A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?

A. Erythema (redness) and edema (swelling) of the affected ear are classic signs of otitis media, an infection or inflammation of the middle ear. In otitis media, the middle ear becomes inflamed and fluid accumulates behind the eardrum, leading to redness and swelling of the tympanic membrane and surrounding tissues.
B. Tugging on the affected ear lobe is a common behavior observed in children with otitis media. Ear pulling or rubbing is often a sign of ear pain or discomfort, which can result from the pressure caused by the accumulation of fluid and inflammation in the middle ear.
C. Pain when manipulating the affected ear lobe is another common symptom of otitis media. Children with this condition may experience tenderness or discomfort when the affected ear is touched or manipulated due to the underlying inflammation and infection.
D. Clear drainage from the affected ear is not typically associated with otitis media. Instead, otitis media is characterized by the presence of middle ear effusion, which may manifest as fluid behind the eardrum. The drainage from otitis media is more commonly serous or purulent rather than clear.

A. While heparin and warfarin both work as anticoagulants, IV heparin is not typically used to increase the effects of warfarin or decrease the length of hospital stay. Heparin is often administered initially to rapidly achieve therapeutic anticoagulation while waiting for warfarin to reach its full therapeutic effect, but it is not intended to directly enhance the action of warfarin.
B. This statement is accurate and provides a clear explanation to the client. Warfarin, an oral anticoagulant, takes several days to achieve a therapeutic level in the bloodstream and to exert its anticoagulant effect. During this time, IV heparin is continued to prevent clot formation until the therapeutic level of warfarin is reached.
C. While both heparin and warfarin work to prevent blood clots, they do not directly dissolve existing clots. Rather, they prevent the formation of new clots and the growth of existing ones. This explanation does not fully address the client's question regarding why both medications are necessary.
D. Discontinuing IV heparin prematurely without reaching a therapeutic level of warfarin could increase the risk of thrombus formation or embolization. Therefore, discontinuing IV heparin should be done under the guidance of the provider based on the client's INR levels and the target therapeutic range for warfarin.