A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

Hold the medication and notify the HCP

Administer the medication as ordered.

Prepare to administer vitamin K (AquaMephyton).

Assess the client for abnormal bleeding.

Fat embolism

Answer and Explanation

The Correct Answer is B

A. Hold the medication and notify the HCP: This is unnecessary. An INR of 2.7 is within the therapeutic range for a client with a mechanical valve replacement (2.5 to 3.5). No intervention is required.

B. Administer the medication as ordered: The INR of 2.7 is within the desired therapeutic range for clients on warfarin with mechanical valve replacements, so the nurse should proceed with the prescribed dose.

C. Prepare to administer vitamin K (AquaMephyton): Vitamin K is used to reverse the effects of warfarin if the INR is too high (usually greater than 5).

D. Assess the client for abnormal bleeding: While important, this is not the first action. The INR is within the therapeutic range, so the priority is to administer the medication.

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Correct Answer is A

Explanation

A. It indicates a normal depolarization of the atria: A PR interval of 0.12–0.20 seconds is within the normal range, representing normal conduction through the atria and AV node.

B. It provides information about atrial repolarization: Atrial repolarization is obscured by the QRS complex and not reflected in the PR interval.

C. It shows an early indication of first-degree heart block: First-degree heart block is indicated by a PR interval longer than 0.20 seconds.

D. It reflects a delayed conduction through the atria: A delay in conduction would result in a prolonged PR interval.

A. Hypokalemia B. Hypercalcemia C. Hyponatremia D. Hyperkalemia

Correct Answer is A

Explanation

A. Hypokalemia: U waves are often seen on an electrocardiogram in clients with hypokalemia. They represent delayed repolarization of the Purkinje fibers due to low potassium levels.

B. Hypercalcemia: Hypercalcemia affects the QT interval, typically shortening it, but it does not cause U waves.

C. Hyponatremia: Electrocardiographic changes are not commonly associated with hyponatremia.

D. Hyperkalemia: Hyperkalemia causes peaked T waves, prolonged PR intervals, and wide QRS complexes, not U waves.

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A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

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