A nurse is reviewing the medical record of a client who is to undergo open heart surgery. Which of the following findings should the nurse report to the provider as a contraindication to receiving heparin?

COPD

Thalassemia

Thrombocytopenia

Rheumatoid arthritis

Answer and Explanation

The Correct Answer is C

Choice A Reason:

COPD (Chronic Obstructive Pulmonary Disease) - While COPD might influence the choice of anaesthesia and perioperative management, it is not a direct contraindication to heparin.

Choice B Reason:

Thalassemia - Thalassemia is a genetic blood disorder that affects haemoglobin production and the structure of red blood cells. It does not directly impact the ability to receive heparin.

Choice C Reason:

Thrombocytopenia. Thrombocytopenia, which is a low platelet count, is a contraindication to receiving heparin, an anticoagulant. Heparin works by preventing the formation of blood clots, but if a person has a low platelet count, their ability to form blood clots is already compromised. Administering heparin in this situation could increase the risk of bleeding and further reduce platelet count.

Choice D Reason:

Rheumatoid arthritis - Rheumatoid arthritis is an autoimmune condition affecting joints. It is not a contraindication to heparin use, but the client's overall health and medications should be considered when planning surgery and anticoagulant therapy.

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Correct Answer is B

Explanation

Choice A Reason:

Decreased bowel sounds: Hyponatremia (low serum sodium levels) primarily affects the nervous system and can lead to neurological symptoms such as confusion, seizures, and headache. It doesn't typically directly affect bowel sounds. Therefore, this option is not the expected finding.

Choice B Reason:

Increased central venous pressure: As I mentioned earlier, hyponatremia can lead to cerebral edema (swelling of the brain) due to the movement of water into cells. This swelling can increase intracranial pressure and, in turn, affect the central venous pressure by impacting blood return to the heart. While the relationship between hyponatremia and central venous pressure might be complex, it's a more relevant consideration compared to the other options provided.

Choice C Reason:

Hyperreflexia: Hyponatremia can lead to changes in brain function and neurological symptoms, including altered reflexes. Hyperreflexia, which is an exaggerated response to stimuli, can indeed be a manifestation of hyponatremia, making this option a potential expected finding.

Choice D Reason:

Contusion: A contusion is a bruise that results from damage to blood vessels beneath the skin. Hyponatremia is not directly related to the formation of contusions. This option is not the expected finding in a client with low serum sodium levels.

A. Peripheral pulses 2+ bilaterally B. Creatinine 0.8 mL/dL C. Unine specific gravity 1.045 D. weight gain 1.1 kg (2.4 lb) in 24 hr

Correct Answer is C

Explanation

Choice A Reason:

Peripheral pulses 2+ bilaterally - This indicates good peripheral circulation and is not typically a concerning finding.

Choice B Reason:

Creatinine 0.8 mg/dL - A creatinine level of 0.8 mg/dL is within the normal range and does not indicate acute kidney failure.

Choice C Reason:

Urine specific gravity 1.045 A urine specific gravity of 1.045 is significantly elevated and could indicate concentrated urine, which might be a concern in a client with acute kidney failure. Elevated specific gravity could suggest dehydration, impaired kidney function, or other kidney-related issues. The nurse should report this finding to the provider for further evaluation and intervention.

Choice D Reason:

Weight gain 1.1 kg (2.4 lb) in 24 hr - While weight gain should be monitored closely in clients with kidney failure, 1.1 kg in 24 hours might not be an immediate concern, depending on the client's overall condition and baseline weight. However, it should still be followed up on in subsequent assessments.

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A nurse is reviewing the medical record of a client who is to undergo open heart surgery. Which of the following findings should the nurse report to the provider as a contraindication to receiving heparin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has a serum sodium level of 120 mEq/L. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

A nurse is assessing a client who has acute kidney failure. Which of the following findings should the nurse report to the provider?

Correct Answer is C

Explanation

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