A client is receiving heparin sodium 5000 units IV and oral warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg. The nurse educated the client that heparin and warfarin are both used because:
the heparin provides anticoagulation until the warfarin becomes effective.
this combination facilitates the dissolving of the clot.
smaller doses of both drugs can be used with this method of administration.
this combination provides immediate maximum protection against clot formation.
The Correct Answer is A
A. Heparin acts quickly to provide immediate anticoagulation, while warfarin takes several days to reach therapeutic levels. Heparin ensures that the client is adequately anticoagulated during the initial phase while waiting for warfarin to take effect.
B. Neither heparin nor warfarin directly dissolves clots. They are both anticoagulants that prevent further clot formation and allow the body's natural processes (fibrinolysis) to break down the existing clot over time. The combination does not specifically facilitate the dissolution of clots.
C. This statement is misleading. The use of both medications is not primarily about reducing the doses. Instead, each medication has its own dosing based on the patient’s needs, and the combination is used for timing and efficacy rather than dose reduction.
D. While heparin does provide immediate anticoagulation, saying it provides "maximum protection" could be misleading. It does ensure effective anticoagulation in the short term, but the maximum effect is related to individual response and therapeutic levels, which vary. Additionally, once warfarin reaches therapeutic levels, it becomes the primary agent for long-term anticoagulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
A. While maintaining adequate hydration is important for overall health and can help the kidneys function properly, this statement alone does not capture the full scope of kidney-related issues associated with diabetes, such as diabetic nephropathy. It’s important to emphasize regular monitoring of kidney function through lab tests (e.g., microalbuminuria) as part of diabetes management.
B. People with diabetes are at increased risk for eye complications such as diabetic retinopathy, cataracts, and glaucoma. Regular eye exams are essential for early detection and management of these conditions, making this information critical for a client with diabetes.
C. Many sources recommend at least annual foot exams, but those with neuropathy or previous foot problems may need more frequent evaluations (every 3 to 6 months). This statement is generally accurate but should be tailored to the individual's risk factors.
D. Regular physical activity is generally recommended for individuals with diabetes as it improves insulin sensitivity, helping to manage blood glucose levels. While extreme exercise without proper management can lead to complications, stating that excessive exercise increases insulin resistance is misleading. The key is to balance exercise with proper nutrition and medication.
Correct Answer is A
Explanation
A. The client's fasting blood glucose levels (70-80 mg/dl) are within the normal range, and a post- prandial blood glucose level below 200 mg/dl is also considered well-controlled, particularly for someone on an intensified insulin regimen. The hemoglobin A1c level of 4.5% indicates excellent long- term glucose control, typically representing average blood glucose levels of around 90 mg/dl.
B. Hyperglycemia is characterized by elevated blood glucose levels. Given the client's consistently normal fasting and post-prandial levels, they are not at an increased risk for hyperglycemia. Instead, they are maintaining their glucose levels well.
C. Insulin resistance typically manifests as elevated blood glucose levels despite adequate insulin levels or increased insulin requirements. In this case, the client's blood glucose levels are well-controlled, indicating that they are likely responding well to insulin therapy and are not showing signs of insulin resistance.
D. While the client’s blood glucose levels are well-controlled, the risk for hypoglycemia depends on various factors, including insulin dosage, timing, and food intake. However, consistently normal levels do not directly indicate a risk for hypoglycemia unless insulin doses are excessively high or meals are skipped. Therefore, this choice is not justified given the data provided.
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