A nurse in reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider?

Partial thromboplastin time (PTT) 65 seconds

Hematocrit 45%

White blood cell count 8.000/mm3

Platelets

Answer and Explanation

The Correct Answer is A

A. Partial thromboplastin time (PTT) 65 seconds: The normal PTT range is typically between 25 to 35 seconds for patients not on anticoagulants. For a patient receiving heparin therapy, the therapeutic PTT range is usually 1.5 to 2.5 times the normal value, which translates to approximately 60 to 100 seconds. A PTT of 65 seconds is at the lower end of the therapeutic range and may require adjustment in dosage or closer monitoring, especially if there are concerns about achieving adequate anticoagulation for the treatment of a pulmonary embolism. It is important to report this value to the provider.

B. Hematocrit 45%: A hematocrit of 45% is within the normal range for adult females (38% to 47%) and males (40% to 54%). This value does not indicate any immediate concern related to heparin therapy or the treatment of a pulmonary embolism.

C. White blood cell count 8.000/mm³: A white blood cell count of 8,000/mm³ is within the normal range (4,500 to 11,000/mm³) and does not indicate any infection or inflammatory process that requires immediate reporting.

D. Platelets: The specific platelet count value is not provided. However, heparin therapy can lead to thrombocytopenia (low platelet count), so if the platelet count is below 150,000/mm³, it should be reported to the provider. Without the specific value, it is not possible to determine if this requires reporting.

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Correct Answer is D

Explanation

A. Vigorously brush the client's teeth: Vigorous brushing is not appropriate for an unconscious client. It can cause trauma to the gums or teeth and increase the risk of aspiration if the client has any residual secretions or fluids in the mouth. Gentle brushing should be employed to avoid injury.

B. Hold the toothbrush at a 90° angle: Holding the toothbrush at a 90° angle is not necessary for clients who are unconscious. A more effective angle may be around 45° to effectively clean the surfaces of the teeth while minimizing the risk of gagging or aspiration.

C. Place two fingers in the client's mouth: This action could be harmful, as placing fingers in the mouth of an unconscious client poses a risk of injury or could inadvertently trigger a gag reflex. Instead, proper oral care should be conducted using appropriate tools without placing fingers inside the mouth.

D. Turn the client to the side: Turning the client to the side is the best action as it helps prevent aspiration of secretions or fluids during oral care. This position allows for safer access to the mouth while also promoting drainage of any excess fluids, reducing the risk of choking or aspiration pneumonia.

A. 212 B. 214 C. 208 D. 216

Correct Answer is C

Explanation

A. 212: Room 212 is a semi-private, positive-pressure airflow room. Positive-pressure rooms are used for patients who are immunocompromised to prevent outside pathogens from entering, which would not be suitable for a client with a productive cough and a positive Mantoux test, as this indicates a risk for tuberculosis (TB) transmission.

B. 214: Room 214 is a semi-private, negative-pressure room. While negative-pressure rooms are suitable for clients with infectious diseases like TB, the semi-private setup may not be appropriate due to the potential for airborne transmission to another patient.

C. 208: Room 208 is a private, negative-pressure airflow room. This is the most appropriate assignment for the client with a productive cough and a positive Mantoux test, as negative-pressure rooms help contain airborne pathogens and prevent their spread to other areas. The private setting also reduces the risk of exposing other patients to potential infection.

D. 216: Room 216 is a private, positive-pressure airflow room. Similar to Room 212, this type of room is designed to protect immunocompromised patients rather than those with infectious diseases like TB. Assigning the client to this room would increase the risk of transmission to healthcare workers and other patients.

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A nurse in reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing oral care for a client who is unconscious. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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