A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should expect which of the following prescriptions?

Choice A Reason:
Meloxicam is incorrect. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used primarily for managing mild to moderate pain and inflammation. While it can provide relief for mild pain, it may not be potent enough to effectively manage severe pain, especially in cases of advanced cancer-related pain, where stronger analgesics are often necessary.
Choice B Reason:
Aspirin is incorrect. Aspirin, like meloxicam, is an NSAID used for mild to moderate pain relief and has anti-inflammatory properties. While it can be effective for certain types of pain, it's generally not the first choice for severe pain management, particularly in cases of advanced cancer-related pain where stronger opioids are typically required for adequate relief.
Choice C Reason:
Hydromorphone is correct. Hydromorphone is a potent opioid analgesic used to manage severe pain, especially in cancer-related pain or post-operative settings. In cases of severe pain, opioids like hydromorphone are commonly utilized due to their effectiveness in providing relief.
Choice D Reason:
Caldofor is incorrect. The term "Caldofor" does not appear to correspond to any recognized medication commonly used for pain relief. It's possible that this might be a misspelling or an unfamiliar or less common drug name. Without a specific drug identification, it's challenging to assess its suitability or effectiveness for managing severe pain associated with pancreatic cancer.

Choice A Reason:
Decreased respiratory rate is incorrect. Heparin administration and an elevated aPTT typically do not directly cause a decrease in respiratory rate. Respiratory rate changes might occur due to other factors such as respiratory conditions, pain, or medications affecting the respiratory center, but they are not commonly linked to heparin therapy.
Choice B Reason:
Increased blood pressure is incorrect. Heparin therapy and an elevated aPTT do not typically result in increased blood pressure. Heparin's primary effect is on preventing blood clotting, and while it can indirectly affect blood pressure by preventing clot formation, it doesn't typically cause a significant increase in blood pressure.
Choice C Reason:
Decreased temperature is incorrect. Heparin therapy and an elevated aPTT do not generally cause a decrease in body temperature. Changes in body temperature might occur due to various reasons such as infection, environmental factors, or certain medications, but they are not directly linked to heparin administration.
Choice D Reason:
Increased pulse rate is correct. An increased pulse rate can be an early indicator of bleeding or a potential side effect of heparin administration. Heparin's anticoagulant effect might predispose individuals to bleeding, so an increased pulse rate could indicate a response to potential bleeding complications rather than a direct effect of heparin itself.