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134 a client is receiving enoxa parin and warfarin

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134.A client is receiving enoxa-parin and warfarin therapy fora venous thromboembolism(VTE). Which laboratory valueindicates that anticoagulationis adequate and enoxaparincan be discontinued?A. Activated partial thrombo-plastin time (aPPT) is half ofthe control valueB. Prothrombin time (PT) is 0.5times normal.C. International normalized ra-C. International normalized ratio (INR) is2.5.Oral anticoagulants such as warfarin aremonitored by PT or the INR. Because thefull anticoagulant effect of warfarin is de-layed for 3 to 5 days, it is usually admin-istered concurrently with heparin until de-sired anticoagulation has been achieved(i.e., when the PT is 1.5 to 2 times normalor the INR is 2.0 to 3.0)52 / 78
PrepU Questions for Exam 2 (CARDIAC)Study online at tio (INR) is 2.5.D. K+ level is 3.5.135.Health teaching includes ad-vising patients on ways to re-duce PAD. The nurse shouldalways emphasize that thestrongest risk factor for thedevelopment of atherosclerot-ic lesions is:A. Cigarette smoking.B. Lack of exercise.C. Obesity.D. Stress.A. Cigarette smoking.Nicotine decreases blood flow, increas-es heart rate and blood pressure, andincreases the risk for clot formation byincreasing platelet aggregation. Smokershave a four-fold higher risk of developingpain from arterial disease than nonsmok-ers. Carbon monoxide, produced by burn-ing tobacco, combines with hemoglobinmore readily than oxygen, thus deprivingtissues of oxygen.136.You are assessing a client re-cently admitted to your unit forhypotension. While assessingthis client, you find a pulsatilemass near the umbilicus. Whatwould you suspect?A. Coronary artery diseaseB. Aortic aneurysmC. Raynaud's diseaseD. Peripheral artery diseaseB. Aortic aneurysmA pulsating mass may be felt or even seenaround the umbilicus or to the left of mid-line over the abdomen. Options A, C, andD would not present with a pulsating massnear the umbilicus; therefore, they are in-correct.137.The nurse is caring for a clientwith upper extremity arterialdisease. Which assessmentswill the nurse include in theclient's plan of care? Select allthat apply.A. Measure blood pressure onboth arms.B. Encourage activities usingthe affected extremity.C. Assess capillary refill onboth arms every 2 hours.A, C, DArterial stenosis and occlusions occur lessfrequently in the upper extremities thanin the legs, and cause less severe symp-toms because the collateral circulation issignificantly better in the arms. Howeversymptoms of upper extremity arterial dis-ease include arm fatigue and pain withexercise, the inability to hold or grasp ob-jects, and possible difficulty driving. Theassessment of this client includes measur-53 / 78
PrepU Questions for Exam 2 (CARDIAC)Study online at D. Compare radial pulses onboth wrists every 2 hours.

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