A nurse is reinforcing teaching with a client who is postpartum and receiving warfarin for deep-vein thrombosis. Which of the following instructions should the nurse include?
"Take 650 milligrams of aspirin for leg discomfort."
"You should not take oral contraceptives while taking this medication."
"You will be able to stop taking this medication in 2 weeks."
"Use a disposable razor for shaving while taking this medication."
The Correct Answer is B
- Rationale for A: Aspirin is an antiplatelet agent and can increase the risk of bleeding, especially when combined with warfarin, an anticoagulant. Therefore, taking aspirin for leg discomfort is not recommended as it can exacerbate bleeding risks.
- Rationale for B: Oral contraceptives can interfere with the effectiveness of warfarin and increase the risk of thrombotic events. Women taking warfarin, especially in the postpartum period, should avoid oral contraceptives due to the potential for increased blood clotting.
- Rationale for C: The duration of warfarin therapy for deep-vein thrombosis is typically longer than 2 weeks. It is determined by the physician based on the extent of the clot and the patient's response to the medication.
- Rationale for D: Using a disposable razor can help minimize the risk of cuts and subsequent bleeding, which is a concern when taking anticoagulants like warfarin. It is a safer alternative to other shaving methods that may cause skin abrasions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A respiratory rate of 10/min indicates magnesium sulfate toxicity, which can cause respiratory depression. Close monitoring of respiratory rate is essential to identify and manage potential toxicity.
B. Urine output of 40 mL/hr is not an immediate sign of toxicity but requires monitoring. Decreased urine output can be a sign of complications, but it is not the primary indicator of magnesium sulfate toxicity.
C. Nausea is a common side effect of magnesium sulfate but not necessarily indicative of toxicity. More severe symptoms like respiratory depression are critical for diagnosing toxicity.
D. Facial flushing is a common, mild side effect of magnesium sulfate and not a sign of toxicity. Monitoring for more severe symptoms is essential to assess for toxicity.
Correct Answer is B
Explanation
A. Notifying the provider may be necessary if the problem persists, but the first step is to address the most likely cause of the deviation.
B. A fundus that is firm but deviated to the left suggests that the bladder may be distended. Emptying the bladder can help the uterus to return to its midline position and promote proper uterine involution.
C. Monitoring perineal pads for clots is important, but the first action should be to resolve the potential cause of the fundal deviation.
D. Administering an analgesic is not a priority action for addressing fundal deviation.
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