A pregnant patient is admitted with possible deep venous ...

[leo leo]

A pregnant patient is admitted with possible deep venous thrombosis (DVT). Orders are left to start warfarin (Coumadin) 5 mg p.o., once daily. Which of the following actions by the nurse is most appropriate?
 
  A.
  Call the physician to clarify the order and document the conversation.
  B.
  Instruct the patient not to get out of bed without assistance.
  C.
  Start the warfarin as soon as it is available from the pharmacy.
  D.
  Teach the patient about the risks and benefits of anticoagulation.

Question 2

A postpartum woman being dismissed complains to the nurse that she has extreme fatigue, shoulder pain, and has noticed what looks like blood in her urine. Which laboratory finding would the nurse correlate with these symptoms?
 
  A.
  Arterial blood pH: 7.35
  B.
  Blood glucose: 100 mg/dL
  C.
  Platelet count: 98,000/mm3
  D.
  White blood cell count: 9,000/mm3

[momo1250]

Answer to Question 1

ANS: A
Coumadin is contraindicated in pregnant women because it crosses the placenta. If anticoagulation is needed, heparin is the drug of choice. The nurse should consult with the physician about the orders and carefully document the conversation and results. Teaching is an appropriate nursing activity but is not the priority. The patient on heparin should be counseled to call for assistance before getting up because of the risk for injury, but the priority is obtaining the correct drug. The nurse should not start the Coumadin.

Answer to Question 2

ANS: C
This woman has symptoms of possible HELLP syndrome, which is characterized by poor liver function and thrombocytopenia. The platelet count is very low, consistent with this condition. The other laboratory values are within normal limits.

[leo leo]

Excellent

[parshano]

Gracias!