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 A

Explanation

A. Inability to exhale retained carbon dioxide: During an acute asthma attack, airway obstruction due to bronchospasm, inflammation, and increased mucus production leads to air trapping. This makes it difficult for the client to fully exhale, resulting in the retention of carbon dioxide. Hyperinflation of the lungs and respiratory acidosis can occur as a result, contributing to the client's manifestations.

B. Acute loss of alveolar elasticity: A loss of alveolar elasticity is associated with conditions like emphysema, not asthma. Asthma primarily affects the airways rather than the alveoli, and elasticity is not typically impacted during an acute asthma attack.

C. Decreased responsiveness of airways to allergens: Asthma is characterized by increased responsiveness of the airways to triggers such as allergens, not decreased responsiveness. This hyperresponsiveness is a hallmark of the condition and contributes to airway narrowing during an attack.

D. Suppressed bronchiolar inflammatory response: Asthma attacks involve heightened inflammation of the bronchioles, not a suppressed inflammatory response. The inflammation contributes to airway swelling, increased mucus production, and bronchospasm.

A. Capillary blood glucose level 164 mg/dl. B. Crackles in bilateral lower lobes C. WBC count 13.000/mm D. Right upper quadrant pa

Correct Answer is A

Explanation

Choice A Reason:

Capillary blood glucose level 164 mg/dl is appropriate. A capillary blood glucose level of 164 mg/dl is above the target range for blood glucose control. In a client receiving total parenteral nutrition (TPN), it's essential to monitor blood glucose levels closely, as hyperglycaemia can lead to complications. The nurse should intervene by notifying the healthcare provider and following the prescribed protocols for managing elevated blood glucose levels in a client with acute pancreatitis receiving TPN.

Choice B Reason:

Crackles in bilateral lower lobes is inappropriate. Crackles in the lungs could be indicative of fluid accumulation or inflammation, which can occur in various conditions. While it should be monitored, it may not require immediate intervention related to the TPN.

Choice C Reason:

WBC count 13,000/mm is inappropriate-. An elevated white blood cell count could be related to the acute pancreatitis itself or other factors. It might require further assessment and monitoring but may not be directly related to the TPN.

Choice D Reason:

Right upper quadrant pain is inappropriate- The client's right upper quadrant pain might be related to the acute pancreatitis or another cause, but it does not specifically indicate a need to intervene with the TPN at this moment.

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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 caring for a client who is experiencing an acute asthma attack. Which of the following should the nurse identify as a contributing factor to the client's manifestations?

Correct Answer is A

Explanation

A nurse is assessing a client who has acute pancreatitis and has been receiving total parenteral nutrition for the past 72 hr. Which of the following findings requires the nurse to intervene?

Correct Answer is A

Explanation

A nurse is caring for a client who is taking digoxin 0.125 mg PO daily and is at risk for developing digoxin toxicity. The nurse should monitor the client for an imbalance of which of the following electrolytes because it can increase the risk for digoxin toxicity?

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