patho exam 4 homework
The nurse is monitoring a patient receiving alteplase for treatment of a massive pulmonary embolism. Which finding indicates that the therapy is effective?
Pulse oxygen saturation increased
A patient with an acute myocardial infarction is prescribed an intravenous (IV) bolus of tenecteplase. The patient weighs 160 pounds (approximately 73 kg). What dosage should the nurse administer?
40mg
The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin?
Discolored urine
The patient is scheduled to receive argatroban. Which is the correct route by which to administer the drug?
Intravenous
What is the mechanism of action of ezetimibe?
It inhibits absorption of dietary and biliary cholesterol in the small intestine.
The patient is being treated with heparin. The nurse assesses the patent's laboratory test results and finds that the platelet count has dropped to 75,000/mm 3. What action will the nurse perform next?
Notify the primary healthcare provider of this finding
The patient is receiving warfarin therapy, and the nurse finds the international normalized ratio (INR) to be 4.0. How will the nurse interpret this finding?
The level is outside the expected target therapeutic level of anticoagulation: it is too high.
The nurse is caring for a patient who is undergoing treatment with heparin therapy. The nurse assesses the patient's activated partial thromboplastin time (aPTT) and finds it to be 98 seconds. How will the nurse interpret this finding?
The level is outside the expected target therapeutic level of anticoagulation; it is too high
The nurse is monitoring a patient receiving reteplase therapy. Which assessment finding requires the most immediate action?
change in mental status
The nurse determines that the patient has understood the discharge teaching regarding warfarin based on which of the patient's statements?
"I should use a soft toothbrush for dental hygiene."
Which statement made by the patient indicates to the nurse that understanding of the discharge instructions on antihyperlipidemic medications has occurred?
"I will continue to modify my diet and keep exercising to help increase my high-density lipoprotein serum levels."
Which statement indicates the patient understands discharge instructions regarding cholestyramine?
"I will take cholestyramine 1 hour before my other medications
Which discharge instructions should the nurse include for a patient prescribed cholestyramine?
"I will take cholestyramine with water, fruit juice, or soup.
The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin. Which response from the students indicates understanding?
"It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
A patient is started on warfarin therapy while also receiving intravenous heparin. The patient is concerned about the risk for bleeding. What will the nurse tell the patient?
"It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is continued until the warfarin is therapeutic."
The nurse is assessing a patient who has been prescribed atorvastatin. What instruction should the nurse provide for the patient to ensure proper administration of the medication?
"Take the drug in the evening.
The nurse is administering tenecteplase therapy to a patient experiencing an acute myocardial infarction. What will the nurse teach the patient about this therapy?
"This therapy will dissolve the clot that caused the heart attack
The nurse is assessing a patient who has been prescribed cholestyramine. The nurse finds that the patient has decreased peristalsis and bloating. Which intervention should the nurse perform to relieve the symptoms? Select all that apply.
- Provide a diet rich in fiber - Increase the intake of fluid
The health care provider prescribes lovastatin for a patient discharged from the hospital after a myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? Select all that apply.
-"Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains." - "Do not start any new medications without first talking to your health care provider." - "Before starting this medication a blood test will be done to check your total cholesterol level and measure liver enzymes."
The nurse is caring for a patient prescribed gemfibrozil. For which patient should the nurse question the use of this drug?
A patient with history of gallstones
A patient is receiving an intravenous heparin drip. Which laboratory value requires immediate action by the nurse?
Activated partial thromboplastin time (aPTT) of 120 seconds
A bleeding patient receiving warfarin has an international normalized ratio (INR) of 6. What is the nurse's best course of action?
Administer phytonadione
The nurse is teaching a patient about therapy with anticoagulants. What is essential information to include in the teaching plan?
Anticoagulants prevent clots from forming
A patient is prescribed omega 3-acid ethyl esters and simvastatin for hyperlipidemia. The nurse is looking at the patient's medication history and expresses concern over which medication?
Aspirin
A patient with warfarin toxicity is prescribed phytonadione. Which nursing assessment ensures patient safety?
Assess the prothrombin time (PT)
How does simvastatin exert its action?
By inhibiting the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase
The laboratory calls to report a drop in the platelet count to 90,000/mm 3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate?
Call the healthcare provider to discuss the reduction or withdrawal of heparin.
The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemic drug would be most beneficial for the patient?
Colesevelam
Which drug is approved for hyperlipidemia and to help control hyperglycemia in patients with type 2 diabetes?
Colesevelam
Which antilipemic medication reduces serum cholesterol by inhibiting its absorption in the small intestine?
Ezetimibe
The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "Your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in the patient's blood report?
High levels of low-density lipoproteins (LDLs)
The nurse is caring for a patient who takes warfarin for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. How should the nurse interpret this finding?
INR is too low; the dose may need to be increased
A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug?
Muscle pain and tenderness
A patient with hyperlipidemia has been prescribed simvastatin. While caring for the patient, the nurse unknowingly administers niacin along with simvastatin. Which complication may the patient have due to the drugs' interaction?
Myopathy
The patient has been placed on aspirin as an antiplatelet drug. Which side effect is the patient most likely to experience?
Nausea
A patient who is receiving heparin therapy has bruises covering the abdomen as well as red-colored urine. What does the nurse need to assess?
Platelet level
The nurse is reviewing laboratory data before initiating a patient's heparin infusion. Which finding requires immediate action?
Platelets 95,000/mm 3
The nurse assesses the patient's prothrombin time (PT) to determine the effectiveness of anticoagulant therapy and notes that it is 32 seconds. How will the nurse interpret this value?
The PT is significantly elevated
A patient is prescribed a therapeutic lifestyle change (TLC) diet. The patient understands the diet when he states which of the following?
The TLC diet was prescribed to help me reduce my low-density lipoproteins (LDL) cholesterol and maintain a healthy weight.
The nurse is preparing to administer an anticoagulant to a patient. Which action, if observed, is in error?
The nurse administers enoxaparin intramuscularly to a patient
The nurse is caring for a patient who has hyperlipidemia and who has been prescribed gemfibrozil. On reviewing the medical history of the patient, the nurse learns that the patient is taking warfarin. What does the nurse anticipate after reviewing the patient's medical history?
The patient has an increased risk of bleeding.
A patient with hyperlipidemia is treated with atorvastatin. On the follow-up visit, the nurse discovers that the patient has had no improvement in cholesterol levels. What could be the reason for this?
The patient is taking the medication in the morning
Laboratory reports indicate that a patient's serum cholesterol concentration is 250 mg/dL and triglyceride levels are 450 mg/dL. The health care provider prescribes gemfibrozil to lower cholesterol levels. What is the desired effect of the drug on the patient's lipoprotein levels?
There would be a decrease in low-density lipoprotein (LDL) levels
In which patient would a low-dose aspirin be contraindicated?
a pt with hemorrhagic stroke
A patient diagnosed with hypercholesterolemia is prescribed lovastatin. Based on this medication order, the nurse will contact the health care provider about which reported condition in the patient's history?
hepatic disease
When will the nurse administer hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins)?
in the evening
A patient is taking pravastatin sodium. Which assessment finding requires immediate action by the nurse?
muscle pain
A patient who has been receiving an infusion of heparin has an activated partial thromboplastin time (aPTT) of 120 seconds. What is the nurse's first action?
shut off the heparin drip
