoglobin (Hgb) level of 16 g/dL is within the normal range for adults, which typically falls between 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. Therefore, this value does not warrant reporting to the provider as it does not indicate an immediate concern.

Choice B reason : A prothrombin time (PT) of 45 seconds is significantly higher than the normal range of 11 to 13.5 seconds for individuals not on anticoagulation therapy. For patients on warfarin, the target PT is usually 1.5 to 2 times the normal value, depending on the indication for therapy. However, a PT of 45 seconds suggests a high risk of bleeding and requires immediate medical attention.

Choice C reason : The activated partial thromboplastin time (aPTT) of 36 seconds is within the normal range of approximately 21 to 35 seconds⁸. This result indicates that the blood's intrinsic clotting pathway is functioning within expected parameters and does not need to be reported.

Choice D reason : A platelet count of 190,000/mm is within the normal range, which is typically 150,000 to 450,000 platelets/mm. This value is not concerning and does not need to be reported to the provider.

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A nurse is reinforcing teaching about warfarin with a client who has a new onset of atrial fibrillation. Which of the following statements should the nurse include in the teaching?

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