A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?
The onset of warfarin is delayed.
Warfarin prevents platelet aggregation.
Heparin has fewer adverse effects.
Heparin has a longer half-life.
The Correct Answer is A
Choice A reason:
The onset of warfarin is delayed, meaning it takes longer to achieve a therapeutic effect. Warfarin requires several days to adjust to effective anticoagulation levels because it works by inhibiting the synthesis of clotting factors that are already present and active in the bloodstream. In contrast, heparin has an immediate anticoagulant effect when administered, which is crucial for patients with acute conditions like deep vein thrombosis.
Choice B reason:
Warfarin does not prevent platelet aggregation. Instead, it works by inhibiting vitamin K-dependent clotting factors, which are essential for blood coagulation. Platelet aggregation is primarily inhibited by antiplatelet drugs like aspirin or clopidogrel, not anticoagulants like warfarin.
Choice C reason:
Heparin does not necessarily have fewer adverse effects compared to warfarin. Both anticoagulants have their specific risks and side effects. Heparin is preferred in acute settings due to its rapid onset of action, but it can cause complications like heparin-induced thrombocytopenia (HIT), which requires careful monitoring.
Choice D reason:
Heparin does not have a longer half-life than warfarin. In fact, heparin's half-life is relatively short, which is why it is often administered via continuous infusion or frequent subcutaneous injections. Warfarin has a longer half-life, but its delayed onset of action makes it less suitable for immediate anticoagulation needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason:
Nasogastric suctioning is a common intervention in managing acute pancreatitis when there is severe nausea, vomiting, or evidence of intestinal obstruction. The procedure helps to decompress the stomach, reduce pancreatic stimulation, and minimize the risk of aspiration. It is particularly indicated for patients who cannot tolerate oral intake or exhibit signs of paralytic ileus. By reducing gastric distension and suppressing pancreatic secretions, nasogastric suctioning aids in alleviating symptoms and improving patient outcomes.
Choice B reason:
Narcotic analgesics are essential for controlling the intense abdominal pain that accompanies acute pancreatitis. The pain arises due to inflammation and autodigestion of pancreatic tissue by enzymes like trypsin. Medications such as morphine or hydromorphone provide effective relief by acting on opioid receptors in the central nervous system. Adequate pain management is crucial not only for patient comfort but also to mitigate stress-related complications that can worsen inflammation or systemic effects.
Choice C reason:
Steroid therapy is generally not part of the treatment for acute pancreatitis unless there is an associated autoimmune component. In most cases, the use of steroids could exacerbate the condition or increase the risk of complications such as infections. As such, this option is not appropriate in routine management of acute pancreatitis.
Choice D reason:
Restriction of food intake is a critical component of the treatment plan. Fasting minimizes pancreatic stimulation and allows the inflamed pancreas to rest. Typically, patients are kept nil by mouth (NPO) until their symptoms subside. Nutrition can then be gradually reintroduced, starting with clear liquids and advancing as tolerated. Enteral feeding via a nasojejunal tube may be considered if prolonged fasting is required.
Choice E reason:
IV fluids are a cornerstone of acute pancreatitis management. Fluid resuscitation is necessary to address hypovolemia caused by fluid shifts, vomiting, and third-spacing of fluids into inflamed tissues. Aggressive hydration with isotonic crystalloids, such as normal saline or lactated Ringer's solution, helps maintain hemodynamic stability and improves microcirculation in the pancreas, reducing the risk of complications such as necrosis or organ failure.
Correct Answer is B
Explanation
Choice A reason:
As mentioned earlier, infusion reactions are common with Amphotericin B, including symptoms like fever and chills. Therefore, recognizing that these reactions occur is correct and indicates a proper understanding of the medication's effects.
Choice B reason:
Rapid administration of Amphotericin B is incorrect because it increases the risk of severe side effects. The infusion should be slow to ensure patient safety, indicating that the student needs further teaching on this point. Thus, this choice is incorrect and suggests a misunderstanding.
Choice C reason:
Frequent rotation of the IV site or the use of a central line is standard practice to minimize the risk of phlebitis. This practice is correct and shows that the student understands how to manage the complications associated with Amphotericin B infusion.
Choice D reason:
Amphotericin B's primary use is to treat systemic fungal infections. This is a correct statement, reflecting an accurate understanding of the drug's purpose and does not require further teaching.
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