The nurse is providing discharge teaching for a client who developed a pulmonary embolism after total knee surgery. The client has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client?

Anticoagulant therapy usually needs to be continued between 3 and 6 months and up to 12 months.

The client should take a vitamin supplement containing vitamin K.

Warfarin will continue to break up the clot over the weeks.

Warfarin should be taken with aspirin

Answer and Explanation

The Correct Answer is A

Rationale:
A. Anticoagulant therapy for a pulmonary embolism is typically continued for 3–6 months, and sometimes up to 12 months or longer, depending on risk factors and medical history. This is correct and should be part of discharge teaching.
B. Vitamin K can interfere with warfarin’s effectiveness; clients should avoid supplements with high vitamin K unless advised otherwise by their provider.
C. Warfarin does not dissolve existing clots; it prevents new clots from forming and existing ones from growing. The body gradually breaks down the clot on its own.
D. Taking warfarin with aspirin increases bleeding risk unless specifically prescribed; clients should be cautioned against using other blood-thinning medications without provider approval.

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Correct Answer is C

Explanation

Rationale:
A. Sunlight exposure can trigger flares in clients with SLE due to photosensitivity; minimizing UV exposure is recommended.
B. While moderate activity is beneficial, overexertion can lead to flares; clients should balance activity with rest.
C. Monitoring body temperature regularly helps detect early signs of infection, which clients with SLE are at increased risk for due to immunosuppressive therapy and the disease itself. This shows appropriate understanding.
D. Stopping steroids abruptly can lead to adrenal insufficiency and flare-ups; medications should only be adjusted under medical supervision.

A. Encourage the client to ambulate and increase fluid intake to stimulate urination B. Check the client's bladder for distention and notify the healthcare provider if necessary. C. Increase the client's fluid intake and reassess the output in 4 hours. D. Administer the prescribed pain medication and document the findings

Correct Answer is B

Explanation

Rationale:
A. Encouraging ambulation and fluids may help, but the low urine output (oliguria) over 3 hours warrants assessment of bladder distention first to rule out urinary retention.
B. Checking the bladder for distention is the most appropriate immediate action, as urinary retention is a common postoperative complication that can cause pain and reduced output. The healthcare provider should be notified if retention is present.
C. Increasing fluids alone without assessment may delay necessary intervention.
D. Administering pain medication without assessing the cause of decreased output may mask symptoms and delay diagnosis of urinary retention or other complications.

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The nurse is providing discharge teaching for a client who developed a pulmonary embolism after total knee surgery. The client has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with systemic lupus erythematosus (SLE) is preparing for discharge. The nurse knows that the client has understood health education when the client makes what statement?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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