The nurse is caring for patient with a history of atrial fibrillation who is prescribed warfarin. Sometimes I forget my medication, so l double up doses when I remember " The patient's PT and INR are highly elevated. The nurse anticipates the transfusion of which blood product?

Packed Red Blood Cells (PRBC's)

Platelets

Cryoprecipitate

Fresh Frozen Plasma (FFP)

Answer and Explanation

The Correct Answer is D

A) Packed Red Blood Cells (PRBCs):
Packed Red Blood Cells are typically transfused when there is anemia or significant blood loss leading to low hemoglobin levels. In the case of warfarin overdose or elevated PT/INR, the problem is related to coagulation and not red blood cell count.

B) Platelets:
Platelets are typically transfused when there is thrombocytopenia or a need to address platelet dysfunction (e.g., in patients with bleeding due to low platelet counts). However, the elevated PT and INR in this case are related to the coagulation cascade being inhibited by warfarin, not platelet deficiency.

C) Cryoprecipitate:
Cryoprecipitate is primarily used to replace clotting factors such as fibrinogen, factor VIII, and von Willebrand factor. It is typically transfused in patients with hemophilia or bleeding disorders related to low fibrinogen levels. However, in this case, the issue is related to warfarin-induced inhibition of clotting factors (specifically the vitamin K-dependent factors: II, VII, IX, and X), not a deficiency in fibrinogen or specific clotting factors addressed by cryoprecipitate.

D) Fresh Frozen Plasma (FFP):
Fresh Frozen Plasma (FFP) is the most appropriate choice for this patient. FFP contains all the coagulation factors, including the vitamin K-dependent factors that warfarin inhibits. When a patient on warfarin presents with elevated PT and INR (which indicates impaired clotting ability), FFP is used to replace the clotting factors and help reverse the effects of warfarin.

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Correct Answer is B

Explanation

A) Notify the primary care provider with increased urine output
Increased urine output is not directly related to signs or symptoms of infection associated with a tunneled IV catheter, such as a Hickman catheter. While changes in urinary output might indicate renal or other systemic issues, they do not signal a local infection at the insertion site.

B) Assess daily for redness, swelling, or exudate at insertion site weekly
One of the most common complications of a tunneled IV catheter, such as a Hickman, is infection at the insertion site or along the catheter tract. The nurse should instruct the patient to monitor for signs of infection, including redness, swelling, and exudate (pus or drainage) at the insertion site. These signs suggest possible infection, and early detection is critical to preventing more serious complications like sepsis.

C) The primary care provider will monitor hemoglobin and hematocrit values
While monitoring hemoglobin and hematocrit values is important for assessing overall health and blood status, it is not specifically related to monitoring for infection in a client with a tunneled IV catheter. Hemoglobin and hematocrit can provide information about anemia or dehydration but do not directly indicate an infection at the insertion site.

D) To maintain patency, the catheter should be flushed weekly using a 5ml syringe
Although flushing a tunneled IV catheter to maintain patency is important, this response does not directly address infection prevention, which is the focus of the question. Typically, a catheter should be flushed as per specific guidelines (which may include daily or weekly flushing, depending on the clinical setting).

A. Insertion of a cardioverter-defibrillator B. A medication regimen that includes nitrates C. Immediate cardiac transplantation D. Insertion of a drug eluting stent

Correct Answer is A

Explanation

A) Insertion of a cardioverter-defibrillator:
Hypertrophic cardiomyopathy (HCM) is a condition characterized by abnormal thickening of the heart muscle, particularly the septum, which can lead to obstruction of blood flow and contribute to the development of arrhythmias. The most concerning arrhythmias in HCM include ventricular tachycardia and ventricular fibrillation, both of which can lead to sudden cardiac arrest. A cardioverter-defibrillator (ICD) is a device that monitors the heart's rhythm and can deliver a shock to restore normal rhythm in the event of a life-threatening arrhythmia.

B) A medication regimen that includes nitrates:
Nitrates are vasodilators commonly used in the treatment of conditions like angina and heart failure. However, nitrates are generally avoided in patients with hypertrophic cardiomyopathy because they can exacerbate the condition by decreasing preload and increasing the outflow tract obstruction due to the thickened heart muscle.

C) Immediate cardiac transplantation:
Cardiac transplantation is a treatment for end-stage heart failure, typically in patients who have not responded to medical or surgical treatments. While hypertrophic cardiomyopathy can lead to heart failure, it is not the first line treatment for dysrhythmias or complications from the disease.

D) Insertion of a drug-eluting stent:
Drug-eluting stents are used to prevent restenosis (narrowing) of coronary arteries after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). However, hypertrophic cardiomyopathy is not caused by coronary artery disease.

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The nurse is caring for patient with a history of atrial fibrillation who is prescribed warfarin. Sometimes I forget my medication, so l double up doses when I remember " The patient's PT and INR are highly elevated. The nurse anticipates the transfusion of which blood product?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

The nurse is caring for client who is diagnosed with hypertrophic cardiomyopathy. Which medical Intervention should the nurse anticipate for this client for the complications of dysrhythmias?

Correct Answer is A

Explanation

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