A nurse is caring for a patient who has a new prescription for warfarin.
Which of the following diagnostic test results should the nurse use to monitor the therapy’s effect?
Platelet count.
White blood cell count (WBC).
Prothrombin time (PT).
Activated partial thromboplastin time (aPTT).
The Correct Answer is C
Platelet count is not the primary diagnostic test used to monitor the therapy’s effect of warfarin. Platelets are involved in the clotting process, but warfarin specifically works by inhibiting the synthesis of vitamin K-dependent clotting factors, which does not directly involve platelets.
Choice B rationale
The white blood cell count (WBC) is not used to monitor the effect of warfarin therapy. WBC is typically used to monitor for infection or inflammation, not the coagulation status of a patient.
Choice C rationale
Prothrombin time (PT) is the correct answer. Warfarin therapy is monitored using the PT, which is reported as the International Normalized Ratio (INR). Warfarin inhibits the synthesis of vitamin K-dependent clotting factors, which include Factors II, VII, IX, and X, and Proteins C and S. The PT/INR is sensitive to changes in these factors. An elevated INR indicates a higher risk of bleeding, while a lower INR suggests a higher risk of clotting.
Choice D rationale
Activated partial thromboplastin time (aPTT) is not typically used to monitor warfarin therapy. The aPTT test evaluates the intrinsic and common pathways of coagulation, which includes factors XII, XI, IX, VIII, X, V, II (prothrombin), and I (fibrinogen). Warfarin affects the extrinsic pathway and common pathway, not the intrinsic pathway. Therefore, aPTT is not the best test to monitor the effects of warfarin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A decrease in systolic blood pressure is not a physiological change that increases the risk of dehydration in older adults.
Choice B rationale
An increase in saliva production does not occur with aging and does not increase the risk of dehydration.
Choice C rationale
An increase in the percentage of body water does not occur with aging. In fact, total body water decreases with age, which can contribute to an increased risk of dehydration.
Choice D rationale
A decrease in kidney function is a common physiological change that occurs with aging. This can lead to a decreased ability to concentrate urine and conserve water, increasing the risk of dehydration.
Correct Answer is D
Explanation
Choice A rationale
While electrolyte balance is important in patient care, it is not the primary reason for measuring gastric residual before administering a feeding through an NG tube.
Choice B rationale
Confirming the placement of the NG tube is crucial before administering a feeding. However, measuring the gastric residual is not the primary method used to confirm tube placement.
Choice C rationale
Removing gastric acid that might cause dyspepsia is not the main purpose of measuring gastric residual. Dyspepsia, or indigestion, is typically managed with medications and dietary modifications.
Choice D rationale
The primary purpose of measuring gastric residual is to identify delayed gastric emptying. Gastric residual refers to the volume of formula or contents remaining in the stomach from the previous feeding. If gastric emptying is delayed, the nurse should avoid overfeeding the patient and causing gastric distention.
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