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.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
A. Wear the lap belt high across the abdomen is incorrect. The lap belt should be worn low across the pelvis, not high across the abdomen, to avoid injury in the event of a collision.
B. Place the shoulder harness across the gravid uterus is incorrect. The shoulder harness should be placed across the chest and between the breasts, not directly across the uterus, to ensure safety.
C. Disable the vehicle's driver-side airbags is incorrect. Airbags should not be disabled, as they are crucial for safety. The seat should be adjusted to a safe distance from the steering wheel to avoid potential injury from the airbag.
D. Move the seat as far away as possible from the steering wheel is correct. This adjustment ensures that the driver is positioned safely away from the steering wheel and airbag, reducing the risk of injury during a collision.
Correct Answer is D
Explanation
A. Terbutaline is typically used to manage preterm labor, not a contraindication for dinoprostone, which is used for labor induction.
B. FHR (Fetal Heart Rate) of 140/min with moderate variability is within normal limits and would not be a reason to withhold dinoprostone.
C. WBC count is within normal limits, indicating no infection, thus not a contraindication for dinoprostone.
D. Lesions noted on vaginal introitus and labia majora could indicate an active Herpes simplex virus infection, which is a contraindication for vaginal delivery due to the risk of neonatal infection.
E. Breech presentation is a concern for delivery method but does not contraindicate the use of dinoprostone for labor induction.
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