A nurse is caring for a patient who is receiving heparin therapy via continuous IV infusion for treatment of deep vein thrombosis (DVT). The nurse should monitor which of the following laboratory values to evaluate therapeutic effectiveness of heparin therapy?

Activated partial thromboplastin time (aPTT)

Prothrombin time (PT)

International normalized ratio (INR)

Platelet count

Hemoglobin.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A) Activated partial thromboplastin time (aPTT). This is because aPTT is the most commonly used laboratory test to monitor the therapeutic effect of heparin therapy.

Heparin is an anticoagulant that inhibits the formation of thrombin and fibrin, which are essential for blood clotting. Heparin therapy is indicated for the treatment of deep vein thrombosis (DVT), which is a condition where blood clots form in the deep veins of the legs or pelvis.

Choice B) Prothrombin time (PT) is wrong because PT is used to monitor the therapeutic effect of warfarin therapy, not heparin therapy.

Warfarin is another anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors. Warfarin therapy is also indicated for the treatment of DVT, but it has a different mechanism of action and monitoring than heparin therapy.

Choice C) International normalized ratio (INR) is wrong because INR is a standardized way of reporting PT results that accounts for the variability of different laboratory methods. INR is also used to monitor the therapeutic effect of warfarin therapy, not heparin therapy.

Choice D) Platelet count is wrong because platelet count is not directly affected by heparin therapy. However, platelet count should be monitored periodically in patients receiving heparin therapy to detect heparin-induced thrombocytopenia (HIT), which is a rare but serious complication of heparin therapy that causes a drop in platelet count and an increased risk of thrombosis.

Choice E) Hemoglobin is wrong because hemoglobin is not directly affected by heparin therapy. However, hemoglobin should be monitored periodically in patients receiving heparin therapy to detect bleeding complications, which are the most common adverse effects of heparin therapy.

The normal range for aPTT is 25 to 35 seconds, but the therapeutic range for heparin therapy is usually 1.5 to 2.5 times the normal range, depending on the indication and protocol.

The normal range for PT is 11 to 13 seconds, and the therapeutic range for warfarin therapy is usually an INR of 2 to 3, depending on the indication and protocol

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Correct Answer is C

Explanation

Activated partial thromboplastin time (aPTT).

Dabigatran (Pradaxa) is a direct oral anticoagulant (DOAC) that inhibits thrombin, a key enzyme in the coagulation cascade.

Dabigatran prolongs the aPTT, which is a measure of the intrinsic and common pathways of coagulation.The aPTT can be used to monitor the anticoagulant effect of dabigatran, although routine monitoring is not required.

Choice A) Prothrombin time (PT) is wrong because PT measures the extrinsic and common pathways of coagulation, which are not affected by dabigatran.

PT is used to monitor warfarin therapy, not dabigatran.

Choice B) International normalized ratio (INR) is wrong because INR is a standardized version of PT that is used to monitor warfarin therapy, not dabigatran.

INR is not affected by dabigatran.

Choice D) Platelet count is wrong because platelet count is a measure of the number of platelets in the blood, which are involved in primary hemostasis.

Platelet count is not affected by dabigatran, which acts on secondary hemostasis.

Normal ranges for these tests are:

• aPTT: 25 to 35 seconds

• PT: 11 to 13.5 seconds

• INR: 0.8 to 1.2

• Platelet count: 150,000 to 450,000 per microliter of blood

A. Ibuprofen B. Naproxen C. Acetaminophen D. Aspirin.

Correct Answer is C

Explanation

The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend acetaminophen, which is the safest pain reliever while taking warfarin.Acetaminophen does not interfere with the anticoagulant effect of warfarin and does not increase the risk of bleeding.

Choice A is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can enhance the anticoagulant effect of warfarin and increase the likelihood of harmful bleeding.

NSAIDs can also cause stomach ulcers, kidney damage, and high blood pressure.

Choice B is wrong because naproxen is another NSAID that has the same risks as ibuprofen.

Naproxen should be avoided by patients taking warfarin.

Choice D is wrong because aspirin is also an anticoagulant that can increase the risk of bleeding when taken with warfarin.

Aspirin can also cause stomach irritation, ulcers, and allergic reactions.

The normal range for INR is 2 to 3 for patients with atrial fibrillation who are taking warfarin.

An INR of 2.5 indicates that the patient’s blood is taking longer to clot than normal, but not too long.

The patient should have regular blood tests to monitor their INR and adjust their warfarin dose if needed.

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A nurse is caring for a patient who is receiving heparin therapy via continuous IV infusion for treatment of deep vein thrombosis (DVT). The nurse should monitor which of the following laboratory values to evaluate therapeutic effectiveness of heparin therapy?

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Naxlex Comprehensive Predictor Exams

A patient has been prescribed dabigatran (Pradaxa) for atrial fibrillation (AF). Which laboratory test should be monitored while on this medication?

Correct Answer is C

Explanation

A patient who has atrial fibrillation is taking warfarin and has an INR of 2.5.The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend which medication?

Correct Answer is C

Explanation

A client who has atrial fibrillation is prescribed dabigatran etexilate mesylate (Pradaxa). The nurse should instruct the client to report which of the following findings immediately? (Select all that apply.)

The patient has been receiving heparin therapy for deep vein thrombosis (DVT). The patient’s activated partial thromboplastin time (aPTT) result is 90 seconds (therapeutic range: 60-80 seconds). What will be included in patient care? (Select all that apply.).

A nurse is reviewing the medication list of a client who is prescribed dabigatran and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications can increase the risk of bleeding in this client?

A nurse is caring for a patient who is receiving heparin therapy via continuous IV infusion for treatment of deep vein thrombosis (DVT). The nurse should monitor which of the following laboratory values to evaluate therapeutic effectiveness of heparin therapy?

A client has been prescribed warfarin (Coumadin) for treatment of deep vein thrombosis (DVT). Which of the following instructions should the nurse include in patient teaching? Select all that apply.

A nurse is caring for a client who has atrial fibrillation and is receiving warfarin therapy to prevent thromboembolism formation. The nurse should monitor which of the following laboratory values to determine the effectiveness of the medication?

A nurse is teaching a client who has a new prescription for bivalirudin about potential adverse effects of the drug. Which of the following effects should the nurse include? (Select all that apply.)

A nurse is caring for a client who is receiving argatroban IV for HIT and requires urgent surgery. The nurse should stop the infusion at least how many hours before the surgery?