A patient diagnosed with a pulmonary embolism is receiving a continuous Heparin infusion. Which findings should prompt the nurse to notify the healthcare provider?

The patient’s PTT is 70 seconds (control 25-40).

The patient develops ecchymosis at the venipuncture site.

The patient develops hematuria.

There is an order for Coumadin 2.5 mg to start today.

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale
A PTT of 70 seconds (control 25-40) indicates that the patient’s blood is taking longer than normal to clot, which could increase the risk of bleeding. This could be a sign of excessive anticoagulation from the Heparin infusion.
Choice B rationale
Ecchymosis at the venipuncture site could be a sign of bleeding under the skin, which could indicate that the patient is receiving too much Heparin.
Choice C rationale
Hematuria, or blood in the urine, could be a sign of bleeding in the urinary tract, which could be a side effect of Heparin therapy.
Choice D rationale
If there is an order for Coumadin 2.5 mg to start today, the healthcare provider should be notified. Coumadin and Heparin are both anticoagulants, and using them together could increase the risk of bleeding.

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Correct Answer is C

Explanation

Choice A rationale
A pH of 7.55, PaCO2 of 30 mm Hg, PaO2 of 80 mm Hg, and HCO3 of 24 mEq/L would indicate respiratory alkalosis, which is not typically associated with progressive COPD67.
Choice B rationale
A pH of 7.40, PaCO2 of 40 mm Hg, PaO2 of 94 mm Hg, and HCO3 of 22 mEq/L represent normal ABG values.
Choice C rationale
A pH of 7.30, PaCO2 of 60 mm Hg, PaO2 of 70 mm Hg, and HCO3 of 30 mEq/L are indicative of respiratory acidosis with metabolic compensation, which is commonly seen in patients with progressive COPD67.
Choice D rationale
A pH of 7.38, PaCO2 of 45 mm Hg, PaO2 of 88 mm Hg, and HCO3 of 26 mEq/L would indicate a slight respiratory acidosis, which is not typically associated with progressive COPD67.

A. “As your appetite returns, your sense of smell will also return.”. B. “Your body will slowly develop an ability to smell through your stoma.”. C. “Your sense of smell will gradually return after several months.”. D. “Breathing through a stoma has altered your sense of smell.”.

Correct Answer is D

Explanation

Choice A rationale
While it’s true that appetite and sense of smell are closely linked, the return of appetite does not necessarily mean the return of the sense of smell, especially after a total laryngectomy.
Choice B rationale
The body does not develop an ability to smell through the stoma. The sense of smell is primarily mediated by the olfactory nerve (Cranial Nerve I), which is located in the upper part of the nasal cavity.
Choice C rationale
The sense of smell does not typically return after several months following a total laryngectomy. This is because the surgery involves removal of the larynx and separation of the airway from the mouth, nose and throat.
Choice D rationale
Breathing through a stoma after a total laryngectomy does alter the sense of smell. This is because the nose and mouth are bypassed during breathing, and these are the primary routes for smell.

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A patient diagnosed with a pulmonary embolism is receiving a continuous Heparin infusion. Which findings should prompt the nurse to notify the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the arterial blood gas (ABG) results for a patient diagnosed with progressive Chronic Obstructive Pulmonary Disease (COPD). Which ABG results should the nurse expect for a patient with progressive COPD?

Correct Answer is C

Explanation

A nurse is caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the patient’s concern through which of the following responses?

Correct Answer is D

Explanation

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