The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

Test a sample of urine for the presence of occult blood

Check the client's weight

Instruct the client to increase his water intake

Review results of liver function studies

Answer and Explanation

The Correct Answer is D

A.   While testing for occult blood can help rule out hematuria (blood in the urine), it’s not the immediate priority. Dark urine could be related to several factors, including dehydration or changes in liver function, making this not the best first step.
B.   While monitoring weight is important, it doesn't directly address the issue of dark urine. Weight changes might indicate fluid retention or loss but are not as immediately relevant to the urine color change.
C.   Increasing water intake can help dilute the urine and may help with hydration. However, before suggesting this, it's important to understand the underlying cause of the urine change.
D.   Glipizide and other sulfonylureas can affect liver function, and dark urine can indicate potential liver issues, such as bilirubinuria (bilirubin in the urine). Reviewing liver function studies would provide critical information to assess if the change in urine color is related to liver dysfunction or other serious issues.

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Correct Answer is A

Explanation

A. Heparin acts quickly to provide immediate anticoagulation, while warfarin takes several days to reach therapeutic levels. Heparin ensures that the client is adequately anticoagulated during the initial phase while waiting for warfarin to take effect.
B. Neither heparin nor warfarin directly dissolves clots. They are both anticoagulants that prevent further clot formation and allow the body's natural processes (fibrinolysis) to break down the existing clot over time. The combination does not specifically facilitate the dissolution of clots.
C. This statement is misleading. The use of both medications is not primarily about reducing the doses. Instead, each medication has its own dosing based on the patient’s needs, and the combination is used for timing and efficacy rather than dose reduction.
D. While heparin does provide immediate anticoagulation, saying it provides "maximum protection" could be misleading. It does ensure effective anticoagulation in the short term, but the maximum effectis related to individual response and therapeutic levels, which vary. Additionally, once warfarin reaches therapeutic levels, it becomes the primary agent for long-term anticoagulation.

A. Prone with arms elevated B. Supine with the stump flat on the bed C. Supine with the stump supported on pillows D. Reverse Trendelenburg

Correct Answer is C

Explanation

A. While positioning a patient prone can help with certain surgical recovery situations, it is not typically used immediately after an above-the-knee amputation. Additionally, elevating the arms may not provide any benefit and could cause discomfort.
B. This position can increase the risk of contractures in the residual limb, especially with an above-the- knee amputation. Keeping the stump flat may also lead to swelling and discomfort.
C. This position allows for proper elevation of the stump, which can help reduce swelling and promote healing. Supporting the stump on pillows prevents the risk of contractures and maintains the limb in a neutral position. It provides comfort and stability while facilitating blood flow.
D. While this position can help with venous return and reduce the risk of complications such as orthostatic hypotension, it is not specifically beneficial for an above-the-knee amputation recovery. It may not adequately address the need for proper stump support and elevation.

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The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving heparin sodium 5000 units IV and oral warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg. The nurse educated the client that heparin and warfarin are both used because:

Correct Answer is A

Explanation

The nurse is caring for a client who has returned to the nursing unit from the post anesthesia care unit (PACU) 40 minutes ago following an above the knee amputation (AKA) of the right leg. In which position should the nurse place the client at this time?

Correct Answer is C

Explanation

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