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Author Question: A patient with atrial fibrillation is receiving warfarin (Coumadin). The nurse notes that the ... (Read 145 times)

gonzo233

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on: Jul 23, 2018
A patient with atrial fibrillation is receiving warfarin (Coumadin). The nurse notes that the patient's INR is 2.7. Before to giving the next dose of warfarin, the nurse will notify the provider and:
 
  a. administer the dose as ordered.
  b. request an order to decrease the dose.
  c. request an order to give vitamin K (phytonadione).
  d. request an order to increase the dose.

Question 2

A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery.
 
  On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible _____ and request an order for _____.
  a. congestive heart failure; furosemide (Lasix)
  b. hemorrhage; vitamin K (phytonadione)
  c. myocardial infarction: tissue plasminogen activator (tPA)
  d. pulmonary embolism; heparin


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morrie123456

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Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: A
This patient has an INR in the appropriate range, so no change in warfarin dosing is necessary. It is not correct to request an order to either decrease or increase the dose of warfarin. It is not necessary to give vitamin K, which is an antidote for warfarin toxicity.

Answer to Question 2

ANS: D
This patient is exhibiting signs of pulmonary embolism. Heparin is used when rapid onset of anticoagulants is needed, as with pulmonary embolism. The patient would have respiratory cracks and a cough with congestive heart failure. Hemorrhage involves a decrease in blood pressure, bruising, and lumbar pain. The patient has pleuritic pain, which is not consistent with the chest pain of an MI.


gonzo233

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Reply #2 on: Jul 23, 2018
Both answers were spot on, thank you once again


morrie123456

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Reply #3 on: Jul 23, 2018
Great! Please up vote :D


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