A patient is receiving heparin therapy during hemodialysis for chronic renal failure and develops heparin-induced thrombocytopenia (HIT). The nurse anticipates that which medication will be ordered for this patient?

Warfarin

Clopidogrel

Argatroban

Alteplase.

Answer and Explanation

The Correct Answer is C

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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Correct Answer is B

Explanation

This statement indicates that the patient understands that rivaroxaban (Xarelto) is an anticoagulant that can increase the risk of bleeding and bruising.The patient should avoid activities that may cause injury, such as contact sports, sharp objects, or falls.

Choice A is wrong because aspirin is also an antiplatelet drug that can further increase the risk of bleeding when taken with rivaroxaban.The patient should not take aspirin or any other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting the prescriber.

Choice C is wrong because rivaroxaban can be taken with or without food.The patient does not need to take the medication with food to prevent stomach upset or absorption problems.

Choice D is wrong because rivaroxaban should be taken as prescribed and not stopped abruptly without consulting the prescriber.Stopping the medication can increase the risk of blood clots and stroke.The patient should not stop taking the medication even if they feel better or have no symptoms.

A. 2 hours B. 4 hours C. 6 hours D. 8 hours.

Correct Answer is B

Explanation

Argatroban is a direct thrombin inhibitor (DTI) that is used as an alternative anticoagulant for patients with heparin-induced thrombocytopenia (HIT) who require urgent surgery. Argatroban has a half-life of about 40 to 50 minutes and is cleared by the liver.The infusion should be stopped at least 4 hours before the surgery to allow adequate time for the anticoagulant effect to wear off.The activated partial thromboplastin time (aPTT) should be monitored before and after the infusion to assess the degree of anticoagulation.

Choice A is wrong because 2 hours is not enough time to stop the argatroban infusion before surgery.

The patient may still have a high risk of bleeding if the aPTT is prolonged.

Choice C is wrong because 6 hours is longer than necessary to stop the argatroban infusion before surgery.

The patient may have a higher risk of thrombosis if the anticoagulation effect is too low.

Choice D is wrong because 8 hours is much longer than necessary to stop the argatroban infusion before surgery.

The patient may have a very low level of anticoagulation and a high risk of thrombosis if the infusion is stopped for too long.

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A patient is receiving heparin therapy during hemodialysis for chronic renal failure and develops heparin-induced thrombocytopenia (HIT). The nurse anticipates that which medication will be ordered for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving argatroban IV for HIT and requires urgent surgery. The nurse should stop the infusion at least how many hours before the surgery?

Correct Answer is B

Explanation

A nurse is caring for a patient who has been prescribed enoxaparin (Lovenox) subcutaneously for prophylaxis against deep vein thrombosis (DVT). The nurse should instruct the patient to:

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: *.

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.

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 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.)

A patient has been prescribed dabigatran (Pradaxa) for atrial fibrillation (AF). Which laboratory test should be monitored while on this medication?

A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

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