A patient is 2 days postoperative for a hip replacement, and her ...

[kellyjaisingh]

A patient is 2 days postoperative for a hip replacement, and her mobility is limited. The patient complains of pleuritic chest pain, shortness of breath, and hemoptysis, and her oxygen saturation level is 82 to 84.
 
  The nurse should anticipate administration of ___________, for the signs and symptoms of ____________.
  a. heparin; pulmonary embolus
  b. furosemide (Lasix); right-sided heart failure
  c. hydrochlorothiazide (HydroDIURIL); pulmonary edema
  d. tissue plasminogen activator (tPA); myocardial infarction

Question 2

Comparing the adverse effects of the antiplatelet drug clopidogrel (Plavix) with those of aspirin, the nurse should draw which of the following conclusions?
 
  a. Clopidogrel causes less GI bleeding than aspirin.
  b. Rash commonly occurs with aspirin but not with clopidogrel.
  c. Clopidogrel poses a greater risk of intracranial hemorrhage than aspirin does.
  d. Clopidogrel carries an higher risk for neutropenia and granulocytopenia than does aspirin.

[anoriega3]

Answer to Question 1

ANS: A
The scenario describes the signs and symptoms of pulmonary emboli, as well as the patient's risk factors for pulmonary embolism. Heparin is the preferred anticoagulant because of its rapid onset of action.
Furosemide would not be indicated in this situation, because the patient is not experiencing signs or symptoms of right-sided heart failure.
Hydrochlorothiazide would not be indicated in this situation. Although shortness of breath and decreased oxygen saturations are consistent with pulmonary edema, the patient typically produces excessive amounts of frothy sputum.
Although the patient is experiencing chest pain, the presentation of the pain is inconsistent with that of myocardial infarction, therefore tPA is not indicated. Although tPA can also be administered in pulmonary embolism, the patient's recent surgery prevents this.

Answer to Question 2

ANS: A
Compared with aspirin, clopidogrel causes less GI bleeding.
Rash is not associated with the use of aspirin; however, 4 of patients taking clopidogrel develop a rash.
Compared with aspirin, clopidogrel causes less intracranial hemorrhage.
Clopidogrel does not cause neutropenia or granulocytopenia.

[kellyjaisingh]

TYSM

[Laurenleakan]

Excellent