A nurse is providing education of enoxaparin to a patient diagnosed with deep venous thrombosis. Which statement by the patient indicates understanding of the teaching?

"It eliminates the clotting factors."

"This medication will keep the blood clot from growing larger."

"This medication will decrease my risk for bleeding."

"I will get this medication in my veins."

Answer and Explanation

The Correct Answer is B

A. "It eliminates the clotting factors." - This statement suggests a misunderstanding of how enoxaparin works. Enoxaparin is a low molecular weight heparin that does not eliminate clotting factors but rather inhibits the activity of factor Xa, a key enzyme involved in the coagulation cascade. By inhibiting factor Xa, enoxaparin prevents the conversion of prothrombin to thrombin, thereby reducing the formation of fibrin clots. It does not eliminate existing clotting factors from the bloodstream.

B. "This medication will keep the blood clot from growing larger." - This statement demonstrates a correct understanding of enoxaparin's mechanism of action. Enoxaparin is an anticoagulant medication that works by preventing the enlargement of existing blood clots. By inhibiting the activity of factor Xa, enoxaparin prevents the conversion of prothrombin to thrombin, thereby reducing the formation of fibrin clots and preventing existing clots from growing larger.

C. "This medication will decrease my risk for bleeding." - This statement is incorrect. Enoxaparin, like other anticoagulants, actually increases the risk of bleeding due to its mechanism of action. By inhibiting the coagulation cascade, enoxaparin prolongs the time it takes for blood to clot, which can lead to an increased risk of bleeding, particularly in patients who are predisposed to bleeding or are taking other medications that affect clotting.

D. "I will get this medication in my veins." - This statement is incorrect. Enoxaparin is administered subcutaneously, not intravenously. It is usually injected into the fatty tissue of the abdomen or thigh using a prefilled syringe with a short, thin needle. The subcutaneous route of administration allows for slow absorption and sustained anticoagulant effects over time.

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Correct Answer is C

Explanation

A. Continue to administer the metoprolol tartrate as ordered:
Metoprolol is a beta-blocker commonly used to treat hypertension, angina, and heart failure. One of its main effects is to decrease heart rate and blood pressure. In this scenario, the patient's vital signs reveal a low heart rate (48 bpm) and relatively low blood pressure (100/50 mmHg). Given that metoprolol can further reduce heart rate and blood pressure, it would be prudent for the nurse to withhold the medication until further assessment is conducted.

B. Ask the patient if her pulse is within the normal range:
While it's essential to assess the patient's understanding of her condition, asking if her pulse is within the normal range is not sufficient. The nurse should perform a more thorough assessment and consider the clinical significance of the vital signs obtained. In this case, a heart rate of 48 bpm is lower than the typical normal range for adults (60-100 bpm), indicating bradycardia, which may be symptomatic or concerning in the context of administering a beta-blocker like metoprolol.

C. Hold the medication and call the provider:
Given the patient's low heart rate (bradycardia) and relatively low blood pressure, holding the metoprolol tartrate and contacting the healthcare provider is the most appropriate action. Bradycardia and hypotension can be signs of excessive beta-blockade, especially with medications like metoprolol, which can further lower heart rate and blood pressure. The nurse should notify the provider promptly to discuss the patient's condition and determine the appropriate course of action.

D. Ask the patient to eat salty foods:
Encouraging the patient to eat salty foods would not address the underlying issue of bradycardia and hypotension. While increasing salt intake may help raise blood pressure in some cases, it is not a standard intervention for managing symptomatic bradycardia or low blood pressure caused by medication effects.

A. Dry skin B. Burning sensation C. Diarrhea D. Irregular heart rate

Correct Answer is D

Explanation

A. Dry skin:
Dry skin is not a commonly reported side effect of diltiazem, a calcium channel blocker used for blood pressure management. While dry skin can occur due to various reasons, it is less likely to be directly associated with diltiazem use. Therefore, it is not the side effect that the nurse should prioritize instructing the patient to report to the provider.

B. Burning sensation:
Although burning sensation is not a common side effect of diltiazem, it can occasionally occur as a skin reaction or hypersensitivity reaction to the medication. While this symptom may warrant attention, it is generally less concerning compared to other potential side effects of diltiazem. Therefore, while it is important for the patient to report any unusual sensations or discomfort, burning sensation alone may not be the most critical side effect to report.

C. Diarrhea:
Diarrhea is a potential side effect of diltiazem use. Calcium channel blockers like diltiazem can affect gastrointestinal motility and lead to gastrointestinal disturbances, including diarrhea. While diarrhea can be bothersome and may indicate intolerance to the medication, it is generally considered a common side effect rather than a severe adverse reaction. Therefore, while the nurse should educate the patient about the possibility of diarrhea and encourage reporting any persistent or severe cases, it may not be the most critical side effect to report to the provider.

D. Irregular heart rate:
Irregular heart rate, including bradycardia or tachycardia, is a significant and potentially serious side effect of diltiazem. As a calcium channel blocker, diltiazem can affect cardiac conduction, leading to alterations in heart rate and rhythm. Irregular heart rate can indicate a significant cardiovascular complication and may require prompt medical attention. Therefore, the nurse should prioritize instructing the patient to report any changes in heart rate, including palpitations, rapid heartbeat, or irregular pulse, to the provider immediately.

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A nurse is providing education of enoxaparin to a patient diagnosed with deep venous thrombosis. Which statement by the patient indicates understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse takes a patient's vital signs prior to giving metoprolol tartrate and obtains the following results: T 98 degrees F, P 48, R 16 bpm, BP 100/50 and a pulse oximeter of 98%. What action will the nurse take?

Correct Answer is C

Explanation

The nurse is caring for a patient taking diltiazem for blood pressure management. The nurse instructs the patient to report which side effect to the provider?

Correct Answer is D

Explanation

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