An older adult recovering from a myorcardial infarction (MI) has ...

[bobypop]

An older adult recovering from a myorcardial infarction (MI) has been taking subcutaneous heparin but is now to receive oral warfarin (Coumadin). The nurse prepares to teach the patient which topics? (Select all that apply.)
 
  a. Administration of both medications for up to 5 days
  b. Need to use a soft bristle toothbrush
  c. Use of atropine as an antidote for exces-sive bleeding
  d. Need to continue drawing partial throm-boplastin times
  e. Need to drink at least eight cups of fluids daily

Question 2

A 74-year-old adult is experiencing dumping syndrome after gastric resection surgery. The nurse caring for the patient instructs the patient to
 
  a. stop smoking.
  b. abstain from beverages that contain caffeine.
  c. eat three low-carbohydrate meals daily.
  d. drink only between meals.

[blakcmamba]

Answer to Question 1

A, B, D
Heparin and warfarin (Coumadin) are anticoagulants used to prevent the enlargement of existing thrombi and new clot formation after an MI. Therapeutic effects of heparin are monitored by partial thromboplastin times; the antidote is protamine sulfate. Warfarin is monitored by the in-ternational normalized ratio (INR); the antidote is vitamin K. Patients who initially receive hepa-rin for anticoagulation and who need oral anticoagulation for maintenance usually take both forms of medication for 3 to 5 days to develop therapeutic blood levels. Bleeding is a complica-tion. Patients need to be taught bleeding precautions.

Answer to Question 2

D
The institution of small, frequent meals that are low in carbohydrates will diminish the incidence of these symptoms. Resting after eating and drinking fluids between (rather than during) meals will also help alleviate these symptoms. Smoking and caffeine are not related, and eating only three meals a day is not warranted.