A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Petechiae

Slowing pulse rate

Confusion

Pruritus

Answer and Explanation

The Correct Answer is A

Rationale:

A. Petechiae are small, pinpoint red or purple spots on the skin that may indicate bleeding or thrombocytopenia, which can be a side effect of heparin therapy.

B. Slowing pulse rate is not typically associated with heparin therapy.

C. Confusion is not typically associated with heparin therapy.

D. Pruritus (itching) is not typically associated with heparin therapy.

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Correct Answer is B

Explanation

Rationale:

A. Looking for P waves is important for assessing atrial activity, but it does not directly calculate heart rate.

B. Counting how many QRS complexes occur in a 6-second strip and multiplying by 10 is a quick and accurate way to calculate heart rate.

C. Reading the monitor or ECG interpretation provides information about the rhythm and morphology of the heart, but it does not directly calculate heart rate.

D. Measuring T waves is important for assessing cardiac repolarization, but it does not directly calculate heart rate.

A. The client will need annual flu vaccine B. Update Covid 19 vaccination C. You will require antibiotics before dental work. D. Avoid sick contacts

Correct Answer is C

Explanation

Rationale:

A. The client may need an annual flu vaccine, but this is not specific to infective endocarditis.

B. Updating the Covid-19 vaccination is important, but this is not specific to infective endocarditis.

C. The client will require antibiotics before dental work to prevent the spread of bacteria from the mouth to the heart.

D. Avoiding sick contacts is important for general health but is not specific to infective endocarditis.

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A nurse is caring for a client who is receiving intravenous heparin therapy for deep vein thrombosis. The nurse evaluates for side effects of this drug by observing for:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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