The nurse is caring for a 35-year-old woman who came to her ...

[berenicecastro]

The nurse is caring for a 35-year-old woman who came to her gynecologist today to receive a Gardasil injection.
 
  The patient says she is sexually active since age 14, admitting to more than 10 sexual partners, and has used oral birth control as a contraceptive because I don't like using barrier methods. The provider tells the patient she is not a good candidate for the injection and the patient asks the nurse why. What is the nurse's best response? A) Gardasil is only given to women between the ages of 9 and 26 years of age.
  B) The drug is only effective if administered before exposure to human papillomavirus (HPV).
  C) The drug cannot be administered to a woman who is sexually active.
  D) The drug cannot be administered until further Food and Drug Administration (FDA) testing has been completed.

Question 2

A 76-year-old patient is receiving IV heparin 5,000 units every 8 hours. An activated thromboplastin time (aPTT) is drawn 1 hour before the 8:00 AM dose; the aPTT is at 3.5 times the control value. What is the nurse's priority action?
 
  A) Give a larger dose to increase the aPTT.
  B) Give the dose as ordered and chart the results.
  C) Check the patient's vital signs prior to administering the dose.
  D) Hold the dose and call the result to the physician.

[ecabral0]

Answer to Question 1

B
Feedback:
This patient is not a candidate for Gardasil primarily because she has most likely already been exposed to HPV and there would be no benefit to the injection. Gardasil is a vaccine that needs to be administered before exposure to be effective. Although the drug is normally given to women aged 9 to 26 years old, it could be given to an older person who has not become sexually active yet. Although sexual activity would not preclude administering the injection to a young girl who has had only one sexual partner, multiple partners increase the likelihood of exposure to HPV. The FDA continues to monitor testing related to the need for booster shots and the length of time the immunity remains active, as well as long-term adverse effects of the drug but the drug is available to the public by prescription.

Answer to Question 2

D
Feedback:
The therapeutic level of heparin is demonstrated by an activated partial thromboplastin time (aPTT) that is 1.5 to 3 times the control value. The patient's value is 3.5 times control, which indicates clotting time is a bit too delayed and the dosage will likely either be reduced or a dosage may be held according to the order received from the physician. It would be inappropriate to give two doses at once, give the dose and chart the results, or simply check the vital signs without holding the dose and calling the physician.

[berenicecastro]

Both answers were spot on, thank you once again

[ecabral0]

Great! Please up vote