This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, ... (Read 111 times)

Starlight

  • Hero Member
  • *****
  • Posts: 567
on: Jul 23, 2018
A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders lab work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:
 
  a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
  b. phytonadione (vitamin K1) 2.5 mg PO.
  c. protamine sulfate 20 mg PO.
  d. protamine sulfate 20 mg slow IV push.

Question 2

A postoperative patient will begin anticoagulant therapy with rivaroxaban (Xarelta) after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin.
 
  The patient's creatinine clearance is 50 mL/min. The nurse will:
  a. administer the first dose of rivaroxaban as ordered.
  b. notify the provider to discuss changing the patient's antibiotic.
  c. request an order for a different anticoagulant medication.
  d. request an order to increase the dose of rivaroxaban.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

Jsherida

  • Sr. Member
  • ****
  • Posts: 314
Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: A
Vitamin K1 is given for warfarin overdose and may be given IV in an emergency. To reduce the incidence of an anaphylactoid reaction, it should be infused slowly. In a non-emergency situation, it would be appropriate to give vitamin K1 orally. Protamine sulfate is used for heparin overdose.

Answer to Question 2

ANS: B
Patients with impaired renal function who are taking macrolide antibiotics will experience increased levels of rivaroxaban, increasing the risk of bleeding. It is correct to discuss using a different antibiotic if possible. The nurse should not administer the dose without discussing the situation with the provider. The patient's renal impairment is minor; if it were more severe, using a different anticoagulant might be appropriate. It is not correct to increase the dose of rivaroxaban.


Starlight

  • Member
  • Posts: 567
Reply 2 on: Jul 23, 2018
Great answer, keep it coming :)

kusterl

  • Member
  • Posts: 315
Reply 3 on: Yesterday
Thanks for the timely response, appreciate it

« previous next »
 

Did you know?

Never take aspirin without food because it is likely to irritate your stomach. Never give aspirin to children under age 12. Overdoses of aspirin have the potential to cause deafness.

Did you know?

A good example of polar molecules can be understood when trying to make a cake. If water and oil are required, they will not mix together. If you put them into a measuring cup, the oil will rise to the top while the water remains on the bottom.

Did you know?

Multiple experimental evidences have confirmed that at the molecular level, cancer is caused by lesions in cellular DNA.

Did you know?

There used to be a metric calendar, as well as metric clocks. The metric calendar, or "French Republican Calendar" divided the year into 12 months, but each month was divided into three 10-day weeks. Each day had 10 decimal hours. Each hour had 100 decimal minutes. Due to lack of popularity, the metric clocks and calendars were ended in 1795, three years after they had been first marketed.

Did you know?

Blastomycosis is often misdiagnosed, resulting in tragic outcomes. It is caused by a fungus living in moist soil, in wooded areas of the United States and Canada. If inhaled, the fungus can cause mild breathing problems that may worsen and cause serious illness and even death.

Overview of gas exchange between the environment, blood, and cells. Overview of gas exchange between the environment, blood, and cells.
A subdural hematoma. A meningeal vein is ruptured and blood has accumulated in the subdural space, p A subdural hematoma. A meningeal vein is ruptured and blood has accumulated in the subdural space, p
Vacutainer evacuated specimen tubes with Hemogard closure blood collection tubes. Vacutainer evacuated specimen tubes with Hemogard closure blood collection tubes.
Purpura, an inflammation of the blood vessels. Purpura, an inflammation of the blood vessels.
A Mono-Diff test in which the presumptive well contains the patient's serum mixed with ... A Mono-Diff test in which the presumptive well contains the patient's serum mixed with ...
Take Charge of Your Blood Pressure! Take Charge of Your Blood Pressure!
Video: Structure of Amino Acid, Peptide Bonds & Polypeptides

For a complete list of videos, visit our video library