The patient has been started on warfarin (Coumadin) for deep vein thrombosis. The patient asks when the medication will break up the clots. The nurse's best response would be:
"This medication will not break down clots but will make it less likely that the clot will get larger."
"It will break down the clot within 8 to 12 hours of administration."
"It will take 7 to 10 days for the clot to break down."
"You will need to be on this medication for a long time before it will break down the clot."
The Correct Answer is A
A. "This medication will not break down clots but will make it less likely that the clot will get larger." Warfarin (Coumadin) is an anticoagulant medication that works by inhibiting the synthesis of certain clotting factors in the liver. It does not directly break down existing clots but prevents the formation of new clots and the extension of existing ones. This response provides accurate information about the mechanism of action of warfarin.
B. "It will break down the clot within 8 to 12 hours of administration." This statement is incorrect. Warfarin does not have an immediate effect on existing clots. Its action is primarily preventive, reducing the risk of further clot formation and allowing the body's natural processes to gradually break down existing clots over time.
C. "It will take 7 to 10 days for the clot to break down." While the body's natural processes may start breaking down the clot within this timeframe, warfarin itself does not directly cause the dissolution of clots. This response is partially accurate in terms of the timeline for the body's natural clot resolution but does not specify that warfarin itself is not responsible for clot breakdown.
D. "You will need to be on this medication for a long time before it will break down the clot." This statement is misleading. Warfarin's role is to prevent the formation of new clots and further extension of existing ones rather than directly breaking down clots. Additionally, the duration of warfarin therapy is typically determined based on the individual's risk factors for clot formation, and it may not necessarily correlate with the time it takes for existing clots to resolve.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["23"]
Explanation
To determine how many milliliters (mL) of potassium chloride the nurse should administer to provide 30 mEq, we can set up a proportion:
20 mEq is contained in 15 mL. So, to find out how many mL contain 30 mEq, we can set up the proportion:
20 mEq:15 mL=30 mEq:? mL20mEq:15mL=30mEq:xmL
Cross multiply:
20×?=15×3020×x=15×30
20?=45020x=450
Now, solve for ?x:
?=45020x=20450
?=22.5x=22.5
So, the nurse should administer approximately 22.5 mL of potassium chloride.
Rounded to the nearest whole number, this would be 23 mL.
Therefore, the nurse should administer 23 mL of potassium chloride.
Correct Answer is D
Explanation
A. Clotting at the incision site. Enoxaparin (Lovenox) is an anticoagulant medication used to prevent blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE), which are common complications following orthopedic surgeries like knee replacement. Monitoring for clotting at the incision site is essential to ensure that the medication is effectively preventing excessive clot formation while also ensuring that the patient does not experience excessive bleeding.
B. Increased pain. While increased pain could be a concern postoperatively, particularly after a surgical procedure like knee replacement, it is not a specific monitoring parameter for enoxaparin administration. Pain management is typically addressed separately, and increased pain may indicate issues such as inadequate analgesia, surgical complications, or other factors unrelated to enoxaparin therapy.
C. Gingival hyperplasia. Gingival hyperplasia refers to an overgrowth of gum tissue and is not directly associated with enoxaparin therapy. This side effect is more commonly associated with certain medications such as phenytoin and cyclosporine rather than anticoagulants like enoxaparin. Monitoring for gingival hyperplasia would not be relevant in this context.
D. Signs and symptoms of bruising and bleeding. This is the correct answer. Enoxaparin is an anticoagulant medication, which increases the risk of bleeding. Therefore, monitoring for signs and symptoms of bruising and bleeding is crucial to detect any potential complications such as hemorrhage or hematoma formation. This includes assessing for unusual bruising, bleeding from the gums, nosebleeds, hematuria, melena, or any other signs of internal or external bleeding. Prompt recognition and management of bleeding complications are essential to ensure patient safety during enoxaparin therapy, especially following orthopedic surgery.
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