A client has a prescription for heparin 5000 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.

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

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

Answer and Explanation

The Correct Answer is D

Choice A reason:

Requesting a prescription to change the route of administration and use the available heparin is not appropriate. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable on a unit-for-unit basis. They have different pharmacokinetics and dosing requirements. Changing the route without proper guidance can lead to incorrect dosing and potential complications.

Choice B reason:

Calculating and administering the equivalent dose of the available low molecular weight heparin is incorrect. LMWH and UFH have different dosing protocols and are not directly interchangeable. Administering LMWH instead of UFH without proper conversion and guidance can result in inappropriate anticoagulation.

Choice C reason:

Diluting the available heparin in 250 ml of normal saline solution prior to IV administration is not appropriate. The prescription specifies heparin 5000 units IV STAT, which indicates an immediate need for intravenous administration. Diluting and administering it in this manner does not align with the urgency of the order.

Choice D reason:

Advising the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately is the correct action. This ensures that the client receives the prescribed medication in the correct form and dosage as ordered by the healthcare provider. It is crucial to follow the specific instructions for heparin administration to ensure patient safety and effective anticoagulation.

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Correct Answer is C

Explanation

Choice A Reason:

Taking the medications at least 12 hours apart does not address the interaction between erythromycin and oral contraceptives. Erythromycin can reduce the effectiveness of oral contraceptives by increasing the metabolism of the hormones in the contraceptive, leading to a higher risk of unintended pregnancy. Therefore, simply spacing out the medications will not mitigate this risk.

Choice B Reason:

Stopping the oral contraceptive immediately is not advisable without consulting a healthcare provider. Abruptly discontinuing the contraceptive can lead to hormonal imbalances and unintended pregnancy. The primary concern with erythromycin is its potential to reduce the effectiveness of the contraceptive, not that it necessitates stopping the contraceptive altogether.

Choice C Reason:

Using an additional form of contraception is the most appropriate advice. Erythromycin can interfere with the effectiveness of oral contraceptives, so using a backup method, such as condoms, is recommended to prevent unintended pregnancy. This ensures that the client remains protected while taking both medications.

Choice D Reason:

Avoiding prolonged exposure to direct sunlight is not relevant to the interaction between erythromycin and oral contraceptives. While some medications can increase photosensitivity, this is not a primary concern with erythromycin in the context of contraceptive use.

A. Consult with a pharmacist about scheduling the dose one hour after the client eats. B. Withhold the medication until the client’s breakfast tray is available on the unit. C. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk. D. Instruct the client that it is necessary to take nothing but water with the medication.

Correct Answer is D

Explanation

Choice A reason:

Consulting with a pharmacist about scheduling the dose one hour after the client eats is not appropriate for risedronate. This medication should be taken on an empty stomach to ensure proper absorption. Taking it with food or beverages other than water can significantly reduce its effectiveness.

Choice B reason:

Withholding the medication until the client’s breakfast tray is available is incorrect. Risedronate should be taken first thing in the morning, at least 30 minutes before any food, drink (other than water), or other medications.

Choice C reason:

Assigning unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk is not appropriate. Milk and other beverages can interfere with the absorption of risedronate, making it less effective.

Choice D reason:

Instructing the client that it is necessary to take nothing but water with the medication is the correct action. Risedronate should be taken with a full glass of plain water to ensure it reaches the stomach quickly and is absorbed properly. This helps maximize the medication’s effectiveness and reduces the risk of esophageal irritation.

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A client has a prescription for heparin 5000 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

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Explanation

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Explanation

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