NUR2474 | NUR 2474 Exam 2 | Pharmacology for Professional Nursing Exam 2 | Rasmussen
NUR2474 | NUR 2474 Exam 2 | Pharmacology for Professional Nursing Exam 2 | Rasmussen
NUR2474 | NUR 2474 Exam 2 | Pharmacology for Professional Nursing Exam 2 | Rasmussen
NUR2474 | NUR 2474 Exam 2 |
Pharmacology for Professional
Nursing Exam 2 | Rasmussen
A patient who takes warfarin (Coumadin) is brought to the emergency
department after accidentally taking too much warfarin. The patient's
heart rate is 78 beats per minute and the blood pressure is 120/80 mm
Hg. A dipstick urinalysis is normal. The patient does not have any
obvious hematoma or petechiae and does not complain of pain. The
nurse will anticipate an order for:
a.vitamin K (phytonadione).
b.protamine sulfate.
c.a PTT.
d.a PT and an INR - Correct Answer - d.a PT and an INR
This patient does not exhibit any signs of bleeding from a warfarin
overdose. The vital signs are stable, there are no hematomas or
petechiae, and the patient does not have pain. A PT and INR should be
drawn to evaluate the anticoagulant effects. Vitamin K may be given if
laboratory values indicate overdose. Protamine sulfate is given for
heparin overdose. PTT evaluation is used to monitor heparin therapy.
A patient has been taking warfarin (Coumadin) for atrial fibrillation. The
provider has ordered dabigatran etexilate (Pradaxa) to replace the
warfarin. The nurse teaches the patient about the change in drug
,regimen. Which statement by the patient indicates understanding of the
teaching?
a."I may need to adjust the dose of dabigatran after weaning off the
warfarin."
b."I should continue to take the warfarin after beginning the dabigatran
until my INR is greater than 3."
c."I should stop taking the warfarin 3 days before starting the
dabigatran."
d."I will stop taking the warfarin and will start taking the dabigatran when
my INR is less than 2." - Correct Answer - d."I will stop taking the
warfarin and will start taking the dabigatran when my INR is less than 2."
When switching from warfarin to dabigatran, patients should stop taking
the warfarin and begin taking the dabigatran when the INR is less than
2. It is not correct to begin taking the dabigatran before stopping the
warfarin. While warfarin is stopped before beginning the dabigatran, the
decision to start taking the dabigatran is based on the patient's INR and
not on the amount of time that has elapsed.
A patient will begin taking dabigatran etexilate (Pradaxa) to prevent
stroke. The nurse will include which statement when teaching this
patient?
a.Dabigatran should be taken on an empty stomach to improve
absorption.
b.It is important not to crush, chew, or open capsules of dabigatran.
c.The risk of bleeding with dabigatran is less than that with warfarin
(Coumadin).
,d.To remember to take dabigatran twice daily, a pill organizer can be
useful.
- Correct Answer - b.It is important not to crush, chew, or open capsules
of dabigatran.
Patients should be taught to swallow capsules of dabigatran intact;
absorption may be increased as much as 75%, increasing the risk of
bleeding, if the capsules are crushed, chewed, or opened. Dabigatran
may be taken with or without food. The risk of bleeding is not less than
that of warfarin. Dabigatran is unstable when exposed to moisture, so
using a pill organizer is not recommended.
A postoperative patient will begin anticoagulant therapy with rivaroxaban
(Xarelta) after knee replacement surgery. The nurse performs a history
and learns that the patient is taking erythromycin. The patient's
creatinine clearance is 50 mL/min. The nurse will:
a.administer the first dose of rivaroxaban as ordered.
b.notify the provider to discuss changing the patient's antibiotic.
c.request an order for a different anticoagulant medication.
d.request an order to increase the dose of rivaroxaban. - Correct Answer
- b.notify the provider to discuss changing the patient's antibiotic.
Patients with impaired renal function who are taking macrolide antibiotics
will experience increased levels of rivaroxaban, increasing the risk of
bleeding. It is correct to discuss using a different antibiotic if possible.
The nurse should not administer the dose without discussing the
situation with the provider. The patient's renal impairment is minor; if it
, were more severe, using a different anticoagulant might be appropriate.
It is not correct to increase the dose of rivaroxaban.
A nurse caring for a patient receiving heparin therapy notes that the
patient has a heart rate of 98 beats per minute and a blood pressure of
110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC
shows a platelet count of less than 100,000 mm3. The nurse will:
a.administer oxygen and notify the provider.
b.discontinue the heparin and notify the provider.
c.request an order for protamine sulfate.
d.request an order for vitamin K (phytonadione). - Correct Answer -
b.discontinue the heparin and notify the provider.
This patient is showing signs of heparin-induced thrombocytopenia, so
the heparin should be discontinued immediately and the provider should
be notified. The purplish color of the fingertips is caused by thrombosis,
not hypoxia, so oxygen is not indicated. This patient may need continued
anticoagulation therapy, so a request for protamine sulfate is not correct.
Heparin is not a vitamin K inhibitor.
A patient with epistaxis and a history of hemophilia A is admitted to the
unit and is scheduled for replacement therapy. The nurse should prepare
to administer which medication?
a.Tranexamic acid (Cyklokapron)
b.Aminocaproic acid (Amicar)
c.Desmopressin (Stimate)
d.Factor VIII - Correct Answer - d.Factor VIII
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller nursehailey. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
