Which of the following would be included in bleeding precautions for a client taking warfarin? SELECT ALL THAT APPLY

Use soft bristled tooth brush

Report black or bloody bowel movements

Limit all fruits and vegetables

Report coffee ground or bloody emesis

Shave with electric razor instead of razor blade

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Using a soft bristled tooth brush can prevent gum bleeding and irritation that may occur with a hard bristled tooth brush. Gum bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.

Choice B reason: Reporting black or bloody bowel movements is important because it can indicate gastrointestinal bleeding, which can be a serious complication of warfarin therapy. Gastrointestinal bleeding can cause anemia, shock, and even death if not treated promptly.

Choice C reason: Limiting all fruits and vegetables is not necessary for a client taking warfarin. However, some fruits and vegetables, especially those that are high in vitamin K, can interfere with the effect of warfarin and increase the risk of clotting. Vitamin K is found in green leafy vegetables, such as spinach, kale, broccoli, and cabbage, and some fruits, such as avocado, kiwi, and grapes. The client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.

Choice D reason: Reporting coffee ground or bloody emesis is also important because it can indicate upper gastrointestinal bleeding, which can be another serious complication of warfarin therapy. Upper gastrointestinal bleeding can cause hematemesis, melena, anemia, and hypovolemic shock.

Choice E reason: Shaving with an electric razor instead of a razor blade can prevent skin cuts and bleeding that may occur with a razor blade. Skin cuts and bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.

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Correct Answer is B

Explanation

Choice A reason: This is incorrect because 30 minutes is too long to wait for reassessing a client with chest pain. Nitroglycerin has a rapid onset of action and should relieve chest pain within 5 minutes. If not, the client may need another dose or emergency care.

Choice B reason: This is correct because 5 minutes is the appropriate time to reassess a client after administering nitroglycerin sublingual. The nurse should check the client's blood pressure, heart rate, and pain level. If the pain persists, the nurse should follow the protocol for giving another dose or calling for help.

Choice C reason: This is incorrect because 1 hour is too long to wait for reassessing a client with chest pain. Nitroglycerin has a short duration of action and may need to be repeated every 5 minutes for up to 3 doses. Waiting for an hour may put the client at risk of worsening cardiac ischemia or infarction.

Choice D reason: This is incorrect because 15 minutes is too long to wait for reassessing a client with chest pain. Nitroglycerin should have an effect within 5 minutes. If the pain is not relieved by then, the client may need another dose or emergency care.

Correct Answer is ["8"]

Explanation

To calculate the amount of belimumab that the nurse should administer, we can use the following steps:

Convert the patient's weight from pounds to kilograms.

Multiply the patient's weight in kilograms by the dosage of belimumab (10 mg/kg) to find the total dosage required.

Determine the volume of the drug needed using the concentration of the available belimumab solution.

Given:

Patient's weight = 136 lb

Dosage of belimumab = 10 mg/kg

Available concentration of belimumab = 80 mg/mL

Let's calculate step by step:

Convert patient's weight from pounds to kilograms:

Patient's weight in kg = 136 lb × (1 kg / 2.2 lb) ≈ 61.8 kg

Calculate the total dosage required:

Total dosage = 10 mg/kg × 61.8 kg ≈ 618 mg

Determine the volume of the drug needed using the concentration of the available belimumab solution:

Volume of drug = Total dosage / Concentration of belimumab

Volume of drug = 618 mg / 80 mg/mL ≈ 7.7 mL

Rounding to the nearest whole number, the nurse should administer 8 mL of the belimumab.

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Which of the following would be included in bleeding precautions for a client taking warfarin? SELECT ALL THAT APPLY

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Naxlex Comprehensive Predictor Exams

When should the nurse reassess a client after administering 0.4 mg nitroglycerin sublingual to a client with chest pain?

Correct Answer is B

Explanation

A nurse is preparing to administer belimumab 10 mg/kg via intermittent IV bolus to a client who weighs 136 lb. Available is belimumab 80 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["8"]

Explanation

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