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?

Withhold the medication.

Decrease the dose of the medication.

Increase the dose of the medication.

Administer the current dose of the medication.

Answer and Explanation

The Correct Answer is D

A. Withhold the medication: An INR of 2.5 is generally within the therapeutic range for many conditions, including atrial fibrillation. Withholding the medication might lead to a decreased INR, potentially increasing the risk of clotting.
B. Decrease the dose of the medication: If the INR is above the therapeutic range (usually 2.0-3.0 for atrial fibrillation), the provider might consider decreasing the dose. However, an INR of 2.5 is within the typical therapeutic range, so a decrease in dose might not be warranted.
C. Increase the dose of the medication: An INR of 2.5 is generally within the therapeutic range for many conditions. Increasing the dose in this situation could elevate the INR further, potentially leading to an increased risk of bleeding.
D. Administer the current dose of the medication: Since the INR is within the therapeutic range, the nurse should expect the provider to maintain the current dose of warfarin. Adjustments to the dose might be considered if the INR deviates significantly from the target range.

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Correct Answer is C

Explanation

A. Discard the medication if it is yellow: Amphotericin B lipid complex is typically yellow in color. This is a normal characteristic of the medication, and it should not be discarded based on color. The nurse should be aware of the expected color and administer the medication as prescribed.
B. Administer the medication over 2 hr: Amphotericin B lipid complex is often administered over an extended period (usually over 2 to 6 hours) to minimize the risk of infusion-related reactions. However, if the prescription specifies an intermittent IV bolus, the nurse should follow the prescribed administration route and rate.
C. Prime the tubing with 0.9% sodium chloride (Correct Answer): Amphotericin B lipid complex can interact with dextrose-containing solutions, leading to the formation of a precipitate. Therefore, it is recommended to prime the IV tubing with 0.9% sodium chloride before administering the medication to prevent any potential interaction.
D. Use a gravity flow set: The choice of infusion set may depend on the specific institutional policies and the patient's condition. However, using a pump or a controlled infusion device is often recommended when administering medications like amphotericin B to ensure accurate infusion rates and reduce the risk of adverse reactions.

A. PT 11 seconds B. APTT 50 seconds C. Hematocrit 456 D. Platelets 300,000/mm²

Correct Answer is C

Explanation

A.PT (Prothrombin Time) 11 seconds: The prothrombin time measures the extrinsic pathway of the coagulation cascade. A PT of 11 seconds is within the normal range, and it indicates that the extrinsic clotting pathway is functioning appropriately. There is no need to report this value.
B. APTT (Activated Partial Thromboplastin Time) 50 seconds: The APTT measures the intrinsic pathway of the coagulation cascade. A value of 50 seconds is prolonged and may suggest that the client is receiving an effective anticoagulant dose. However, the APTT target range can vary based on the specific therapeutic goal and the heparin protocol in use. It's essential to follow the healthcare provider's guidance on the target APTT range.
C. Hematocrit 456: The normal range for hematocrit is usually expressed as a percentage. A value of 456 is outside the normal range and likely represents an error or a misinterpretation. The nurse should verify this value, as an extremely high hematocrit could be indicative of an issue such as dehydration or an analytical error.
D. Platelets 300,000/mm²: A platelet count of 300,000/mm² is within the normal range. There is no need to report this value as it suggests a normal platelet count.

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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?

Nursing Test Bank

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