A patient has received an overdose of intravenous heparin and is showing signs of excessive bleeding.
Which substance is the antidote for heparin overdose?
Protamine Sulfate.
Potassium Chloride.
Vitamin E.
Vitamin K.
The Correct Answer is A
This question tests the knowledge of pharmacological antidotes for anticoagulant toxicity. It requires identifying the correct reversal agent that neutralizes the specific molecular structure of heparin to stop anticoagulation and control life-threatening hemorrhage effectively in a clinical emergency.
Choice A rationale
Protamine sulfate is a positively charged protein that binds to the negatively charged heparin molecule. This interaction forms a stable, inactive complex, effectively neutralizing heparin’s anticoagulant activity and reversing the risk of bleeding in overdose cases.
Choice B rationale
Potassium chloride is a mineral supplement used to treat or prevent hypokalemia. It has no pharmacological role in the reversal of heparin-induced anticoagulation and would not stop bleeding caused by an anticoagulant overdose.
Choice C rationale
Vitamin E is a fat-soluble vitamin. While it has some mild anti-platelet effects at high doses, it does not function as an antidote to heparin and has no role in the emergency management of anticoagulant-induced excessive bleeding.
Choice D rationale
Vitamin K is the pharmacological antidote for warfarin, a vitamin K antagonist. It functions by promoting the synthesis of clotting factors in the liver and is completely ineffective at neutralizing the anticoagulant effects of intravenous heparin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["Bolus 4.36 mL"," infusion rate 0.87 mL\/hr"]
Explanation
Step 1 is convert 160 pounds to kilograms: 160 lb ÷ 2.2 = 72.73 kg.
Step 2 is calculate the bolus dose: 72.73 kg × 60 units/kg = 4,363.8 units.
Step 3 is calculate bolus volume: 4,363.8 units ÷ 1,000 units/mL = 4.36 mL.
Step 4 is calculate infusion dose: 72.73 kg × 12 units/kg/hr = 872.76 units/hr.
Step 5 is calculate infusion rate: 872.76 units/hr ÷ 1,000 units/mL = 0.87 mL/hr. Final calculated answer: Bolus 4.36 mL, infusion rate 0.87 mL/hr.
Correct Answer is C
Explanation
This question tests understanding of perioperative medication management for patients on incretin mimetics. It requires applying knowledge of how GLP-1 receptor agonists affect gastric emptying, which poses a significant aspiration risk during anesthesia, necessitating cessation prior to elective surgical procedures to ensure patient safety.
Choice A rationale
Increasing the dose is contraindicated because it would exacerbate gastrointestinal motility concerns and increase the risk of aspiration during anesthesia. Furthermore, perioperative hyperglycemia is managed with sliding-scale insulin, not by increasing non-insulin injectable medications on the morning of surgery.
Choice B rationale
Continuing GLP-1 agonists is unsafe because these medications delay gastric emptying. If the stomach remains full during induction of anesthesia, the risk of vomiting and pulmonary aspiration significantly increases, which can lead to life-threatening respiratory complications for the patient.
Choice C rationale
Guidelines recommend holding GLP-1 receptor agonists 1 week before elective surgery. This timeframe allows the drug's effect on gastric emptying to dissipate, reducing the risk of aspiration during anesthesia while also preventing potential complications from unpredictable blood glucose management during surgery.
Choice D rationale
Switching to oral hypoglycemics is not an evidence-based practice for perioperative management. Oral agents have different metabolic and kinetic profiles, and the focus during the surgical period is on maintaining glycemic control through insulin therapy, not shifting to different oral drug classes.
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