A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

Request a prescription to change the route of administration and use the available heparin.

Calculate and administer the equivalent dose of the available low molecular weight heparin.

Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately.

Dilute the available heparin in 250 mL of normal saline solution prior to IV administration.

Answer and Explanation

The Correct Answer is C

A) Request a prescription to change the route of administration and use the available heparin:
Changing the route of administration without a prescription is not within the nurse's scope of practice and could lead to medication errors or adverse effects. It's essential to follow the prescribed route of administration to ensure patient safety.

B) Calculate and administer the equivalent dose of the available low molecular weight heparin:
Low molecular weight heparin (LMWH) has different dosing and potency compared to unfractionated heparin. Calculating an equivalent dose without a specific conversion ratio could result in under- or overdosing, leading to ineffective anticoagulation or increased risk of bleeding.

C) Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately:
This is the correct action. Since the prescription specifies unfractionated heparin administered intravenously, the nurse should notify the pharmacy to provide the correct medication promptly. Using a different form of heparin could lead to dosing errors or ineffective treatment.

D) Dilute the available heparin in 250 mL of normal saline solution prior to IV administration:
This action is not appropriate because it assumes that the available heparin is suitable for intravenous administration, which may not be the case. Dilution may also alter the concentration and potency of the medication, leading to inaccurate dosing and potential adverse effects.

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

A) Obtain a soft bristle toothbrush for the client:
This is an appropriate action because bleeding and tender gums can indicate oral bleeding, which may be exacerbated by the use of a standard toothbrush. Switching to a soft bristle toothbrush can help minimize trauma to the gums and reduce bleeding.

B) Provide a PRN nonsteroidal anti-inflammatory drug (NSAID) for gum discomfort:
Administering NSAIDs in this situation is not recommended. NSAIDs can further increase the risk of bleeding due to their antiplatelet effects. Therefore, providing an NSAID could exacerbate the client’s bleeding symptoms.

C) Review most recent coagulation lab values:
This is a crucial action to assess the client’s coagulation status and determine if the bleeding and bruising are related to anticoagulant therapy. Reviewing coagulation lab values, such as prothrombin time (PT) and international normalized ratio (INR), can provide important information about the client’s clotting function and guide further management.

D) Report findings to the healthcare provider:
This is essential to ensure timely evaluation and management of the client’s symptoms. Bleeding and bruising after anticoagulant therapy may indicate an increased risk of bleeding complications, and the healthcare provider needs to be informed promptly for further assessment and possible adjustment of the anticoagulant regimen.

E) Complete a medication variance report:
While documenting the client’s symptoms and actions taken is important for quality assurance and tracking adverse events, completing a medication variance report may not be the immediate priority in this situation. The focus should be on assessing the client’s condition, managing symptoms, and communicating with the healthcare provider for appropriate intervention

A. Stop the oral contraceptive immediately. B. Use an additional form of contraception. C. Take the medications at least 12 hours apart. D. Avoid prolonged exposure to direct sunlight

Correct Answer is B

Explanation

A) Stop the oral contraceptive immediately:
This instruction is incorrect and potentially harmful. Suddenly stopping oral contraceptives can lead to unintended pregnancy and disrupt the client's menstrual cycle. It's crucial for the client to continue taking their oral contraceptive unless advised otherwise by their healthcare provider.

B) Use an additional form of contraception:
This is the correct recommendation. Erythromycin is an antibiotic that can reduce the effectiveness of oral contraceptives by altering gut flora and potentially interfering with their absorption. Therefore, using an additional form of contraception, such as condoms, is advised while taking erythromycin to prevent unintended pregnancy.

C) Take the medications at least 12 hours apart:
While spacing medications apart can sometimes minimize interactions, specific instructions regarding the timing of erythromycin and oral contraceptive administration should be obtained from the healthcare provider. Simply spacing the medications apart may not sufficiently prevent contraceptive failure.

D) Avoid prolonged exposure to direct sunlight:
This instruction is unrelated to the interaction between erythromycin and oral contraceptives. While erythromycin can increase sensitivity to sunlight (photosensitivity), it does not directly affect the effectiveness of oral contraceptives. Therefore, while it's important to advise clients to protect themselves from sun exposure while taking erythromycin, it's not directly related to contraceptive use.

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A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After receiving the third dose of a new oral anticoagulant prescription, an older client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Correct Answer is B

Explanation

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