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 A

Explanation

A. Limit the intake of foods high in potassium: Spironolactone is a potassium-sparing diuretic, which means it can cause potassium levels to rise. Therefore, the nurse should advise the patient to limit the intake of potassium-rich foods to avoid hyperkalemia.
B. Cover your skin before going outside: This instruction is not specifically related to the use of spironolactone. It is more relevant for medications that cause photosensitivity or skin reactions.
C. Replace salt with a salt substitute: Many salt substitutes contain potassium, which could increase the risk of hyperkalemia when taking spironolactone. Therefore, replacing salt with a potassium-containing salt substitute is not recommended.
D. Monitor skin for excessive bruising: While monitoring for bruising is important, it is more relevant for anticoagulants or medications that affect blood clotting, not specifically for spironolactone.

A. Affirm the decision to use the medication when the symptoms start to worsen. B. Assess the patient's current mental status before deciding to support the decision. C. Confirm that the daughter is aware of the progressive nature of the disease. D. Explain that the drug should be used early in the course of the disease process.

Correct Answer is D

Explanation

A. Affirm the decision to use the medication when the symptoms start to worsen: Waiting to start rivastigmine until symptoms worsen may not be the best approach, as early intervention can be more beneficial in managing symptoms and slowing disease progression.
B. Assess the client’s current mental status before deciding to support the decision: While assessing the client's mental status is important, the immediate concern is to educate on the timing of medication use rather than evaluating the current state of the client.
C. Confirm that the daughter is aware of the progressive nature of the disease: It is important for the daughter to understand the progressive nature of Alzheimer's disease, but this does not directly address the timing for starting rivastigmine.
D. Explain that the drug should be used early in the course of the disease process: Rivastigmine, a cholinesterase inhibitor, is most effective when started early in the course of Alzheimer's disease. Early use can help manage symptoms more effectively and potentially delay progression.

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Naxlex Comprehensive Predictor Exams

A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

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