To prevent deep vein thromboses following knee replacement surgery, an adult male client is receiving daily subcutaneous enoxaparin. 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/mm² (150 to 400 × 10^9/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/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 10^9/L).

Hematocrit 45% (0.45 volume fraction).

Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L).

Serum creatinine 1.0 mg/dL (88.4 μmol/L).

Answer and Explanation

The Correct Answer is A

Choice A reason: Platelet count of 100,000/mm³ (100 x 10^9/L) is below the normal range and indicates thrombocytopenia, which is a decrease in the number of platelets in the blood. Thrombocytopenia can increase the risk of bleeding and bruising, and can be a serious adverse effect of enoxaparin. This laboratory result requires immediate action by the nurse, such as notifying the prescriber, monitoring for signs of bleeding, and withholding the next dose of enoxaparin.

Choice B reason: Hematocrit 45% (0.45 volume fraction) is within the normal range and does not indicate any problem with the client's red blood cells or oxygen-carrying capacity.

Choice C reason: Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L) is within the normal range and does not indicate any problem with the client's kidney function or hydration status.

Choice D reason: Serum creatinine 1.0 mg/dL (88.4 μmol/L) is within the normal range and does not indicate any problem with the client's kidney function or muscle metabolism.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is ["0.8"]

Explanation

The correct answer is 0.8 mL.

To find the answer, we can use the following formula:

(mg of medication ordered / mg of medication per mL) = mL to administer

Substituting the values from the question, we get:

(80 mg / 60 mg per 0.6 mL) = 0.8 mL

Therefore, the nurse should administer 0.8 mL of enoxaparin sodium injection.

A. Trouble sleeping B. Difficulty with urination C. Unexplained weight loss D. Recent oral intake

Correct Answer is D

Explanation

Choice A reason: Trouble sleeping is not a relevant information for administering pyridostigmine, which is a cholinesterase inhibitor that improves muscle strength and function in patients with myasthenia gravis. Trouble sleeping may be caused by other factors, such as stress, pain, or medication side effects.

Choice B reason: Difficulty with urination is not a pertinent information for administering pyridostigmine, which does not affect urinary function or bladder control. Difficulty with urination may indicate a urinary tract infection, prostate enlargement, or kidney stones.

Choice C reason: Unexplained weight loss is not a significant information for administering pyridostigmine, which does not affect metabolism or appetite. Unexplained weight loss may be a sign of an underlying condition, such as hyperthyroidism, diabetes, or cancer.

Choice D reason: Recent oral intake is the correct information for administering pyridostigmine, which should be taken on an empty stomach or before meals to enhance its absorption and effectiveness. Pyridostigmine can also help prevent or reduce dysphagia (difficulty swallowing), which is a common symptom of myasthenia gravis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["0.8"]

Explanation

A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication?

Correct Answer is D

Explanation

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