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 D
Explanation
A. Easy bruising indicates the medication is effective: While some bruising is possible, excessive bruising doesn't necessarily mean the medication is working effectively. It could indicate excessive anticoagulation, requiring dose adjustments.
B. Inject the medication deep into the thigh muscle: Heparin is injected subcutaneously, targeting the fatty tissue layer just beneath the skin. Injecting into the muscle can be painful and decrease absorption.
C. Expect stools to become black and tarry: Black stools can be a sign of upper gastrointestinal bleeding, a potential but uncommon side effect. The nurse should instruct the client to report any black stools but not expect them as a normal occurrence.
D. Use a soft bristle toothbrush: This is important because heparin increases bleeding risk, and a soft-bristled toothbrush minimizes gum irritation and potential bleeding.
Correct Answer is C
Explanation
- White Blood Cell Count (WBC): WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation. WBCs do not adhere to the vessel wall during hemostasis.
- Activated Partial Thromboplastin Time (aPTT): aPTT measures the time it takes for blood to clot. It is primarily used to monitor heparin therapy, not warfarin. aPTT is not specific for warfarin monitoring.
- Prothrombin Time (PT): PT measures how quickly blood clots. It is used to monitor warfarin therapy and assess clotting factors. PT is essential for monitoring warfarin effectiveness.
- Platelet Count: Platelets are crucial for clot formation. Platelet count helps assess platelet function. Platelets play a direct role in hemostasis.
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