A nurse is preparing to administer heparin to a client. The nurse notices that the client's medical record indicates that the client has already been receiving anticoagulation therapy at home. Which of the following actions should the nurse take?

Administer the medication as prescribed.

Inform the client of her right to refuse any treatment.

Contact the Occupational, Health, and Safety Administration (OSHA).

Clarify the prescription with the provider.

Answer and Explanation

The Correct Answer is D

A. Administering heparin without clarifying the client's existing anticoagulation therapy could lead to potential overdosing or adverse effects due to cumulative anticoagulant effects.
B. While informing the client of her right to refuse treatment is important, it does not address the potential risk of duplicative therapy in this situation.
C. Contacting OSHA is not relevant to the situation of clarifying medication orders.
D. Clarifying the prescription with the provider is essential to ensure the safety and appropriateness of administering heparin in the context of the client's existing therapy, preventing medication errors and ensuring optimal patient care.

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Correct Answer is B

Explanation

A. Waiting to document medications until the end of a shift increases the risk of errors and delays in patient care due to potential inaccuracies.
B. Avoiding distractions during medication preparation helps maintain focus and reduces the likelihood of errors.
C. Preparing medications for multiple clients simultaneously increases the risk of medication mix-ups and errors.
D. Medications should not be removed from automatic dispensing systems before review by pharmacists, as this can lead to medication errors and compromised safety protocols.

A. Expect stools to become black and tarry. B. Use a soft bristle toothbrush. C. Inject the medication deep into the thigh muscle. D. Easy bruising indicates the medication is effective.

Correct Answer is B

Explanation

A. Black, tarry stools are not an expected effect of subcutaneous heparin; this symptom should be reported to a healthcare provider.
B. Using a soft bristle toothbrush is recommended to minimize the risk of bleeding gums, which can occur due to heparin's anticoagulant effects.
C. Subcutaneous heparin should be injected into the fatty tissue of the abdomen or thigh, not deep into the muscle.
D. Easy bruising is a potential side effect of heparin but does not indicate effectiveness; it should be monitored and reported if excessive.

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A nurse is preparing to administer heparin to a client. The nurse notices that the client's medical record indicates that the client has already been receiving anticoagulation therapy at home. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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