A nurse is providing discharge instructions to the parent of a 10yearold child following a cardiac catheterization. Which of the following instructions should the nurse include?

Give the child acetaminophen for discomfort.

Offer the child clear liquids for the first 24 hr.

Assist the child to take a tub bath for the first 3 days.

Keep the child home for 1 week.

Answer and Explanation

The Correct Answer is A

A. Give the child acetaminophen for discomfort.This is the most appropriate discharge instruction. Mild discomfort at the catheter insertion site is common after a cardiac catheterization. Acetaminophen is recommended for pain relief as it is effective and does not increase the risk of bleeding, unlike NSAIDs (e.g., ibuprofen, aspirin), which can interfere with platelet function.
B. Offer the child clear liquids for the first 24 hr. The child can resume a normal diet as tolerated after the procedure. There is no restriction to clear liquids unless the child experiences nausea or vomiting postprocedure. Encouraging hydration is important, but there is no need to limit food intake unless directed by the provider.
C. Assist the child to take a tub bath for the first 3 days. The child should avoid tub baths for at least 3 days to prevent infection and irritation at the catheter insertion site. Instead, a sponge bath or quick shower is recommended to keep the area clean and dry.
D. Keep the child home for 1 week. Most children can resume normal activities within 24 to 48 hours, although strenuous activities, such as sports and heavy lifting, should be avoided for several days. The exact time frame depends on the child’s condition and provider recommendations, but a full week of home rest is usually unnecessary unless complications occur.

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Correct Answer is C

Explanation

A. Progressive increase in platelet production. In DIC, platelet levels decrease rather than increase due to widespread consumption of platelets in abnormal clot formation. This depletion leads to an increased risk of bleeding.
B. Immediate sodium and fluid retention. DIC primarily affects coagulation and does not directly cause significant sodium or fluid retention. Fluid shifts may occur due to capillary leakage and organ dysfunction, but these are secondary effects rather than primary findings.
C. Excessive thrombosis and bleeding. This is correct. DIC is a disorder of widespread clotting followed by excessive bleeding. Small clots form throughout the vascular system, consuming clotting factors and platelets, leading to an inability to control bleeding in later stages. Clients may experience petechiae, purpura, oozing from IV sites, and internal organ damage due to ischemia.
D. Increased clotting factors. In DIC, clotting factors are depleted due to their excessive use in forming clots. This depletion contributes to the inability to clot properly, resulting in hemorrhage as the disorder progresses.

A. Protamine sulfate B. Vitamin K C. Deferasirox D. Acetylcysteine

Correct Answer is A

Explanation

A. Protamine sulfate is the specific antidote for heparin toxicity, working by neutralizing heparin’s anticoagulant effects. It binds to heparin to form a stable complex, preventing excessive bleeding. It is administered intravenously (IV) in cases of heparin overdose or severe bleeding complications.
B. Vitamin K is the antidote for warfarin (Coumadin), not heparin. It promotes the synthesis of clotting factors II, VII, IX, and X, but it does not affect heparin’s mechanism of action, which works by inhibiting thrombin and factor Xa.
C. Deferasirox is an iron chelating agent used to treat iron overload in conditions like thalassemia or hemochromatosis. It does not reverse anticoagulation caused by heparin.
D. Acetylcysteine is primarily used to treat acetaminophen (Tylenol) overdose and as a mucolytic for respiratory conditions. It has no role in counteracting heparin’s effects.

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