Question

3. A patient who is taking warfarin (Coumadin) arrives to the emergency department and reports rectal bleeding. Which of the following drugs should healthcare professional have available? a. Filgrastim (Neupogen) b. Deferoxamine (Desferal) c. Protamine d. Vitamin K 4. The nurse is planning to administer aboutaneous Enoxaparin 40mg using a prefilled syringe to a client post hip surgery. The RN will advise the client to report sign of symptoms of bleeding including the following: SELECT ALL THAT APPLY A. Increased heart rate B. Increase blood pressure C. Bruising D Hematoma formation E Black tarry wools 5. The oral anticoagulant, Warfarin is prescribed for a patient with atrial fibrillation. The following lab value will be monitored to ensure the Warfarin is in the therapeutic level. A. Platelet level B. INR C. Vitamin K level D. CBC 6. The nurse is caring for a hospitalized patient receiving IV heparin. The patient begins to vomit blood. The RN stops the IV heparin drip and plans to administer the following antidote? A. Vitamin K B. Atropine C. Protamine D. Calcium gluconate 7. The RN is caring for a patient admitted to the Emergency room to rule out stroke. The head CT confirmed an acute ischemic stroke is present. The RN is prepared to administer the following medication to reverse the stroke formation A. Heparin B. Warfarin C. Alteplase D. Aspirin 8. The nurse is assessing a client during a transfusion of a unit of whole blood. The client acutely develops cough, shortness of breath, elevated blood pressure, and distended neck veins. The RN

Answer 1

Answers:

3. d. Vitamin K

Vitamin K acts as an antidote for coumadin. Vitamin K reverses the action of anticoagulant properties and stopped the bleeding. Hence option C is correct.

Filgrastim is administered in case of neutropenia, Desferal is an iron-binding agent. Protamine is an antidote for heparin. Hence option a,b,c are incorrect.

4. c. bruising

d. Hematoma formation.

e. Black tarry stools.

Rationale:

Enoxaparin is an anticoagulant that prevents the blood from a clot. The most common side effect is bleeding. The symptoms of bleeding include bruising at the site of injection, black tarry stools. So option c,d,e are more appropriate.

Internal bleeding leads to the formation of hematoma which leads to life-threatening complications. Hence option a,b are incorrect.

5.B. INR

Rationale:

An INR range is necessary to detect the therapeutic dose of warfarin especially patient with atrial fibrillation. INR helps to detect blood-thinning factors. If the INR is too high, then there is an increased risk of bleeding and warfarin dosage has been adjusted. Hence option B is correct.

CBC, platelet, vitamin K level is not directly related to blood clotting factors. Hence options A,C,D are incorrect.

6. C. Protamine

Rationale:

Protamine act as an antidote for heparin. It reverses the effects of heparin. Hence option C is correct.

Vitamin K is an antidote for coumadin, atropine is used as an antidote in treating certain poisoning, calcium gluconate is an antidote for magnesium sulfate. Therefore, these are incorrect.