A patient is diagnosed with a pulmonary embolism. Which of the following treatments should the nurse anticipate?
Initiation of a high-sodium diet
Application of a cast to the affected limb
Administration of anticoagulant therapy
Administration of bronchodilators
The Correct Answer is C
A. Initiation of a high-sodium diet. A high-sodium diet is not indicated in pulmonary embolism management; it could worsen fluid retention and cardiovascular strain.
B. Application of a cast to the affected limb. Casting is not appropriate for pulmonary embolism, as it is not an orthopedic injury. Immobilization could increase the risk of further clot formation.
C. Administration of anticoagulant therapy. Anticoagulant therapy, such as heparin or warfarin, is the primary treatment for pulmonary embolism to prevent further clot formation and allow the body to dissolve the clot.
D. Administration of bronchodilators. Bronchodilators may alleviate respiratory symptoms but do not treat the underlying clot in pulmonary embolism. Anticoagulation remains the primary treatment.
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Correct Answer is D
Explanation
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.
Correct Answer is ["B","C","D"]
Explanation
A. Obese extremities. Clients with Cushing's syndrome typically experience central (truncal) obesity with thin extremities due to fat redistribution and muscle wasting, not obese extremities.
B. Buffalo hump: A "buffalo hump" (fat pad on the back of the neck) is a common characteristic of Cushing's syndrome due to abnormal fat distribution.
C. Purple striations. Purple or reddish striae on the abdomen and other areas are commonly seen in Cushing's syndrome due to skin thinning and collagen breakdown.
D. Moon face. A round, full face (moon face) is a classic sign of Cushing's syndrome due to fat deposits in the face.
E. Tremors. Tremors are not typically associated with Cushing's syndrome and are more often associated with neurological or metabolic conditions.