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 D
Explanation
Improved cognition should indicate to the nurse that the treatment with a hypertonic solution for hyponatremia is effective.
Hyponatremia can cause confusion and other neurological symptoms, so an improvement in cognition would suggest that the treatment is working to correct the electrolyte imbalance.
Choice A is wrong because Chvostek’s sign is a clinical sign of hypocalcemia, not hyponatremia.
Choice B is wrong because while vomiting can be a symptom of hyponatremia, a decrease in vomiting alone does not necessarily indicate that the treatment is effective.
Choice C is wrong because while hyponatremia can cause cardiac arrhythmias, the absence of arrhythmias alone does not necessarily indicate that the treatment is effective.
Correct Answer is ["A","C","D"]
Explanation
When self-administering enoxaparin, the client should “Insert the entire length of the needle into the skin during injection” 1, “Grasp the skin between the thumb and forefinger while injecting the medication” , and “Alternate injection sites between the sides of the abdomen”
Choice B is wrong because the client should not massage the insertion site after injecting the medication.
Choice E is incorrect because the client should not expel the air bubble from the prefilled syringe.
The air bubble helps to ensure that all of the medication is injected and prevents leakage from the injection site.
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