A nurse is caring for a client who is diagnosed with a deep vein thrombosis (DVT) and is receiving heparin. The client asks the nurse how long it will take for the heparin to dissolve the clot, which of the following responses should the nurse give?
"Depending on the level of your PT/INR, the clot will begin to dissolve."
"After the first dose, the clot will begin to dissolve."
"It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
"Heparin does not dissolve clots. It stops new clots from forming."
The Correct Answer is D
A. "Depending on the level of your PT/INR, the clot will begin to dissolve.": This response is misleading, as heparin's effect is not primarily monitored by PT/INR; rather, heparin is monitored by activated partial thromboplastin time (aPTT). Moreover, heparin does not directly dissolve clots; it prevents further clot formation.
B. "After the first dose, the clot will begin to dissolve.": This statement inaccurately suggests that heparin has an immediate effect on dissolving existing clots. While heparin acts quickly to inhibit further clotting, it does not lead to the dissolution of clots after the first dose.
C. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.": This is not accurate for heparin, which has an immediate effect on coagulation. While the therapeutic effects can be optimized over several days, heparin begins to work right away to prevent further clotting.
D. "Heparin does not dissolve clots. It stops new clots from forming.": This response accurately describes the mechanism of action of heparin. Heparin prevents the extension of existing clots and the formation of new clots, but it does not actively dissolve clots. This clarification is essential for the client’s understanding of their treatment and expectations regarding DVT management.
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Correct Answer is A
Explanation
A) Inhibits platelet aggregation: The primary benefit of aspirin following a myocardial infarction (MI) is its ability to inhibit platelet aggregation. By preventing platelets from clumping together, aspirin reduces the risk of further clot formation, which is critical in preventing additional cardiac events and improving overall cardiovascular outcomes.
B) Anti-inflammatory properties: While aspirin does have anti-inflammatory effects, this is not the primary reason it is prescribed after an MI. The focus in the post-MI setting is on its role in preventing clot formation rather than addressing inflammation.
C) Antiemetic: Aspirin is not an antiemetic and does not alleviate nausea or vomiting. Clients experiencing gastrointestinal issues or nausea would require different medications for those symptoms.
D) Anti-pyretic: Although aspirin can reduce fever, this effect is not the primary concern in the post-MI setting. The immediate goal is to improve heart health and prevent further thrombotic events, making platelet inhibition the most relevant benefit.
Correct Answer is A
Explanation
A) Gallstones: Gemfibrozil is associated with an increased risk of gallstones. This medication can alter the metabolism of lipids and bile, potentially leading to the formation of gallstones. Clients should be monitored for symptoms such as abdominal pain or discomfort that could indicate gallbladder issues.
B) Decreased PT time: Gemfibrozil does not typically affect prothrombin time (PT). Instead, it may interact with anticoagulants and potentially increase PT time, requiring careful monitoring in patients taking both medications.
C) Hyperkalemia: While hyperkalemia can occur with certain lipid-lowering medications, it is not a common side effect associated with gemfibrozil. This drug primarily affects triglycerides and cholesterol levels without significantly impacting potassium levels.
D) Increased creatinine clearance: Gemfibrozil is not known to increase creatinine clearance; in fact, it can sometimes affect renal function. Monitoring kidney function is important, but increased creatinine clearance is not an expected outcome with this medication.