The nurse is caring for a patient with a fever and severe ...

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The nurse is caring for a patient with a fever and severe diarrhea in addition to thrombophlebitis. How will this patient's condition impact the clotting process?
 
  A) Depleted production of Hageman factor
  B) Increased production of thrombin
  C) Activation of plasminogen
  D) Reduced production of fibrinolysin

Question 2

A new mother required an episiotomy during the birth of her baby. Two days after delivery, the patient is in need of a laxative. What will be the most effective drug for the nurse to administer?
 
  A) Bisacodyl (Dulcolax)
  B) Castor oil (Neolid)
  C) Magnesium sulfate (epsom salts)
  D) Docusate (Colace)

[meryzewe]

Answer to Question 1

C
Feedback:
Plasminogen is the basis for the clot-dissolving system. It is converted to plasmin (fibrinolysin) by several factors including Hageman's factor, which is factor XII found in circulating blood. Activated thrombin breaks down fibrinogen to form fibrin threads, which form a clot inside the blood vessel. Patients with diarrhea or fever could alter the normal clotting process by, respectively, loss of vitamin K from the intestine or activation of plasminogen.

Answer to Question 2

D
Feedback:
Docusate is a stool softener that will make expulsion of stool easier in a traumatized body area following an episiotomy. Care must be taken to choose a mild laxative that will not enter breast milk and not affect the newborn if the mother is nursing. Docusate is the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate because they do not soften the stool and are harsher laxatives that can enter breast milk.

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