A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?
Partial thromboplastin time (PTT) 55 seconds
Hematocrit 45%
White blood cell count 8,000/mm³
Platelets 74,000/mm³
The Correct Answer is D
A. Partial thromboplastin time (PTT) 55 seconds: This PTT value is within the therapeutic range for a client on heparin therapy.
B. Hematocrit 45%: This hematocrit value is within normal limits and is not concerning.
C. White blood cell count 8,000/mm³: A WBC count of 8,000/mm³ is within the normal range and does not require reporting.
D. Platelets 74,000/mm³: A low platelet count (thrombocytopenia) can indicate heparin-induced thrombocytopenia (HIT), a potentially serious complication of heparin therapy.
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Correct Answer is B
Explanation
A. Suggest that the client rests before eating the meal. Although rest can help with nausea, it does not address the potential issue of digoxin toxicity, which can cause nausea.
B. Check the client's vital signs. Checking vital signs, especially heart rate, is the priority because nausea can indicate digoxin toxicity, which affects heart function.
C. Request a dietary consult. A dietary consult may be helpful if the client continues to refuse meals, but it does not address the immediate potential for digoxin toxicity.
D. Request an order for an antiemetic. Although an antiemetic may help with nausea, assessing for toxicity takes priority.
Correct Answer is D
Explanation
A. Overweight. While weight can affect medication metabolism, it does not specifically increase risk with pseudoephedrine.
B. Migraine headaches. Migraine headaches are not contraindicated with pseudoephedrine, although some stimulants can increase headaches.
C. Eczema. Pseudoephedrine does not typically affect eczema.
D. Hypertension. Pseudoephedrine is a decongestant that can increase blood pressure, so it should be used with caution in clients with hypertension.