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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. While D5 0.45% NS contains dextrose, it is not suitable as an initial treatment in HHS because patients are often hyperglycemic. Starting with dextrose can worsen hyperglycemia.
B. Although providing oxygen may be appropriate if the client shows signs of respiratory distress or hypoxia, it is not the first-line treatment for HHS. The immediate priority is addressing dehydration and hyperglycemia.
C. The initial therapy for HHS involves administering IV fluids, typically starting with 0.9% saline (normal saline). This helps to rapidly rehydrate the client and dilute the high glucose levels in the blood. Correcting dehydration is critical in HHS management.
D. Glucagon is typically used to treat hypoglycemia, not hyperglycemia. In HHS, the patient is hyperglycemic, so administering glucagon would not be appropriate.

A. weight gain of 40 lbs. (18 kg) over the past 2 months B. currently prescribed aripiprazole, a second-generation antipsychotic agent C. sits & plays video games for 10-14 hours per day D. frequently eats salads with grilled chicken E. random blood glucose was 218 mg/dL with labs drawn 1 month ago

Correct Answer is ["B","C","E"]

Explanation

A. While rapid weight gain is a concern, it's important to consider the underlying cause. If the weight gain is medication-related (as in option B), it's a significant risk factor. However, if it's due to other factors like increased appetite or decreased activity, it might not be as directly linked to diabetes risk.
B. Many antipsychotic medications, including aripiprazole, have been linked to metabolic side effects like weight gain, increased blood glucose levels, and dyslipidemia. These metabolic changes can increase the risk of developing type 2 diabetes.
C. A sedentary lifestyle is a well-known risk factor for type 2 diabetes. Reduced physical activity can lead to insulin resistance, a condition where the body's cells become less responsive to insulin.
D. A diet rich in vegetables and lean protein is generally healthy and can help prevent chronic diseases. This option does not directly increase the risk of type 2 diabetes.
E. A random blood glucose level above 200 mg/dL is indicative of diabetes. This is a clear marker of impaired glucose metabolism and a significant risk factor for type 2 diabetes.

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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:

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Naxlex Comprehensive Predictor Exams

A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of Hyperosmolar Hyperglycemic Syndrome (HHS) is made. The nurse prepares for the administration of which initial therapy?

Correct Answer is C

Explanation

What factors in the history of a client with schizoaffective disorders puts the client at higher risk for type 2 diabetes? (SELECT ALL THAT APPLY)

Correct Answer is ["B","C","E"]

Explanation

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