A nurse is assisting with the care of a postoperative client following a total knee replacement. Which of the following medications should the nurse anticipate the provider to prescribe to prevent the formulation of a deep vein thrombosis (DVT)?
Warfarin
Alteplase (PA)
Clopidogrel
Enoxaparin
The Correct Answer is D
A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.
B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.
C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.
D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.
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Correct Answer is C
Explanation
A. Initiate intravenous fluid therapy. While fluid therapy is essential to support circulation and reduce the risk of shock, oxygenation takes priority in fat embolism management.
B. Prepare the client for emergency surgery. Surgery is not typically the first-line intervention for fat embolism; management focuses on supportive care, particularly respiratory support.
C. Administer high-flow oxygen via a non-rebreather mask. High-flow oxygen is the first priority to address hypoxia caused by fat embolism and should be administered immediately to maintain adequate oxygenation.
D. Apply sequential compression devices (SCDs). SCDs are used to prevent venous thromboembolism, but they do not help with the treatment of fat embolism.
Correct Answer is A
Explanation
A. "I understand that CAD is caused by the buildup of fat deposits in my arteries." CAD is caused by the accumulation of plaque (cholesterol, fats, and other substances) within the coronary arteries, which restricts blood flow to the heart muscle.
B. "Only people with a family history of heart disease are at risk for CAD." Although a family history can increase risk, many other factors, like high blood pressure, smoking, high cholesterol, and lifestyle, contribute to CAD risk.
C. "CAD can be completely cured with a healthy diet and exercise." While lifestyle changes can significantly reduce the progression of CAD and improve symptoms, they do not cure the disease.
D. "I should avoid all physical activity to prevent worsening my CAD." Physical activity, when performed safely and under medical guidance, is beneficial for CAD management and can help improve cardiovascular health.