A nurse is assisting in the education of a group of clients about the contraindications of warfarin therapy. Which of the following statements is appropriate to include in the instructions?

"Clients who have rheumatoid arthritis should not take warfarin."

"Clients who have diabetes mellitus type 1 should not take warfarin"

"Clients who have hypertension should not take warfarin"

"Clients who are pregnant should not take warfarin"

Answer and Explanation

The Correct Answer is D

A) "Clients who have rheumatoid arthritis should not take warfarin":
Rheumatoid arthritis itself is not a contraindication for warfarin therapy. However, close monitoring is required due to potential interactions with medications used to treat rheumatoid arthritis and the increased risk of bleeding associated with both conditions.

B) "Clients who have diabetes mellitus type 1 should not take warfarin":
Type 1 diabetes mellitus is not a contraindication for warfarin therapy. However, diabetes increases the risk of complications such as peripheral vascular disease, which may necessitate careful monitoring of INR levels and adjustments to warfarin dosage.

C) "Clients who have hypertension should not take warfarin":
Hypertension alone is not a contraindication for warfarin therapy. However, hypertension is a risk factor for cardiovascular diseases that may require anticoagulation therapy. Close monitoring of blood pressure and potential interactions with antihypertensive medications is essential.

D) "Clients who are pregnant should not take warfarin":
Pregnancy is a contraindication for warfarin therapy due to its teratogenic effects, which can cause fetal harm or birth defects. Pregnant clients requiring anticoagulation therapy may be prescribed alternative medications that are safer during pregnancy, under the guidance of a healthcare provider.

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Correct Answer is D

Explanation

A) Shave excess hair from skin before applying a nitroglycerin patch:
Shaving excess hair is not necessary for applying a nitroglycerin patch. The patch should be applied to a clean, dry, and hairless area of skin to ensure proper adhesion and absorption of medication.

B) Keep a nitroglycerin patch in place 24 hr. per day:
Nitroglycerin patches are typically worn for a specified period (usually 12 to 14 hours) and then removed for a "patch-free" interval to prevent tolerance development. Continuous use can lead to tolerance, reducing the effectiveness of the medication.

C) Put a second patch in place if angina pain occurs:
Applying a second nitroglycerin patch is not recommended without consulting a healthcare provider. Increasing the dosage of nitroglycerin without proper medical advice can lead to hypotension and other adverse effects. The client should follow the prescribed regimen and seek medical assistance if angina pain is not relieved.

D) Fold used patch with medication area to the inside and discard in a closed receptacle:
This is the correct instruction. Used nitroglycerin patches should be folded with the adhesive side together (medication area inside) to prevent accidental exposure and disposed of in a closed receptacle. This helps ensure safe disposal and prevents unintentional contact with the medication by others.

Correct Answer is ["7.5"]

Explanation

We can calculate the volume of potassium chloride solution to administer using the following steps:

Identify the prescribed dose: The nurse needs to administer 20 mEq of potassium chloride.

Identify the concentration of available solution: The potassium chloride liquid is available in a concentration of 40 mEq/15 mL. This means there are 40 milliequivalents (mEq) of potassium chloride in every 15 milliliters (mL) of the solution.

Set up a proportion to find the volume needed:

Desired dose (mEq) : Volume to administer (mL) = Concentration (mEq/mL)

Plug in the values:

20 mEq : Volume to administer (mL) = 40 mEq/15 mL

Solve for the volume:

To isolate the volume (mL), multiply both sides of the proportion by the volume unit (mL) and divide by the dose (mEq).

Volume to administer (mL) = (20 mEq) x (mL) / (40 mEq/15 mL)

We can simplify the calculation before dividing:

Volume to administer (mL) = (20 mEq x 15 mL) / 40 mEq

Volume to administer (mL) = 300 mL / 40 mEq

Volume to administer (mL) = 7.5 mL (round to one decimal place)

Therefore, the nurse should administer 7.5 mL of the potassium chloride solution.

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A nurse is assisting in the education of a group of clients about the contraindications of warfarin therapy. Which of the following statements is appropriate to include in the instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching for a client who has angina pectoris and a new prescription to apply a nitroglycerin transdermal patch daily at home. Which of the following instructions should the nurse give the client?

Correct Answer is D

Explanation

A nurse is preparing to administer potassium chloride 20 mEq. The amount available is potassium chloride liquid 40 mEq/15 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["7.5"]

Explanation

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