An older patient is diagnosed with polycythemia vera. What care ...

[P68T]

An older patient is diagnosed with polycythemia vera. What care will this patient most likely be prescribed? Standard Text: Select all that apply.
 
  1. Ticlopidine
  2. Splenectomy
  3. Hydroxyurea
  4. Chemotherapy
  5. Periodic phlebotomy

Question 2

An older patient receiving warfarin (Coumadin) alternate doses of 2.5 mg/5 mg has an INR of 6.3. What care should the nurse anticipate that this patient will need? Standard Text: Select all that apply.
 
  1. Prepare to begin a heparin infusion.
  2. Administer vitamin K as prescribed.
  3. Administer protamine sulfate as prescribed.
  4. Withhold several doses of prescribed warfarin.
  5. Administer an additional dose of warfarin as prescribed.

[joneynes]

Answer to Question 1

3,5
Rationale: Ticlopidine is a potent inhibitor of platelet aggregation but is used in prevention of stroke and heart attack.
Rationale 2: Splenectomy is not indicated in the treatment of polycythemia vera.
Rationale 3: In polycythemia vera, hydroxyurea can decrease the risk of thrombosis.
Rationale 4: Chemotherapy is not indicated in the treatment of polycythemia vera.
Rationale 5: Periodic phlebotomy significantly decreases the risk of thrombosis.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 6. Identify and prioritize appropriate nursing interventions to care for the older person with hematologic problems.

Answer to Question 2

2,4
Rationale: The INR is used to measure the effects of warfarin. Heparin is not administered for an elevated INR.

[P68T]

Excellent

[parker125]

TYSM