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 D

Explanation

A. Infiltration:
Infiltration refers to the inadvertent administration of a non-vesicant solution into the surrounding tissue. It is characterized by swelling, pallor, and coolness at the infusion site, but redness and inflammation along the vein are not typical signs of infiltration.
B. Extravasation:
Extravasation occurs when a vesicant solution (a substance that can cause tissue damage) infiltrates into the surrounding tissue. It can cause tissue damage and necrosis. While inflammation is a concern with extravasation, it is not the primary sign, and redness may occur later.
C. Venous spasm:
Venous spasm involves the constriction of the blood vessel, leading to decreased blood flow. It is not typically associated with redness and inflammation along the vein.
D. Phlebitis:
This is the correct answer. Phlebitis refers to inflammation of a vein, and it is characterized by redness, warmth, and tenderness along the course of the vein. Phlebitis can be caused by various factors, including irritants in the infused solution, mechanical trauma, or infection.

A. Urticaria B. Distended jugular vein C. Bounding pulse D. Confusion

Correct Answer is A

Explanation

A. Urticaria (hives): Urticaria is a manifestation of an allergic reaction, which can occur during a transfusion reaction. If the client develops urticaria, it suggests an allergic response, and epinephrine may be administered to manage severe allergic reactions.
B. Distended jugular vein: Distended jugular veins may be associated with fluid overload or cardiovascular issues, but it is not a typical indication for administering epinephrine during a blood transfusion reaction.
C. Bounding pulse: A bounding pulse may be associated with increased cardiac output but is not typically an indication for epinephrine administration during a blood transfusion reaction.
D. Confusion: Confusion is a neurological symptom and is not a typical indication for administering epinephrine during a blood transfusion reaction. Neurological symptoms may suggest other complications that need appropriate interventions.

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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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