A client with deep vein thrombosis (DVT) is prescribed anticoagulant therapy. What is the nurse's priority action in monitoring the client's response to the medication?

Assessing for changes in blood pressure.

Monitoring the client's prothrombin time (PT) and international normalized ratio (INR).

Checking the client's blood glucose levels.

Evaluating the client's respiratory rate and pattern.

Answer and Explanation

The Correct Answer is B

A) This choice is incorrect because while monitoring blood pressure is essential, it is not the priority action for clients on anticoagulant therapy. The primary concern is assessing the client's response to the medication and their risk of bleeding.

B) This choice is correct. Monitoring the client's prothrombin time (PT) and international normalized ratio (INR) is crucial in assessing the effectiveness of anticoagulant therapy. The PT and INR measure how long it takes the blood to clot and help determine the appropriate dosage of anticoagulants to achieve the desired therapeutic effect.

C) This choice is incorrect because checking the client's blood glucose levels is not directly related to monitoring the response to anticoagulant therapy. Blood glucose monitoring is essential for clients with diabetes but not a priority in this context.

D) This choice is incorrect because evaluating the client's respiratory rate and pattern is not the priority action for monitoring the response to anticoagulant therapy. Respiratory assessment is vital in detecting potential complications like a pulmonary embolism but does not directly assess the client's anticoagulation status.

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Correct Answer is A

Explanation

A) This choice is correct. The D-dimer blood test is a rapid and sensitive screening test that can help rule out DVT in low-risk individuals. A negative D-dimer result can be useful in excluding DVT, avoiding unnecessary imaging or invasive tests.

B) This choice is incorrect because contrast venography is not a rapid test and involves invasive procedures. It is not used as a first-line screening test due to its complexity and potential risks.

C) This choice is incorrect because magnetic resonance imaging (MRI) may provide valuable information, but it is not the first choice for rapid rule-out of DVT. MRI may be employed in specific cases when initial screening tests are inconclusive.

D) This choice is incorrect because the Wells score assessment is not a diagnostic test but a scoring system to estimate the likelihood of DVT. It does not provide rapid results to rule out DVT directly.

A. "Avoid sitting or standing in one position for extended periods." B. "Massage the legs regularly to improve blood circulation." C. "Increase your intake of leafy greens and foods rich in vitamin K." D. "Take over-the-counter pain medications for leg discomfort."

Correct Answer is A

Explanation

A) This choice is correct. Prolonged sitting or standing in one position can lead to reduced blood flow and stasis, increasing the risk of DVT. Encouraging regular movement and changing positions can help prevent clot formation.

B) This choice is incorrect because massaging the legs may not be suitable for everyone and is not a primary preventive measure for DVT. While it can aid in improving blood circulation, it should be done cautiously and not as a standalone preventive action.

C) This choice is incorrect because increasing the intake of vitamin K-rich foods is not a preventive measure for DVT. Vitamin K is involved in the clotting process, but it does not directly impact the risk of DVT.

D) This choice is incorrect because taking over-the-counter pain medications for leg discomfort does not prevent DVT. While pain management may be necessary for symptomatic relief, it does not address the underlying risk factors for DVT.

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A client with deep vein thrombosis (DVT) is prescribed anticoagulant therapy. What is the nurse's priority action in monitoring the client's response to the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted to the hospital with symptoms suggestive of deep vein thrombosis (DVT). Which test can provide rapid results to rule out DVT and guide further diagnostic workup?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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