Exam 3 Anticoagulants

A patient is receiving an intravenous heparin drip. Which laboratory value requires immediate action by the nurse? Platelet count of 150,000 mm 3 International normalized ratio (INR) of 1.0 Blood urea nitrogen (BUN) level of 12 mg/dL Activated partial thromboplastin time (aPTT) of 120 seconds

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. Stop the intravenous drip. Wait for the INR to decrease. Administer protamine sulfate.

Administer phytonadione.

Which needle length and gauge should the nurse choose to administer subcutaneous heparin? 1½ inch; 20 gauge ⅝ inch; 25 gauge 1½ inch; 18 gauge 1 inch; 26 gauge

⅝ inch; 25 gauge

A patient with deep vein thrombosis receiving an intravenous heparin infusion asks the nurse how this medication works. What is the nurse's best response? "Heparin converts plasminogen to plasmin, which in turn dissolves the clot matrix" "Heparin suppresses coagulation by helping antithrombin perform its natural functions." "Heparin prevents activation of vitamin K and thus blocks synthesis of some clotting factors." "Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels."

"Heparin suppresses coagulation by helping antithrombin perform its natural functions."

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? "Your concern is valid. I will call the doctor to discontinue the heparin." "Because you are now up and walking, you have a higher risk of blood clots and therefore need to be on both medications." "It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is continued until the warfarin is therapeutic." "Because of your valve replacement, it is especially important for you to be given anticoagulant therapy. The heparin and warfarin together are more effective than one alone."

"It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is continued until the warfarin is therapeutic."

A nurse is preparing to administer enoxaparin sodium to a patient for prevention of deep vein thrombosis. Which is an essential nursing intervention? Rub the administration site after injecting. Use the Z-track method to inject the medication. Administer the medication into subcutaneous tissue of the abdomen. Draw up the medication in a syringe with a 22-gauge, 1½-inch needle.

Administer the medication into subcutaneous tissue of the abdomen.

A patient who has been taking warfarin is admitted with coffee-ground emesis. What can the nurse anticipate being prescribed for this patient? Vitamin E Vitamin K Protamine sulfate Calcium gluconate

Vitamin K

When observing a new staff nurse preparing to administer diltiazem, the charge nurse should approve which action? Administering the drug via an infusion pump. Drawing up the medication in a heparin flush. Pushing the medication intravenously over 30 seconds. Hanging the medication secondary to a free-hanging dextrose solution.

Administering the drug via an infusion pump.

The nurse is administering warfarin, an anticoagulant, to a patient with a low albumin level. Which effect of this medication should the nurse expect to observe? Deep vein thrombosis Reduced risk of bruising Increased platelet aggregation Increased prothrombin time/international normalized ratio (PT/INR) levels

Increased prothrombin time/international normalized ratio (PT/INR) levels

A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 1000 units/hr. The nurse will immediately notify the healthcare provider of which findings? Select all that apply. Nosebleeds aPTT of 40 seconds aPTT of 100 seconds Platelet count of 300,000/µL Activated partial thromboplastin time (aPTT) of 65 seconds

Nosebleeds aPTT of 40 seconds aPTT of 100 seconds

The nurse is caring for a pregnant patient with a history of thrombosis. Which prophylactic treatment does the nurse anticipate the health care provider will prescribe for this patient? Warfarin Alteplase Enoxaparin Clopidogrel

Enoxaparin

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 high; vitamin K may be needed. INR is within normal limits; no action is indicated. INR is too low; the dose may need to be increased. INR is too high; intravenous protamine may be needed.

INR is too low; the dose may need to be increased.

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? Obtain vitamin K and prepare to administer it by intramuscular injection. Notify the healthcare provider to discuss the reduction or withdrawal of heparin. Observe the patient and monitor the activated partial thromboplastin time (aPTT) as indicated. Call the healthcare provider to discuss increasing the heparin dose to achieve a therapeutic level.

Notify the healthcare provider to discuss the reduction or withdrawal of heparin.

A patient is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor? Select all that apply. Platelets Vitamin K Prothrombin time (PT) International normalized ratio (INR) Activated partial thromboplastin time (aPTT)

Platelets Activated partial thromboplastin time (aPTT)

A patient is being discharged from the hospital on warfarin for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan? Select all that apply. Wear a medical alert bracelet. Check all urine and stools for discoloration. Do not start any new medication without first talking to the healthcare provider. No laboratory or home monitoring of international normalized ratio (INR) is required after the first 6 months. Enteric-coated aspirin and any aspirin products can be used unless they cause a gastrointestinal ulcer.

Wear a medical alert bracelet. Check all urine and stools for discoloration. Do not start any new medication without first talking to the healthcare provider.