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 D
Explanation
A. Include high-fat foods to maintain weight. High-fat foods can worsen symptoms in ulcerative colitis by increasing bowel irritation and causing malabsorption. A balanced diet that is low in fat is usually recommended.
B. Eat three large meals a day to ensure adequate nutrition. Large meals can increase digestive workload and exacerbate symptoms. Smaller, more frequent meals are generally better tolerated.
C. Increase intake of dairy products to boost calcium levels. Many patients with ulcerative colitis are lactose intolerant or sensitive to dairy, which can worsen symptoms. Calcium can be obtained from other sources if needed.
D. Consume a low-fiber diet to minimize bowel irritation. A low-fiber diet can reduce mechanical irritation in the bowel, which is beneficial during flare-ups of ulcerative colitis.
Correct Answer is D
Explanation
A. Pain in the neck when the patient flexes their head towards the chest. This describes nuchal rigidity, not Kernig sign.
B. Involuntary flexion of the hips and knees when the neck is flexed. This describes Brudzinski sign, not Kernig sign.
C. Photophobia and headache triggered by bright light. These are symptoms of meningitis, but they are not specific to Kernig sign.
D. Pain and resistance when attempting to extend the patient's leg from a flexed position. A positive Kernig sign is when there is pain and resistance to leg extension from a flexed hip and knee position, indicating meningeal irritation.