A nurse discovers that a physician has prescribed that the client with a pulmonary embolism be started on oral warfarin while still receiving intravenous heparin. What is the nurse's best action?
A. Administer the medications as prescribed.
B. Remind the physician that two anticoagulants should not be administered con-currently.
C. Hold the dose of warfarin until the client's partial thromboplastin time is the same as the control value.
D. Monitor the client for clinical manifestations of internal or external bleeding at least every 2 hours.
A
Although both heparin and warfarin are anticoagulants, they have different mechanisms of action and onsets of action. Because warfarin has such a slow onset, it must be started while the client is still receiving heparin.
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A nurse resigns from a position in a hospital to accept a job in a community setting. After starting the new job, the nurse feels helpless and confused, wondering if this was the right career choice. Which of the following terms best describes how the nurse is feeling?
a. Cultural conflict b. Cultural relativism c. Culture shock d. Culture brokering
The nurse is preparing to administer midazolam IV as a preanesthetic agent and understands that its primary purpose is to:
a. decrease pain. c. prevent respiratory depression. b. maintain blood pressure. d. provide amnesic effects.
What disorder of the adnexa is most likely the diagnosis?
A 23-year-old waitress comes to your clinic complaining of severe pelvic pain radiating to her right side. The pain began yesterday and is getting much worse. She has had no burning with urination and denies any recent sexual activity. She has no nausea, vomiting, constipation, diarrhea, fever, or vaginal discharge. Her last period was 3 to 4 weeks ago. Her past medical history consists of severe acne, depression, and mild obesity. She has had no surgeries. She broke up with her boyfriend 6 months ago and denies dating anyone else. She smokes one pack of cigarettes a day, drinks three to four beers two to three times a week, and denies any illegal drug use. Her mother is diabetic and her father has coronary artery disease. On examination you see a mildly obese female in moderate distress. Her blood pressure is 130/80 and her pulse is 90. She is afebrile. On auscultation she has active bowel sounds. She has no rebound or guarding in any abdominal quadrant. Speculum examination shows no lesions on the cervix and no discharge or bleeding from the os. During the bimanual examination she has no cervical motion tenderness, but her right adnexal area is swollen and tender. A urine analysis is normal and the urine pregnancy test is pending. A) Ovarian cyst B) Tubal pregnancy C) Pelvic inflammatory disease
A patient is receiving high doses of a cephalosporin. Which laboratory values will this patient's nurse monitor closely?
a. Blood urea nitrogen (BUN), serum creatinine, and liver function tests b. Complete blood count and electrolytes c. Serum calcium and magnesium d. Serum glucose and lipids