A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?

A serum sodium (Na)

A radiological examination of the chest

A blood urea nitrogen (BUN)

An international normalized ratio (INR)

Answer and Explanation

The Correct Answer is D

A.   Serum sodium levels are typically assessed to evaluate electrolyte balance and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
B.   This could be ordered for various reasons such as assessing lung status or identifying any abnormalities in the chest. It is not directly related to monitoring warfarin therapy.
C.   BUN levels are measured to assess kidney function and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
D.   The INR is a standardized measurement of the blood's ability to clot. Warfarin works by inhibiting vitamin K-dependent clotting factors, thereby prolonging the time it takes for blood to clot. The INR is used to monitor and adjust warfarin dosage to maintain therapeutic anticoagulation levels, especially in patients with conditions like atrial fibrillation who are at risk of blood clots.

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Correct Answer is D

Explanation

A. Applying a warm compress can help dilate the blood vessels, potentially improving circulation around the IV site. This can sometimes alleviate discomfort caused by irritation or infiltration. However, if there is significant pain or swelling, warm compresses may not be sufficient.
B. Applying firm pressure on the syringe plunger during the flush is not recommended. Excessive force could potentially cause damage to the vein or exacerbate pain and discomfort. It's important to flush gently to maintain patency and avoid causing further irritation or complications.
C. If the client reports pain above the IV saline lock and there are signs of infiltration (such as swelling, coolness, or blanching of the skin around the site), removing the IV saline lock may be necessary. Infiltration occurs when IV fluid leaks into the surrounding tissue instead of flowing into the vein, which can lead to discomfort and complications.
D. Injecting the solution more slowly during the flush can help minimize discomfort and reduce the risk of causing further damage. Slower infusion allows for better tolerance by the vein and surrounding tissues, decreasing the likelihood of pain or infiltration.

A. pH 7.45 B. HCO3- 30 mEq/L C. Potassium 3.3 mEq/L D. PaCO2 50 mm Hg

Correct Answer is D

Explanation

A. A pH of 7.45 indicates alkalosis, not acidosis. In respiratory acidosis, the pH would be lower than normal (below 7.35) due to the accumulation of carbon dioxide.
B. A bicarbonate (HCO3-) level of 30 mEq/L is within the normal range (typically 22-26 mEq/L). Bicarbonate levels may be normal or slightly elevated in respiratory acidosis as a compensatory mechanism to buffer the excess acid.
C. Potassium levels can vary in respiratory acidosis but are not typically specified by a specific value. The level of potassium is more directly related to metabolic acid-base disturbances rather than respiratory acidosis.
D. An elevated PaCO2 level above 45 mm Hg indicates respiratory acidosis. In this scenario, a PaCO2 of 50 mm Hg suggests that the client is retaining carbon dioxide, leading to an acidotic state (lower pH).

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A nurse is assessing a preoperative client. The client has a history of atrial fibrillation and is taking warfarin daily. Which test order will the nurse request from the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is attempting to flush the IV saline lock for a client. The client reports pain above se should monitor the client for whic: flush. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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