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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D) Use a soft-bristled toothbrush.
This is because enoxaparin (Lovenox) is an anticoagulant that prevents blood clots by thinning the blood.Therefore, patients who take enoxaparin should avoid activities that can cause bleeding, such as using a hard-bristled toothbrush, flossing, shaving, or cutting their nails.
Choice A) Avoid foods that are high in vitamin K is wrong because vitamin K interacts with warfarin, another anticoagulant, but not with enoxaparin.Vitamin K helps the blood clot, so patients who take warfarin should avoid foods that are high in vitamin K, such as leafy green vegetables, broccoli, or liver.
Choice B) Administer injections into areas with decreased subcutaneous tissue is wrong because enoxaparin should be injected into areas with adequate subcutaneous tissue, such as the abdomen or the thighs.Injecting into areas with decreased subcutaneous tissue can cause bruising, pain, or hematoma formation.
Choice C) Massage injection sites after administration is wrong because massaging the injection sites can cause bleeding, bruising, or irritation.Patients who take enoxaparin should not rub or press on the injection sites after administration.
Correct Answer is C
Explanation
This is because argatroban is a direct thrombin inhibitor that can be used as an alternative anticoagulant for patients with heparin-induced thrombocytopenia (HIT).HIT is an immune-mediated disorder that occurs when antibodies form against heparin and platelet factor 4, leading to platelet activation and thrombosis.The diagnosis of HIT is based on clinical criteria and laboratory tests.
Choice A is wrong because warfarin is a vitamin K antagonist that interferes with the synthesis of clotting factors II, VII, IX, and X.Warfarin is contraindicated in patients with HIT because it can worsen the thrombotic complications and cause skin necrosis.Warfarin should only be started after the platelet count has recovered and the patient is adequately anticoagulated with a non-heparin agent.
Choice B is wrong because clopidogrel is an antiplatelet agent that inhibits the ADP receptor on platelets, preventing their aggregation.Clopidogrel is not effective for the treatment of HIT, as it does not target the underlying mechanism of thrombin generation.Clopidogrel may also increase the risk of bleeding in patients with HIT.
Choice D is wrong because alteplase is a fibrinolytic agent that converts plasminogen to plasmin, which breaks down fibrin clots.Alteplase is not indicated for the treatment of HIT, as it does not prevent further thrombosis and may cause severe bleeding complications.Alteplase may be used as a last resort for life-threatening thrombosis in patients with HIT who do not respond to other therapies.
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