The nurse is administering SUBO enoxaparin to a client following knee replacement surgery to prevent a deep vein thrombosis. Which laboratory result requires immediate action by the nurse?

Reference Range:

Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)] Platelets [150,000 to 400,000/mm3 (150 to 400 x 109/L]] Creatinine [0.5 to 1.1 mg/dL (44 to 97 pmol/L)]

Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Platelet count of 100,000/mm3 (100 x 10

Blood urea nitrogen (BUN) 20 mg/dL (7.) mmol/L).

Serum creatinine 1.0 mg/dL (88.4 μmol/L).

Hematocrit 45% (0.45 volume fraction).

Answer and Explanation

The Correct Answer is A

A. Platelet count of 100,000/mm³ (100 x 10^9/L): Enoxaparin is a low molecular weight heparin used to prevent deep vein thrombosis (DVT), and a low platelet count (thrombocytopenia) can be a serious adverse effect of anticoagulant therapy. A platelet count of 100,000/mm³ is below the normal range (150,000 to 400,000/mm³) and indicates potential thrombocytopenia, which could increase the risk of bleeding and may warrant immediate action.

B. Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L): This BUN level is at the upper limit of normal but does not typically require immediate action unless there are other symptoms or significant changes in kidney function.

C. Serum creatinine 1.0 mg/dL (88.4 μmol/L): This value is within the normal range for serum creatinine and does not indicate an immediate concern related to enoxaparin.

D. Hematocrit 45% (0.45 volume fraction): This hematocrit level is within the normal range and does not typically require immediate action.

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Correct Answer is D

Explanation

A) Hypertension: Phenytoin is primarily used to manage seizures, and hypertension is not a common side effect associated with its use. While monitoring blood pressure is important for overall health, it is not specifically indicated for detecting common side effects of phenytoin.
B) Peripheral edema: Peripheral edema is not a typical side effect of phenytoin. Common side effects are usually related to oral health and skin changes rather than fluid retention or swelling in the extremities.
C) Hematuria: Hematuria, or blood in the urine, is not commonly associated with phenytoin use. This side effect is more relevant to other medications or conditions, and while monitoring for overall health changes is important, it is not a primary concern with phenytoin.
D) Gingival hyperplasia: Phenytoin is well-known for causing gingival hyperplasia, which is the overgrowth of gum tissue. This is a common and notable side effect of long-term phenytoin use, making it important for the nurse to assess for this symptom in clients receiving the medication.

A. Gout. B. Sepsis. C. Myocardial infarction. D. Rheumatoid arthritis.

Correct Answer is C

Explanation

A. Gout: Aspirin is not typically used for treating gout. Gout is commonly treated with medications like allopurinol or colchicine, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used selectively.
B. Sepsis: Aspirin is not a primary treatment for sepsis. Sepsis is usually treated with antibiotics, fluid resuscitation, and supportive care.
C. Myocardial infarction: Aspirin is beneficial for preventing further myocardial infarctions (heart attacks) in patients with a history of cardiovascular events or at high risk. It works by inhibiting platelet aggregation, thereby reducing the risk of blood clot formation that can lead to heart attacks.
D. Rheumatoid arthritis: Although aspirin can be used for symptomatic relief in rheumatoid arthritis due to its anti-inflammatory properties, it is not the primary treatment. Other medications, such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), are typically used.

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Naxlex Comprehensive Predictor Exams

To detect common untoward effects of phenytoin, the nurse should assess a client with a seizure disorder for which sign or symptom?

Correct Answer is D

Explanation

A daily dose of aspirin 325 mg PO is most beneficial for an adult client with which medical diagnosis?

Correct Answer is C

Explanation

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