The patient receives warfarin (Coumadin) and becomes pregnant. ...

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The patient receives warfarin (Coumadin) and becomes pregnant. The physician changes her anticoagulant to enoxaparin (Lovenox). She asks the nurse, Why did the doctor do that? What is the best rationale by the nurse?
 
  1. Because it is easier to maintain your bleeding times in a therapeutic range.
  2. Because warfarin (Coumadin) is known to cause serious cardiac defects.
  3. Because you are less likely to have bleeding with enoxaparin (Lovenox).
  4. Because enoxaparin (Lovenox) cannot get into your baby.

Question 2

A woman brings her husband to the emergency department and tells the nurse that her husband just had a stroke. The physician verifies a thrombotic cerebral vascular accident (CVA) occurred and plans to use alteplase (Activase).
 
  What priority assessment question will the nurse ask the wife?
  1. What other medications does your husband take?
  2. Does your husband have hypertension?
  3. What other medical illnesses does your husband have?
  4. What time did your husband have the stroke?

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Answer to Question 1

Correct Answer: 4
Rationale: Heparin and the low-molecular-weight heparin (LMWH) molecules are too large to cross the placental barrier. The patient would not be less likely to have bleeding with enoxaparin (Lovenox). Warfarin (Coumadin) is not known to cause serious cardiac defects. It is not easier to maintain bleeding times with enoxaparin (Lovenox) than with warfarin (Coumadin).

Answer to Question 2

Correct Answer: 4
Rationale: Alteplase (Activase) must be given within 3 hours of a thrombotic cerebro vascular accident (CVA) for maximum effectiveness. Asking about hypertension is a good question, but is not the priority. Asking about medications is a good question, but is not the priority. Asking about illnesses is a good question, but is not the priority.

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Gracias!

[JCABRERA33]

TYSM