The patient has been receiving heparin therapy for deep vein thrombosis (DVT). The patient’s activated partial thromboplastin time (aPTT) result is 90 seconds (therapeutic range: 60-80 seconds). What will be included in patient care? (Select all that apply.).

Assessing for signs and symptoms of bleeding

Continuing heparin therapy at current rate

Decreasing heparin therapy per protocol

Holding heparin therapy per protocol

Increasing heparin therapy per protocol.

Answer and Explanation

Correct Answer : A,D

A patient with a high aPTT result is at risk for bleeding, so assessing for signs and symptoms of bleeding is important.

Holding heparin therapy per protocol is also appropriate, as heparin is the cause of the prolonged aPTT.

The other choices are wrong because:

• Choice B is wrong because continuing heparin therapy at the current rate will increase the risk of bleeding and further prolong the aPTT.

• Choice C is wrong because decreasing heparin therapy per protocol is not enough to reverse the effects of heparin.

Heparin should be stopped until the aPTT returns to the therapeutic range.

• Choice E is wrong because increasing heparin therapy per protocol will worsen the situation and cause more bleeding and coagulation problems.

The normal range for aPTT is 25 to 35 seconds, and the therapeutic range for heparin therapy is 60 to 80 seconds. A result of 90 seconds indicates excessive anticoagulation and increased bleeding risk.

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Correct Answer is B

Explanation

This statement indicates that the patient understands that rivaroxaban (Xarelto) is an anticoagulant that can increase the risk of bleeding and bruising.The patient should avoid activities that may cause injury, such as contact sports, sharp objects, or falls.

Choice A is wrong because aspirin is also an antiplatelet drug that can further increase the risk of bleeding when taken with rivaroxaban.The patient should not take aspirin or any other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting the prescriber.

Choice C is wrong because rivaroxaban can be taken with or without food.The patient does not need to take the medication with food to prevent stomach upset or absorption problems.

Choice D is wrong because rivaroxaban should be taken as prescribed and not stopped abruptly without consulting the prescriber.Stopping the medication can increase the risk of blood clots and stroke.The patient should not stop taking the medication even if they feel better or have no symptoms.

A. History of hypertension B. History of stroke C. History of peptic ulcer disease D. History of diabetes mellitus. E. Shortness of breath.

Correct Answer is B

Explanation

A history of stroke is an absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction (AMI).This is because thrombolytics can increase the risk of intracranial hemorrhage and worsen the neurological outcome.

Choice A is wrong because history of hypertension is not an absolute contraindication, but a relative one.This means that the benefits of thrombolytic therapy may outweigh the risks in some cases, depending on the severity and duration of hypertension.

Choice C is wrong because history of peptic ulcer disease is also a relative contraindication, not an absolute one.Thrombolytics can increase the risk of gastrointestinal bleeding, but this can be managed with proton pump inhibitors or histamine-2 blockers.

Choice D is wrong because history of diabetes mellitus is not a contraindication at all to thrombolytic therapy.In fact, some studies have shown that diabetic patients with AMI may benefit more from thrombolytic therapy than non-diabetic patients.

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The patient has been receiving heparin therapy for deep vein thrombosis (DVT). The patient’s activated partial thromboplastin time (aPTT) result is 90 seconds (therapeutic range: 60-80 seconds). What will be included in patient care? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been prescribed rivaroxaban (Xarelto) for deep vein thrombosis (DVT). Which statement by the patient indicates understanding of medication teaching?

Correct Answer is B

Explanation

The nurse recognizes what absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction?

Correct Answer is B

Explanation

A nurse is teaching a client who has a new prescription for bivalirudin about potential adverse effects of the drug. Which of the following effects should the nurse include? (Select all that apply.)

A patient who has atrial fibrillation is taking warfarin and has an INR of 2.5.The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend which medication?

A patient has been prescribed dabigatran (Pradaxa) for atrial fibrillation (AF). Which laboratory test should be monitored while on this medication?

A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

A client has been prescribed warfarin (Coumadin) for treatment of deep vein thrombosis (DVT). Which of the following instructions should the nurse include in patient teaching? Select all that apply.

A nurse is caring for a patient who is receiving heparin therapy via continuous IV infusion for treatment of deep vein thrombosis (DVT). The nurse should monitor which of the following laboratory values to evaluate therapeutic effectiveness of heparin therapy?

The nurse is caring for a patient who has received alteplase [Activase]. It is most important for the nurse to take which action?

A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse would ensure what information is gathered correctly before initiating the drip? Select all that apply: *.