A nurse is teaching a client who has a new prescription for bivalirudin about potential adverse effects of the drug. Which of the following effects should the nurse include? (Select all that apply.)

Headache

Fever

Chest pain

Backache E.

Answer and Explanation

Correct Answer : A,E

The nurse should include headache and dyspnea as potential adverse effects of bivalirudin. According to the drug information from various sources, bivalirudin can cause common side effects such as headache, nausea, low or high blood pressure, chest pain, abdominal pain, and shortness of breath (dyspnea).

These side effects should be reported to the provider if they are severe or persistent.

Choice B is wrong because fever is not a common side effect of bivalirudin.

However, fever can be a sign of infection or an allergic reaction to the drug, which should be reported to the provider immediately.

Choice C is wrong because chest pain is not an adverse effect of bivalirudin, but rather a symptom of angina, which is one of the conditions that bivalirudin is used to treat.

Chest pain can also indicate a heart attack or other serious cardiac problems, which require immediate medical attention.

Choice D is wrong because backache is not a common side effect of bivalirudin.

However, backache can be a sign of bleeding in the kidneys or other organs, which can be a serious complication of bivalirudin therapy.

Therefore, any unusual pain or swelling in the back or abdomen should be reported to the provider as soon as possible.

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Correct Answer is ["A","C"]

Explanation

Heparin is an anticoagulant that inhibits blood clotting and prevents harmful clots from forming in blood vessels.However, heparin can also cause some serious side effects, such as bleeding, bruising, low platelet count, allergic reactions, and osteoporosis.

Therefore, patients who are at a high risk for developing these adverse effects should be monitored closely and have their heparin dose adjusted accordingly.

Choice A is correct because a patient who is post-op day 1 from brain surgery has a high risk of bleeding from the surgical site or intracranially.Heparin can increase this risk and cause life-threatening hemorrhage.

Therefore, this patient should not receive heparin unless absolutely necessary and under strict supervision.

Choice B is wrong because a patient with a pulmonary embolism (PE) is a candidate for heparin therapy.

A PE is a blood clot that blocks the blood flow to the lungs and can cause respiratory failure and death.Heparin can prevent the clot from becoming larger and causing more damage, and also prevent new clots from forming.

Therefore, this patient would benefit from heparin therapy and is not at a high risk of adverse effects.

Choice C is correct because a patient with active peptic ulcer disease (PUD) has a high risk of bleeding from the stomach or duodenum.

PUD is a condition where the lining of the digestive tract is eroded by stomach acid and bacteria.Heparin can worsen this condition and cause ulcer bleeding or perforation.

Therefore, this patient should avoid heparin therapy unless absolutely necessary and under strict supervision.

Choice D is wrong because a patient with uncontrolled atrial fibrillation (AF) is a candidate for heparin therapy.

AF is an irregular heartbeat that can cause blood clots to form in the heart chambers and travel to other organs, such as the brain or lungs.Heparin can prevent these clots from forming and reduce the risk of stroke or PE.

Therefore, this patient would benefit from heparin therapy and is not at a high risk of adverse effects.

Normal ranges of heparin depend on the type of heparin used (unfractionated heparin or low molecular weight heparin), the method of administration (intravenous or subcutaneous), and the indication for use (prophylaxis or treatment).Generally, the therapeutic range for heparin level is 0.3 - 0.7 U/mL, measured by anti-Xa assay.However, this range may vary depending on the pregnancy stage and the type of heparin used.The dose of heparin should be individualized according to the results of suitable laboratory tests and clinical response.

A. “Avoid activities that may cause injury.” B. “Take medication with food.” C. “Report signs and symptoms of bleeding immediately.” D. “Monitor vital signs regularly.” E. “Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).”.

Correct Answer is ["A","C","E"]

Explanation

Apixaban (Eliquis) is a blood thinner that prevents blood clots from forming or growing larger.

It is used to treat or prevent deep vein thrombosis (DVT), a condition in which a blood clot forms in a vein deep in the body, usually in the legs.

It can also prevent pulmonary embolism (PE), a condition in which a blood clot breaks off and travels to the lungs, blocking blood flow and causing breathing problems.

Patients taking apixaban should follow these instructions:

• Avoid activities that may cause injury.

Apixaban can increase the risk of bleeding, so patients should be careful not to cut or bruise themselves.

They should use a soft toothbrush, an electric razor, and avoid contact sports or other activities that may cause bleeding.They should also wear a medical alert bracelet or carry an identification card that states they are taking apixaban.

• Report signs and symptoms of bleeding immediately.Patients should notify their doctor or seek emergency care if they have any signs of bleeding, such as unusual bruising, red or black stools, blood in the urine, coughing up blood, vomiting blood, nosebleeds, heavy menstrual bleeding, headaches, dizziness, weakness, or swelling.

• Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).

These drugs can also increase the risk of bleeding and interfere with the effects of apixaban.

Patients should avoid taking aspirin, ibuprofen, naproxen, or other NSAIDs unless prescribed by their doctor.They should also check the labels of any over-the-counter medications or supplements they use and avoid those that contain aspirin or NSAIDs.

Choice B and D are wrong because:

• Take medication with food.Apixaban can be taken with or without food.Taking it with food does not affect its absorption or efficacy.

Therefore, this instruction is not necessary for patients taking apixaban.

• Monitor vital signs regularly.Apixaban does not affect blood pressure, heart rate, or oxygen saturation.

Therefore, monitoring vital signs regularly is not required for patients taking apixaban.However, patients should still follow their doctor’s advice on how often to check their blood tests, such as hemoglobin, hematocrit, and platelets.

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A nurse is teaching a client who has a new prescription for bivalirudin about potential adverse effects of the drug. Which of the following effects should the nurse include? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug therapy? Select all that apply:

Correct Answer is ["A","C"]

Explanation

A nurse is caring for a patient who has been prescribed apixaban (Eliquis) for deep vein thrombosis (DVT). Which instructions should be included in patient teaching? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

A patient has been prescribed rivaroxaban (Xarelto) for deep vein thrombosis (DVT). Which statement by the patient indicates understanding of medication teaching?

A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse would ensure what information is gathered correctly before initiating the drip? Select all that apply: *.

The nurse is caring for a patient who has received alteplase [Activase]. It is most important for the nurse to take which action?

A nurse is caring for a client who has variant angina and is prescribed verapamil. Which of the following are expected outcomes of this medication? (Select all that apply.)

A client has been prescribed warfarin (Coumadin) for treatment of deep vein thrombosis (DVT). Which of the following instructions should the nurse include in patient teaching? Select all that apply.

A nurse is caring for a client who has atrial fibrillation and is receiving warfarin therapy to prevent thromboembolism formation. The nurse should monitor which of the following laboratory values to determine the effectiveness of the medication?

A nurse is reviewing the medication list of a client who is prescribed dabigatran and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications can increase the risk of bleeding in this client?