A nurse is assessing a client who is receiving heparin therapy for deep-vein thrombosis.
Which of the following findings should indicate to the nurse that the therapy is effective?
Platelets within the expected reference range.
Decreased INR.
Presence of pedal pulses bilaterally.
Reduced calf circumference.
The Correct Answer is D
Heparin therapy is used to prevent thrombus propagation and distal embolization while allowing the endogenous fibrinolytic system to dissolve existing clots in deep-vein thrombosis (DVT)1.
A reduction in calf circumference may indicate that the clot is dissolving and the therapy is effective.
Choice A is wrong because platelets within the expected reference range do not necessarily indicate that heparin therapy for DVT is effective.
Choice B is wrong because INR (International Normalized Ratio) is used to monitor warfarin therapy, not heparin therapy.
Choice C is wrong because the presence of pedal pulses bilaterally does not necessarily indicate that heparin therapy for DVT is effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Warfarin is an oral anticoagulant medication and is not administered subcutaneously.
The nurse should clarify this prescription with the provider before administering it.
Choice A is wrong because tetracycline can be prescribed in doses of 1 g orally every 6 hours.
Choice C is wrong because Penicillin G can be prescribed in doses of 5,000,000 units intramuscularly every 4 hours.
Choice D is wrong because Zoledronate can be prescribed as a single intravenous dose of 5 mg.
Correct Answer is A
Explanation
The nurse should monitor the client for hearing loss because it is a potential adverse effect of erythromycin.
Choice B is wrong because a high-fiber diet to prevent constipation is not mentioned as a necessary action when administering erythromycin lactobionate IV bolus.
Choice C is wrong because erythromycin lactobionate IV bolus should not be administered over 10 min; bolus injection (IV push) is contraindicated.
Choice D is wrong because erythromycin lactobionate should not be reconstituted with a 5% dextrose solution; it should be reconstituted with sterile water for injection.
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