Which instruction should the nurse provide an unlicensed assistive personnel (UAP) who is assisting with the personal care of a client receiving clopidogrel?

Maintain a cool, calm room environment.

Provide the client with a soft toothbrush.

Allow the client ample rest periods.

Keep the head of the bed elevated.

Answer and Explanation

The Correct Answer is B

A) Maintain a cool, calm room environment: While a calm environment can be beneficial for overall patient well-being, it is not specifically related to the care of a client on clopidogrel. This instruction does not address the direct needs or precautions associated with clopidogrel use.
B) Provide the client with a soft toothbrush: Clopidogrel is an antiplatelet medication that increases the risk of bleeding. To minimize gum bleeding and oral mucosal damage, it is crucial to use a soft toothbrush to prevent injury. This measure helps to reduce the risk of bleeding complications associated with the medication.
C) Allow the client ample rest periods: While rest is important for overall health, it is not specifically related to the precautions needed for a client on clopidogrel. The primary concern with clopidogrel is managing bleeding risks rather than providing rest.
D) Keep the head of the bed elevated: Elevating the head of the bed is generally useful for managing certain conditions like respiratory issues or gastrointestinal reflux but does not directly relate to the specific needs of a client taking clopidogrel. The focus for clients on clopidogrel should be on preventing bleeding complications.

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Correct Answer is A

Explanation

A. Platelet count of 100,000/mm³ (100 x 10^9/L): Enoxaparin is a low molecular weight heparin used to prevent deep vein thrombosis (DVT), and a low platelet count (thrombocytopenia) can be a serious adverse effect of anticoagulant therapy. A platelet count of 100,000/mm³ is below the normal range (150,000 to 400,000/mm³) and indicates potential thrombocytopenia, which could increase the risk of bleeding and may warrant immediate action.

B. Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L): This BUN level is at the upper limit of normal but does not typically require immediate action unless there are other symptoms or significant changes in kidney function.

C. Serum creatinine 1.0 mg/dL (88.4 μmol/L): This value is within the normal range for serum creatinine and does not indicate an immediate concern related to enoxaparin.

D. Hematocrit 45% (0.45 volume fraction): This hematocrit level is within the normal range and does not typically require immediate action.

A. Pull up 30 units from the 70/30 vial, but only administer one third. B. Withdraw ten units regular insulin from the 70/30 vial. C. Withhold the dose until insulin regular is available on the unit. D. Obtain a new vial of regular insulin and withdraw ten units.

Correct Answer is C

Explanation

A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.

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Which instruction should the nurse provide an unlicensed assistive personnel (UAP) who is assisting with the personal care of a client receiving clopidogrel?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

Correct Answer is C

Explanation

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