A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should expect which of the following prescriptions?
Decrease the dose of the medication.
Increase the dose of the medication.
Withhold the medication.
Administer the current dose of the medication.
The Correct Answer is D
Choice A Reason:
Decrease the dose of the medication is incorrect. Lowering the dose could potentially drop the INR below the therapeutic range, increasing the risk of clot formation.
Choice B Reason:
Increase the dose of the medication is incorrect. Raising the dose might push the INR above the therapeutic range, increasing the risk of bleeding.
Choice C Reason:
Withhold the medication is incorrect. Withholding the medication might lead to inadequate anticoagulation and an increased risk of clot formation.
Choice D Reason:
Administer the current dose of the medication. An INR of 2.5 is within the therapeutic range for many indications, including atrial fibrillation. This means the blood is appropriately anticoagulated to prevent clot formation without an excessive risk of bleeding. In this scenario, maintaining the current dose of warfarin is often appropriate to sustain the desired therapeutic effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Contact the provider to clarify the prescription is not appropriate. Contacting the provider might not be necessary in this case. The prescription specifies "NOW," indicating an urgent administration, which is a clear directive to administer the medication promptly without further clarification.
Choice B Reason:
Administer the medication within 90 minutes is appropriate. "NOW" typically implies an urgent need for administration, and within a hospital setting, "NOW" often indicates a timeframe of around 90 minutes for prompt administration of the medication.
Choice C Reason:
Notify the pharmacy to send the medication immediately is inappropriate. With the prescription stating "NOW," the need for immediate administration usually requires using the hospital's available stock of the medication rather than waiting for delivery from the pharmacy. This action might cause a delay in administration.
Choice D Reason:
Inform the client there is a prescription available if needed is inappropriate. This option is not suitable in this scenario. "NOW" in the prescription implies the immediate need for administration, so informing the client about the availability of the prescription doesn't align with the urgency implied by the directive "NOW."
Correct Answer is ["60"]
Explanation
Step 1: Determine the Lidocaine Concentration
- The solution contains 2 grams (2000 mg) of lidocaine in 500 mL.
- To find the amount of lidocaine per mL:
2000 mg ÷ 500 mL = 4 mg/mL
Step 2: Calculate the Total Dose per Hour
- The prescribed infusion rate is 4 mg per minute.
- In 1 hour (60 minutes), the total dose is:
4 mg/min × 60 min = 240 mg/hr
Step 3: Determine the Infusion Rate in mL/hr
- Since each mL contains 4 mg of lidocaine:
240 mg ÷ 4 mg/mL = 60 mL/hr
The nurse should set the IV pump to 60 mL/hr for the continuous IV infusion of lidocaine at a rate of 4 mg/min.
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