If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor.
Which doctor’s order should the nurse anticipate?
Continue with the same dosage.
Hold dose.
Increase in dosage.
Decrease in dosage.
The Correct Answer is B
This is because a PTT (partial thromboplastin time) test measures how long it takes for blood to clot. A normal PTT range is between 25 to 35 seconds. If the patient’s PTT is too long and greater than 80 seconds, it means their blood is taking too long to clot and they are at risk of bleeding excessively. The nurse should notify the doctor and expect an order to hold the dose of heparin, a type of anticoagulant that prevents blood clots by prolonging the PTT.
Choice A is wrong because continuing with the same dosage of heparin would not correct the prolonged PTT and could cause more bleeding problems for the patient.
Choice C is wrong because increasing the dosage of heparin would further prolong the PTT and increase the risk of bleeding.
Choice D is wrong because decreasing the dosage of heparin would not be enough to bring the PTT back to normal range and would still pose a bleeding risk for the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Food high in potassium should be avoided for clients taking ACE inhibitors. ACE inhibitors are drugs that block the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor and also stimulates the secretion of aldosterone. Aldosterone is a hormone that increases the reabsorption of sodium and water and the excretion of potassium in the kidneys. By inhibiting angiotensin II, ACE inhibitors lower blood pressure and reduce the loss of potassium. However, this can also lead to hyperkalemia, which is a high level of potassium in the blood that can cause cardiac arrhythmias and muscle weakness.Therefore, clients taking ACE inhibitors should limit their intake of foods that are rich in potassium, such as bananas, oranges, tomatoes, potatoes, spinach, beans, nuts, and salt substitutes.
Choice B is wrong because a low sodium diet is recommended for clients taking ACE inhibitors.
A low sodium diet can help lower blood pressure and reduce fluid retention, which are beneficial effects for clients with hypertension, heart failure, or chronic kidney disease.A low-potassium diet should aim for potassium intake of less than 50 or 75 mmol/day and sodium intake of less than 60 mmol/day for hypertensive patients with chronic kidney disease.
Choice C is wrong because adequate fluid intake is not contraindicated for clients taking ACE inhibitors.
Adequate fluid intake can help prevent dehydration and maintain kidney function, especially in patients with diabetes or nephropathy.However, excessive fluid intake may worsen heart failure or edema in some patients, so fluid intake should be individualized and monitored according to the patient’s condition and response to therapy.
Choice D is wrong because foods low in potassium are not harmful for clients taking ACE inhibitors.
Foods low in potassium do not affect the serum potassium level or the risk of hyperkalemia in clients taking ACE inhibitors.However, foods low in potassium may not provide enough dietary potassium for normal cellular functions, so a balanced diet that includes moderate amounts of potassium-rich foods is advisable.
Correct Answer is C
Explanation
Digoxin is a cardiac glycoside that increases the force of heart contractions (positive inotropy) and decreases the heart rate (negative chronotropy) by inhibiting the sodium-potassium ATPase pump in the cardiac cell membranes and affecting the autonomic tone.This helps to improve the symptoms of heart failure and to control the ventricular rate in atrial fibrillation.
Choice A is wrong because positive chronotropy means increasing the heart rate, which is the opposite of what digoxin does.
Choice B is wrong because negative inotropy means decreasing the force of heart contractions, which is also the opposite of what digoxin does.
Choice D is wrong because positive inotropy and positive chronotropy would both increase the workload of the heart, which is not desirable in heart failure or atrial fibrillation.
Normal ranges for digoxin are 0.5 to 2 ng/mL for heart failure and 0.8 to 2 ng/mL for atrial fibrillation.Digoxin has a narrow therapeutic window and can cause serious side effects if overdosed or underdosed.
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