A patient who takes warfarin (Coumadin) is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats per minute and the blood pressure is 120/80 mm Hg. Dipstick urinalysis is normal. The patient does not have any signs of bleeding and does not complain of pain. The nurse will anticipate an order for:
vitamin K (phytonadione)
protamine sulfate
a PTT lab test
an INR lab test
The Correct Answer is A
Choice A reason:
Vitamin K (phytonadione) is the antidote for warfarin overdose. It works by promoting the synthesis of clotting factors that are inhibited by warfarin, thereby reversing the anticoagulant effects. In cases of excessive warfarin intake, administering vitamin K helps restore normal clotting function.
Choice B reason:
Protamine sulfate is the antidote for heparin overdose, not warfarin. It works by neutralizing the anticoagulant effects of heparin, but it has no effect on warfarin-induced anticoagulation. Therefore, it is not appropriate for this situation.
Choice C reason:
A PTT lab test measures the effectiveness of the intrinsic pathway of coagulation and is primarily used to monitor heparin therapy. It is not relevant for managing warfarin overdose, as warfarin affects the extrinsic pathway, which is measured by the PT/INR test.
Choice D reason:
While an INR lab test is essential for monitoring the therapeutic levels of warfarin, the immediate need in this situation is to reverse the effects of the overdose. Administering vitamin K is the necessary intervention to counteract the excessive anticoagulation caused by warfarin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Stenosis is characterized by the constriction and narrowing of the valve opening, which causes the valve leaflets to fail to open completely. This condition restricts blood flow through the valve, leading to increased pressure in the heart and reduced blood flow to the body or lungs, depending on which valve is affected.
Choice B reason:
Regurgitation refers to the condition where the valve does not close properly, allowing blood to flow backward. This is different from stenosis, where the valve opening is narrowed and does not allow sufficient blood flow forward.
Choice C reason:
Insufficiency is another term for regurgitation and involves the backward flow of blood due to improper closure of the valve. It does not describe the condition where the valve opening is narrowed and restricts forward blood flow.
Choice D reason:
Incompetence also refers to the inability of the valve to close properly, leading to regurgitation. It is not used to describe the narrowing of the valve opening, which is the defining characteristic of stenosis.
Correct Answer is B
Explanation
Choice A reason:
Maintaining a healthy lifestyle and avoiding high-fat foods is appropriate advice. Statins are more effective when combined with a healthy diet and lifestyle. This helps in managing cholesterol levels and reducing the risk of cardiovascular events.
Choice B reason:
The statement that muscle pain is not concerning with statin use is inappropriate. Muscle pain can be a significant side effect of statins, known as myopathy, and in rare cases, it can lead to a more severe condition called rhabdomyolysis. Patients experiencing muscle pain should report it to their healthcare provider for evaluation and management.
Choice C reason:
Statins do reduce the risk of coronary events in people with diabetes and slightly elevated LDL levels. This is well-documented and an appropriate part of patient education, as statins are beneficial in preventing cardiovascular events in at-risk populations.
Choice D reason:
Statin use can cause gastrointestinal (GI) side effects, including nausea, constipation, and diarrhea. This information should be part of patient education so that patients are aware of potential side effects and can manage them appropriately.
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