Anticoagulant and Antiplatelet Questions Flashcards
A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. Platelet count
D. Hemoglobin and hematocrit
A. Activated partial thromboplastin time (aPTT)
Which patient does the nurse identify as most likely needing an increased dose of warfarin [Coumadin] to have the same anticoagulant effect?
A. Patient taking acetaminophen [Tylenol] for back pain
B. Patient taking cimetidine [Tagamet] to prevent gastric ulcers
C. Patient taking oral contraceptives to prevent pregnancy
D. Patient taking prednisone [Deltasone] for rheumatoid arthritis
C. Patient taking oral contraceptives to prevent pregnancy
What is the antidote for heparin? A. Ferrous sulfate B. Atropine sulfate C. Protamine sulfate D. Vitamin K
C. Protamine sulfate
A patient is prescribed celecoxib [Celebrex] and warfarin [Coumadin]. The nurse should monitor the patient for what? A. Renal toxicity B. Bleeding C. Stroke symptoms D. Dysrhythmias
B. Bleeding
Nonaspirin NSAIDs differ from aspirin in all but which way?
A. They cause reversible inhibition of COX, so their effects decline as soon as their blood levels decline.
B. They can suppress platelet aggregation, but they are not used to prevent MI and stroke.
C. They increase the risk of MI and stroke and therefore should be used in the lowest effective dosage for the shortest possible time.
D. They are safe to use in children with chickenpox or influenza.
D. They are safe to use in children with chickenpox or influenza.
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? A. Inspiratory wheezing B. Blood pressure of 160/88 mm Hg C. Heart rate of 60 beats/min D. Discolored urine
D. Discolored urine
The laboratory calls to report a drop in the platelet count to 90,000/mm3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate?
A. Observe the patient and monitor the aPTT as indicated.
B. Notify the healthcare provider to discuss the reduction or withdrawal of heparin.
C. Obtain vitamin K and prepare to administer it by IM injection.
D. Call the healthcare provider to discuss increasing the heparin dose to achieve a therapeutic level.
B. Notify the healthcare provider to discuss the reduction or withdrawal of heparin.
The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time (aPTT) is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved? A. 90 B. 70 C. 110 D. 50
B. 70
The nurse is caring for a group of patients taking warfarin [Coumadin]. Which patients are at moderate to high risk for harm as a result of warfarin therapy? Select all that apply.
A. A patient with variant genes that code for VKORC1 and CYP2CP
B. A patient with a current INR of 2.2 treated for deep vein thrombosis
C. A woman with a new onset of symptoms of a pulmonary embolus
D. A patient on day 4 after hip replacement with a new order for warfarin E. A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen
A,C,E
A patient is receiving continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor? Select all that apply.
A. Vitamin K
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Prothrombin time (PT)
E. Platelets
B. Activated partial thromboplastin time (aPTT)
E. Platelets
A patient admitted with deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) requires immediate anticoagulation. What medication would be appropriate for this patient?
A. Heparin
B. Aspirin
C. Warfarin
A. Heparin
The nurse assesses a patient who takes Aspirin on a regular basis. Which finding does the nurse know is an adverse effect of Aspirin therapy? A. Hematemesis B. Dysmenorrhea C. Hives D. Jaundice
A. Hematemesis
A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication? A. Ibuprofen B. Zolpidem C. Loratadine D. Diphenhydramine
A. Ibuprofen
A patient is prescribed a medication that lowers the arterial blood pressure. The nurse should assess for which response by the body to restore the blood pressure?
A.Orthostatic hypotension
B. Fluid retention
C.Reflex tachycardia
D. Increased natriuresis
Answer: C
Rationale: Drugs that lower the arterial pressure will trigger the baroreceptor reflex with the response of reflex tachycardia.
A patient is prescribed a medication that causes venous dilation. It is most important for the nurse to teach the patient about what?
A. B-natriuretic peptide
B. Postural hypotension
C. Increased urination
D. Intermittent claudication
Answer: B
Rationale: Postural hypotension may occur with drugs that promote the dilation of veins or that prevent the veins from constricting.
