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A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse would ensure what information is gathered correctly before initiating the drip? Select all that apply: *.

Vital signs

Weight

PT/INR level

EKG

aPTT level.

Answer and Explanation

Correct Answer : B,E

The nurse would need to know the patient’s weight and aPTT level before starting the IV continuous Heparin drip.

Here is why:

• Weight: Heparin dosing is based on the patient’s weight, so the nurse would want to make sure the documented weight of the patient is current and accurate. The initial bolus and infusion rate are calculated using the patient’s weight in kilograms.

• aPTT: Heparin works by enhancing the activation of antithrombin III, which prevents the activation of thrombin and the conversion of fibrinogen to fibrin. Heparin affects the intrinsic pathway of clotting, and its therapeutic effect is monitored by measuring the activated partial thromboplastin time (aPTT). The normal range for aPTT is about 30-40 seconds, and the therapeutic range for Heparin is 1.5-2.5 times the normal value. The nurse would need to check the baseline aPTT before starting the drip, and then collect an aPTT level every 6 hours per protocol to adjust the infusion rate as needed.

The other choices are wrong because:

• Vital signs: Although vital signs are important to monitor for any patient, they are not specific to Heparin therapy. Heparin does not affect blood pressure, heart rate, respiratory rate, or temperature directly.

• PT/INR: These are coagulation tests that measure the extrinsic pathway of clotting, which is affected by Vitamin K antagonists such as Warfarin. Heparin does not affect the PT/INR levels, so they are not relevant for Heparin therapy.

• EKG: An electrocardiogram (EKG) is a test that measures the electrical activity of the heart. It can help diagnose cardiac arrhythmias, ischemia, infarction, electrolyte imbalances, and other cardiac conditions.

Heparin does not affect the electrical conduction of the heart, so an EKG is not necessary before starting Heparin therapy

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Correct Answer is ["A","B","C"]

Explanation

Dabigatran etexilate mesylate (Pradaxa) is a medication that prevents blood clots and reduces the risk of stroke in patients with atrial fibrillation.

However, it can also cause bleeding as a side effect.

Therefore, the nurse should instruct the client to report any signs of unusual bleeding or bruising, blood in urine or stool, or abdominal pain or swelling immediately.These could indicate a serious complication such as gastrointestinal bleeding, hemorrhage, or internal organ damage.

Choice D, headache or dizziness, is not a correct answer.

Although these symptoms could be caused by dabigatran, they are not as serious or urgent as bleeding.

They could also be due to other factors such as dehydration, low blood pressure, or stress.The nurse should advise the client to monitor these symptoms and seek medical attention if they persist or worsen.

Choice E, shortness of breath, is not a correct answer.

Shortness of breath is not a common side effect of dabigatran.

However, it could be a symptom of atrial fibrillation or its complications such as heart failure or stroke.The nurse should educate the client about the signs and symptoms of these conditions and instruct them to call 911 if they experience chest pain, palpitations, fainting, or weakness.

A. “Heparin works faster than warfarin, so it is given until warfarin reaches an effective level in your blood.” B. “Heparin and warfarin work on different clotting factors in your blood, so they have a synergistic effect.” C. “Heparin is given by injection, while warfarin is given by mouth, so they have different routes of administration.” D. “Heparin prevents new clots from forming, while warfarin helps dissolve existing clots in your blood vessels.” E. “Heparin has a shorter duration of action than warfarin, so it is easier to reverse if bleeding occurs.”.

Correct Answer is ["A","E"]

Explanation

Heparin works faster than warfarin, so it is given until warfarin reaches an effective level in your blood.

Heparin has a shorter duration of action than warfarin, so it is easier to reverse if bleeding occurs.

Choice B is wrong because heparin and warfarin do not have a synergistic effect.

They work on different clotting factors, but they do not enhance each other’s effects.

Choice C is wrong because the route of administration is not relevant to the rationale for using both medications.

Heparin and warfarin can be given by different routes, but that does not explain why they are both necessary.

Choice D is wrong because warfarin does not help dissolve existing clots.

Warfarin prevents the synthesis of vitamin K-dependent clotting factors, but it does not break down clots that have already formed.

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A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse would ensure what information is gathered correctly before initiating the drip? Select all that apply: *.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has atrial fibrillation is prescribed dabigatran etexilate mesylate (Pradaxa). The nurse should instruct the client to report which of the following findings immediately? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

Correct Answer is ["A","E"]

Explanation

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