The client diagnosed with hyperlipidemia has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge?

Warfarin

Simethicone

Simvastatin

Enoxaparin

Answer and Explanation

The Correct Answer is C

A.   Warfarin is an anticoagulant used to prevent blood clots. While it may be prescribed for certain patients at risk for stroke, it is not typically the first-line medication for managing TIA or hyperlipidemia. It is more often used in patients with specific types of atrial fibrillation or mechanical heart valves.
B.   Simethicone is an anti-foaming agent used to relieve gas and bloating. It does not have any role in managing hyperlipidemia or preventing strokes. Thus, this option is not relevant to the client's condition.
C.   Simvastatin is a statin medication used to lower cholesterol levels and reduce the risk of cardiovascular events, including stroke. For a client with hyperlipidemia and a history of TIA, simvastatin would be an appropriate medication to help manage cholesterol and decrease the risk of future ischemic events.
D.   Enoxaparin is a low-molecular-weight heparin used for anticoagulation, often in the context of deep vein thrombosis or pulmonary embolism. It may not be the first choice for TIA management. While it has its uses in preventing clot formation, it is not the standard treatment for a patient who has had a TIA.

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Correct Answer is D

Explanation

A. This statement is not advisable. While it is essential to avoid strenuous activity initially, gentle arm exercises and range-of-motion activities are generally encouraged as soon as possible to promote circulation and help prevent lymphedema. Immobilization can actually increase the risk of lymphedema.
B. This intervention is not recommended for preventing lymphedema. Sleeping on the side of the surgery (in this case, the left side) can put pressure on the affected arm and may not promote proper lymphatic drainage. Clients are often advised to sleep on their back or to position themselves in a way that does not compress the affected arm.
C. This intervention can provide temporary relief if there is swelling or discomfort, but it does not effectively prevent lymphedema. While cool compresses might help reduce inflammation, they are not a primary measure for lymphedema prevention.
D. This is the most effective intervention for preventing lymphedema. Elevating the affected arm helps facilitate lymphatic drainage and reduces the risk of fluid accumulation. Keeping the arm elevated above heart level encourages proper circulation and helps manage swelling.

A. Flank mass and hematuria B. Dark tarry stool and mental status change C. Shortness of breath and chest pain D. Urinary frequency and hypotension

Correct Answer is A

Explanation

A. Renal cancer can often present with a palpable flank mass due to tumor growth. Hematuria (blood in the urine) is also a common finding in patients with kidney tumors and can result from bleeding within the renal system. Flank pain, especially in the context of renal cancer, often accompanies these findings.
B. Dark, tarry stools (melena) suggest gastrointestinal bleeding, which is not directly associated with renal cancer. Mental status changes could indicate various issues, such as metabolic imbalances or anemia, but they are not specific findings for renal cancer.
C. While patients with advanced cancer may experience shortness of breath due to metastasis to the lungs or other complications, chest pain is not a direct finding associated with renal cancer. These symptoms could indicate other issues, such as cardiac or pulmonary problems.
D. While urinary frequency can occur due to various urinary tract issues, it is not a classic symptom of renal cancer. Hypotension is also not a typical finding associated with renal cancer unless there is significant blood loss or other complications.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

The client diagnosed with hyperlipidemia has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge?

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