A nurse is preparing to administer a heparin infusion of 25,000 units in 250 mL of normal saline at a rate of 1000 units per hour for a client diagnosed with a Deep Vein Thrombosis (DVT). The client’s initial activated partial thromboplastin time (aPTT) value is 35 seconds.

Which laboratory result would indicate that the aPTT is at a therapeutic level?

30 seconds

45 seconds

60 seconds

75 seconds

Answer and Explanation

The Correct Answer is D

Step 1 is to understand the therapeutic range for aPTT when a patient is on heparin therapy. The therapeutic range for aPTT is 1.5 to 2.5 times the normal value. Given that the normal aPTT value is around 30-40 seconds, the therapeutic range would be approximately 45-100 seconds. Therefore, an aPTT value of 75 seconds falls within this therapeutic range, indicating that the heparin therapy is effective.

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Correct Answer is C

Explanation

Wearing closed-toe shoes when walking can help protect the feet from injuries. However, it does not directly address the issue of numbness and reduced sensation due to severe peripheral neuropathy.

Choice B rationale

Soaking feet daily to remove pathogens can help maintain hygiene, but it does not directly address the issue of numbness and reduced sensation due to severe peripheral neuropathy.

Choice C rationale

Examining your feet daily is a crucial intervention for patients with severe peripheral neuropathy. Due to the numbness and reduced sensation, patients might not notice injuries or changes in their feet. Regular self-examination can help detect any abnormalities early, preventing further complications.

Choice D rationale

Using lotion on all areas of the feet for moisture can help prevent dryness and cracking of the skin, but it does not directly address the issue of numbness and reduced sensation due to severe peripheral neuropathy.

A. The client will verbalize an understanding of appropriate foot care measures by discharge. B. The client will verbalize the importance of taking anti-platelet medications by discharge. C. The client will discuss exercises that promote healing of wounds prior to discharge. D. The client will recognize the need for an amputation in the near future.

Correct Answer is A

Explanation

Choice A rationale

The client diagnosed with peripheral arterial disease has impaired tissue integrity related to ischemic tissue of the legs and feet. This condition is often caused by factors such as physical trauma, thermal factors, chemical injury, infection, nutritional imbalances, fluid imbalances, and altered circulation. The most appropriate outcome to include in the care plan would be for the client to verbalize an understanding of appropriate foot care measures by discharge. This is because maintaining skin integrity and providing effective wound care are crucial aspects of managing this condition. By understanding and implementing appropriate foot care measures, the client can help prevent further tissue damage, promote healing, and improve their overall quality of life.

Choice B rationale

While taking anti-platelet medications can be an important part of managing peripheral arterial disease, it may not directly address the nursing problem of impaired tissue integrity. Anti-platelet medications can help prevent blood clots and improve blood flow, but they do not directly promote wound healing or tissue regeneration.

Choice C rationale

Discussing exercises that promote healing of wounds can be beneficial for the client. However, it’s important to note that exercises should be appropriate for the client’s condition and overall health status. Overexertion or inappropriate exercises could potentially exacerbate the condition and further impair tissue integrity.

Choice D rationale

Recognizing the need for an amputation in the near future can be a realistic outcome for some clients with severe peripheral arterial disease. However, this is typically considered a last resort when all other treatment options have failed. It’s also a drastic measure that can significantly impact the client’s quality of life.

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Naxlex Comprehensive Predictor Exams

A patient diagnosed with diabetes has severe peripheral neuropathy resulting in numbness and reduced sensation of the feet. What intervention should the nurse teach the patient to prevent injury as a result of this complication?

Correct Answer is C

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

A client diagnosed with peripheral arterial disease has the nursing problem of Impaired Tissue Integrity related to ischemic tissue of the legs and feet. What is an expected outcome to include in the care plan?

Correct Answer is A

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is teaching an adult patient with Type 1 diabetes that a primary cause of the development of diabetic ketoacidosis (DKA) is:

The nurse is evaluating the patient’s response to antibiotic therapy. Which data would indicate that the medication has been effective?

The nurse is caring for a patient with a diagnosis of chronic peripheral arterial disease. Which statement by the patient warrants immediate intervention by the nurse?

A client diagnosed with Raynaud’s disease is experiencing severe pain and spasms in the fingers and toes of their hands. What advice should the nurse include in the discharge instructions for this client?

The nurse is teaching a patient to wash their hands after using the bathroom as an attempt to break the chain of infection. Between which two links in the chain of infection does this action intervene?

The client newly diagnosed with Type 1 diabetes is to be discharged in the morning and has received no instruction on diabetes. What should be the nurse’s teaching priority?