Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:
1. Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case.
2. Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness.
3. Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission.
4. Draw anticoagulation studies to make sure she does not have dangerously high bleeding times.
Question 2
Cecil and his wife are traveling to Southeast Asia on vacation and he has come into the clinic to review his medications. He is healthy with only mild hypertension that is well controlled.
He asks about getting a shot to prevent blood clots like his friend Ralph did before international travel. The correct respond would be:
1. Administer one dose of low-molecular weight heparin 24 hours before travel.
2. Prescribe one dose of warfarin to be taken the day of travel.
3. Consult with a hematologist regarding a treatment plan for Cecil.
4. Explain that Cecil is not at high risk of a blood clot and provide education about how to prevent blood clots while traveling.
Examples of deep-sea corals found in the Sable Gully, 200 km off the coast of Nova Scotia.
Deep Palpation, Bimanual Method
Position of patient to assess jugular vein distention
The physician uses two hands for deep bimanual palpation.
EMS personnel respond to emergencies and transport patients to the hospital.
Deep-well injection