In preparing to discontinue a client's saline lock, the practical nurse (PN) notes that the client is receiving an antiplatelet medication. Which action should the PN implement?
Leave the saline lock in place and notify the charge nurse.
Plan to apply pressure over the site for several minutes.
Encourage the client to drink additional oral fluids.
Prepare a warm pack to apply after removing the lock
The Correct Answer is B
Antiplatelet medications, such as aspirin or clopidogrel, are prescribed to prevent the formation of blood clots by inhibiting platelet aggregation. These medications can increase the risk of bleeding or prolonged bleeding time. Therefore, when removing the saline lock, applying pressure over the site for several minutes helps to minimize the risk of bleeding and promote hemostasis.
A. Leaving the saline lock in place and notifying the charge nurse may not be necessary unless there are specific concerns or complications related to the client's condition.
C. Encouraging the client to drink additional oral fluids is not directly related to the discontinuation of the saline lock and the potential risk of bleeding associated with antiplatelet medication.
D. Preparing a warm pack to apply after removing the lock is not necessary for this situation. Warm packs are typically used for comfort or to promote circulation, but they are not directly related to the risk of bleeding associated with antiplatelet medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.6"]
Explanation
To calculate how many milliliters (mL) the practical nurse (PN) should administer each day, we can first determine the total daily dosage of enoxaparin.
The prescribed dosage is 30 mg every 12 hours, so the total daily dosage is:
30 mg + 30 mg = 60 mg
Next, we can calculate the number of milliliters (mL) needed to deliver the total daily dosage. Since the medication is available in a concentration of 30 mg per 0.3 mL, we can set up a proportion to find the equivalent mL for 60 mg:
30 mg / 0.3 mL = 60 mg / x mL
Cross-multiplying, we get:
30 mg * x mL = 60 mg * 0.3 mL
30x = 18
Dividing both sides by 30, we find:
x = 0.6 mL
Correct Answer is B
Explanation
Monitoring the client's vital signs, including temperature, heart rate, respiratory rate, and blood pressure, is crucial to assess for any signs of infection or complications following surgery.
A. While fluid volume intake and output are important to monitor for overall hydration status, it is not the most immediate concern after reinforcing the dressing.
C. Similarly, assessing the volume of peripheral pulses is important to evaluate peripheral perfusion, but it may not be the highest priority at this time.
D. Incisional pain scale rating is important to assess the client's comfort and pain level, but it should be done after ensuring the security of the surgical dressing.
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