The nurse is reviewing laboratory values for a client receiving a continuous heparin infusion. Which of the following laboratory values should the nurse monitor?

AST and ALT

Prothrombin time (PT)

Activated partial thromboplastin time (aPTT)

International normalized ratio (INR)

Answer and Explanation

The Correct Answer is C

A. AST and ALT are liver enzymes, primarily used to assess liver function, not directly related to monitoring heparin therapy.

B. Prothrombin time (PT) is used to monitor warfarin therapy, not heparin. Heparin therapy is typically monitored with aPTT, whereas warfarin is monitored with PT/INR.

C. Heparin is an anticoagulant that works by inhibiting clotting factors, and the aPTT is used to monitor its effectiveness. The aPTT measures the time it takes for blood to clot and helps ensure the heparin dose is therapeutic without causing excessive bleeding. The typical therapeutic range for aPTT on heparin therapy is 1.5 to 2.5 times the normal value.

D. INR is used to monitor warfarin therapy, not heparin. Heparin does not affect INR levels.

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Correct Answer is A

Explanation

A. Warfarin is an anticoagulant, which increases the risk of bleeding. Activities like straining or forceful nose blowing can increase the risk of bleeding, particularly nasal or internal bleeding, so the nurse should advise the client to avoid these actions.

B. Brushing teeth vigorously is not recommended with warfarin because it can lead to bleeding gums. The nurse should suggest using a soft toothbrush and brushing gently.

C. If a dose of warfarin is missed, the client should not double the dose. They should take the missed dose as soon as they remember, unless it's close to the time for the next dose, in which case they should skip the missed dose and resume the normal dosing schedule.

D. Warfarin is an oral medication, so rotating injection sites is not applicable. This advice is more relevant for injectable medications like insulin or heparin.

A. Decrease in LDL cholesterol from last visit. B. Generalized muscle aches. C. Nausea when taking the medication on an empty stomach D. Clear, light yellow urine output

Correct Answer is B

Explanation

A. A decrease in LDL cholesterol is a desired effect of simvastatin and does not indicate a problem.

B. Generalized muscle aches are a significant concern for patients on statin medications, such as simvastatin. This can be indicative of a serious side effect called rhabdomyolysis, a condition where muscle tissue breaks down and can lead to kidney damage. This should be communicated to the healthcare provider immediately for further evaluation and possible discontinuation of the medication.

C. Nausea when taking the medication on an empty stomach is a common side effect and may be addressed with guidance on when to take the medication.

D. Clear, light yellow urine is normal and does not require further action.

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The nurse is reviewing laboratory values for a client receiving a continuous heparin infusion. Which of the following laboratory values should the nurse monitor?

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