A nurse is reporting a client’s laboratory tests to the provider to obtain a prescription for the client’s daily warfarin.
Which of the following laboratory tests should the nurse plan to report to obtain the prescription for the warfarin?
INR.
Fibrinogen level.
aPTT.
Platelet count.
The Correct Answer is A
Warfarin is a vitamin K antagonist that inhibits the synthesis of factors II, VII, IX, and X in the liver. These factors are part of the extrinsic and common pathways of coagulation, which are measured by the prothrombin time (PT) and the international normalized ratio (INR). The INR is a standardized way of reporting the PT that accounts for the variability of different reagents and instruments. The INR is used to monitor the therapeutic effect of warfarin and to adjust the dose accordingly. The target INR range depends on the indication for warfarin, but it is usually between 2 and 3 for most conditions.
Choice B is wrong because fibrinogen level is not affected by warfarin.
Fibrinogen is a precursor of fibrin, which forms the final step of the coagulation cascade.
Fibrinogen level can be decreased in conditions such as disseminated intravascular coagulation (DIC), liver disease, or severe bleeding.
Choice C is wrong because aPTT is not affected by warfarin.
aPTT measures the intrinsic and common pathways of coagulation, which are mainly dependent on factors VIII, IX, XI, and XII.
These factors are not inhibited by warfarin.
aPTT is used to monitor the effect of heparin, a direct antithrombin agent that inhibits thrombin and factor Xa.
Choice D is wrong because platelet count is not affected by warfarin.
Platelets are cell fragments that adhere to damaged blood vessels and form aggregates to initiate hemostasis.
Platelet count can be decreased in conditions such as immune thrombocytopenia (ITP), heparin-induced thrombocytopenia (HIT), or bone marrow suppression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C"]
Explanation
“I will eat small, frequent meals.”.
This statement indicates an understanding of the discharge teaching because eating small, frequent meals can help reduce the workload of the pancreas and prevent pain and nausea.
“I will eat fish for dinner at least twice per week.” This statement does not indicate an understanding of the discharge teaching because fish is a high-fat food that can aggravate pancreatitis. The client should eat a low-fat diet with no more than 30 grams of fat per day.
“I will limit my morning coffee to no more than two cups.” This statement does not indicate an understanding of the discharge teaching because coffee is a caffeinated beverage that can stimulate the pancreas and worsen inflammation. The client should avoid caffeine and alcohol.
D. “I should expect my bowel movements to be pale in color”. This statement does not indicate an understanding of the discharge teaching because pale stools can be a sign of bile duct obstruction or pancreatic insufficiency, which are complications of pancreatitis. The client should notify the provider if they notice any changes in their stool color or consistency.
E. “I will notify my provider if my urine is dark.” This statement does not indicate an understanding of the discharge teaching because dark urine can be a sign of dehydration or jaundice, which are also complications of pancreatitis. The client should drink plenty of fluids and monitor their skin and eyes for yellowing.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}
Explanation
The correct answer is choice A. Applying warm compresses to the incision site is anticipated for the client, as it can help reduce swelling and pain.
The other choices are contraindicated for the following reasons:
- Choice B: Maintaining bed rest for 2 days postoperatively is contraindicated, as it can increase the risk of complications such as deep vein thrombosis, pulmonary embolism, and pneumonia. The client should be encouraged to ambulate as soon as possible after surgery.
- Choice C: Irrigating indwelling urinary catheter with 50 mL of normal saline is contraindicated, as it can introduce bacteria into the bladder and cause infection. The catheter should be kept patent and draining without irrigation unless there is a specific order from the provider.
- Choice D: Administering enema to relieve constipation is contraindicated, as it can increase the pressure in the pelvic area and cause bleeding or damage to the surgical site. The client should be given stool softeners and laxatives to prevent constipation.
- Choice E: Placing a blanket roll under the client’s knees while in bed is contraindicated, as it can impair blood circulation and cause thrombophlebitis. The client should avoid flexing the knees excessively and elevate the legs slightly when lying down.
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