Week 8-11 PP Questions Flashcards
In which situation could a thrombolytic agent be safely used?
A. CVA within the last 2 months
B. Acute MI within the last 3 hours
C. Recent, serious GI bleeding
D. Obstetrical delivery
B. Acute MI within the last 3 hours
Rationale: Blood clots can cause myocardial infarction and alteplase can be used to dissolve the clot. Other answers are contraindications to thrombolytic agents
Antiplatelet drugs would be useful in which of the following? Select all that apply.
A. Maintaining the patency of grafts
B. Decreasing the risk of fatal MI
C. Preventing re-infarction after MI
D. Dissolving a PE
E. Preventing thromboembolic stroke
A, B, C, & E
Rationale: Antiplatelet drugs are used for the prevention of cardiovascular events. Thrombolytic agents are used to dissolve blood clots which are the cause of a pulmonary embolism.
The patient asks, “will the warfarin dissolve the clot in my leg?”
What is the nurse’s best response?
Warfarin will not dissolve the existing clot, but it will help prevent additional clot formation.
The nurse plans to assess the patient’s lab work before administering the warfarin. What blood test(s) are important to monitor for patients taking warfarin, and what is the therapeutic range?
When a patient is taking warfarin, the nurse should closely monitor INR and PT levels to verify they are in normal range to prevent bleeding complications.
Specifically, the therapeutic range for INR is between 2.0 to 3.0 depending upon the indication.
The nurse knows that the patient will need to monitor his diet when taking warfarin. What dietary instructions should be provided to the patient?
Dietary instructions should be provided to maintain a consistent intake of foods high in vitamin K like leafy green vegetables. Daily changes in intake of foods that are high in vitamin K will influence the effectiveness of warfarin, as well as the patient’s INR levels used to maintain the warfarin levels in therapeutic range.
The nurse plans to provide patient education regarding this newly prescribed medication. Outline education topics to cover with this high-risk medication. (anticoagulant)
Patient education should emphasize bleeding precautions, avoidance of NSAIDs and aspirin, the need for routine therapeutic monitoring, and when to call the provider with signs of increased bleeding.
What is the reversal agent for warfarin?
Vitamin K
What instructions should the nurse include in teaching a client about ferrous sulfate? SATA
A. Take with milk to avoid GI upset
B. This medication may cause constipation
C. Keep away from children
D. Stools may turn green
E. Periodic blood tests needed to evaluate effect
B, C, & E
Rationale: Ferrous sulfate will not turn stool green but can cause black, tarry stools. Dairy products can reduce the absorption of ferrous sulfate and should be avoided. Ferrous sulfate can cause constipation, is fatal to children
if overdosed, and Hgb will be monitored for therapeutic effects.
The nurse would instruct a client taking digoxin to do which of the following?
A. Make up a missed dose the next day
B. Report changes in heart rate
C. Avoid exposure to the sun
D. Switch to another brand if less expensive
B.
Rationale: Digoxin can cause arrhythmias (bradycardia)
The nurse is preparing to administer digoxin
to a client with an apical pulse of 48 beats per
minute. Which is the correct nursing action?
A. Give the drug and notify the primary care provider that the heart rate is low.
B. Retake the pulse in 15 minutes and give the drug if the heart rate is unchanged.
C. Retake the pulse in 1 hour and hold the drug if the heart rate is unchanged.
D. Hold the drug and notify the primary care provider that the heart rate is below 60 beats per minute.
D.
Rationale: The best action is to hold the dose and notify the provider. Digoxin cannot be safely given to a patient who is bradycardic.
What is the mechanism of action of
nitroglycerin?
A. Increase preload on the heart.
B. Increase the afterload on the heart.
C. Dilate coronary arteries.
D. Decrease fluid volume.
C.
Rationale: Nitroglycerin dilates the coronary arteries to increase blood flow and therefore oxygenation to tissues.
A client who is taking an antiarrhythmic
drug will need which of the following?
A. Constant cardiac monitoring until stabilized.
B. Frequent blood tests including blood levels.
C. An antidepressant to combat the adverse effect of depression.
D. Dietary changes to prevent irritation of the heart
muscle.
A.
Rationale: If a patient is unstable, they will likely need an IV antidysrhythmic medication which requires cardiac monitoring
Uncontrolled hypertension can cause which
of the following problems? Select all that apply.
A. Loss of vision
B. Stroke
C. Acceleration of atherosclerosis
D. Kidney disease
E. Diabetes mellitus type 2
A., B., C., & D.
Rationale: Uncontrolled hypertension can accelerate atherosclerosis and cardiovascular disease. Diabetes can contribute to worsening hypertension, but it is hypertension does not cause diabetes.
Which parameter below indicates
effective furosemide therapy for this
patient?
A. Urinary output 750 mL per day
B. Blood pressure 114/72 mmHg
C. Weight loss of 5 pounds in 2 days
D. Serum potassium 3.2 mEq/L
C.
Rationale: Weight loss will occur with fluid loss which is one way to assess effectiveness of the medication. Urinary output is about normal and the goal for this patient is to have excess urinary losses. The blood pressure is within normal parameters, but the patient is not taking for hypertension. The potassium is low which is an adverse effect.
When administering cyanocobalamin (Vitamin B12) to a client with pernicious anemia, the nurse should expect to administer the medication by which route?
A. Intravenous
B. Oral
C. Subcutaneous
D. Topical
C. Subcutaneous
Rationale: Cannot be given orally – the drug will not be absorbed. Not available IV. Topical drugs are typically not absorbed systemically.
