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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Free Nursing Study Resources

Correct Answer is B

Explanation

A) Administer an oral analgesic and evaluate its effectiveness before applying the new patch: This action is unnecessary because the client reports no pain. Administering an oral analgesic would not be appropriate when the client denies pain and the previous fentanyl patch is intact.
B) Apply the new patch in a different location after removing the original patch: This is the correct action. Fentanyl patches should be replaced with new ones in a different location to prevent overdosing and ensure proper absorption. The old patch should be removed to avoid accumulation of excess medication.
C) Remove the patch and consult with the healthcare provider about the client's pain resolution: There is no need to consult the healthcare provider or remove the patch if the client denies pain and the patch is intact. The issue is with replacing the patch rather than evaluating pain.
D) Place the patch on the client's shoulder and leave both patches in place for 12 hours: This is unsafe. Applying a new patch without removing the old one can lead to overdose due to excessive fentanyl. The old patch must be removed before placing a new one.

A. Alternate the use of each nostril when administering the nasal spray each day. B. Do not lie down within thirty minutes of use of the nasal spray. C. Use an nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur. D. Take an over-the-counter antihistamine with each dally dose of nasal spray.

Correct Answer is A

Explanation

A. Alternate the use of each nostril when administering the nasal spray each day: Alternating nostrils can help reduce local irritation and rhinitis associated with the use of nasal spray medications. This practice allows each nostril to recover and reduces the risk of continuous irritation from the spray.
B. Do not lie down within thirty minutes of use of the nasal spray: While this can help ensure the medication is absorbed properly, it is not specifically aimed at reducing rhinitis. It is more important to manage irritation by alternating nostrils.
C. Use a nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur: NSAIDs might not be suitable for everyone, and using them could mask symptoms or lead to additional side effects. They are not a primary strategy for managing rhinitis caused by nasal spray use.
D. Take an over-the-counter antihistamine with each daily dose of nasal spray: Antihistamines are not typically used to manage rhinitis caused by nasal sprays. Additionally, combining medications should be done cautiously and usually under medical advice.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

Correct Answer is B

Explanation

A client is using the nasal spray hormone calcitonin to reduce bone loss from osteoporosis. To reduce rhinitis associated with administration of the nasal spray, the nurse should provide the client with which instruction?

Correct Answer is A

Explanation

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