A patient receiving heparin therapy develops bruising and bleeding gums. What should the nurse suspect and what is the appropriate action?
Suspect an allergic reaction and administer antihistamines.
Suspect a bleeding complication and notify the healthcare provider.
Suspect a hypersensitivity reaction and discontinue the heparin immediately.
Suspect an infection and initiate antibiotic therapy.
The Correct Answer is B
A. Bruising and bleeding gums are not indicative of an allergic reaction, which would typically present with different symptoms such as rash, itching, or swelling. Administering antihistamines would not address the underlying issue.
B. The development of bruising and bleeding gums in a patient on heparin therapy suggests a bleeding complication, which is a known risk of anticoagulation therapy. The nurse should notify the healthcare provider to assess the situation and possibly adjust treatment or perform further evaluations.
C. While hypersensitivity reactions can occur with medications, the symptoms presented here are more aligned with bleeding complications than with hypersensitivity. Discontinuing heparin without consulting the provider could put the patient at risk for thromboembolic events.
D. The symptoms do not indicate an infection; therefore, initiating antibiotic therapy would not be appropriate in this context.
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Correct Answer is D
Explanation
A. Nitrates do not share a cross-sensitivity with penicillin and are safe to use in this client.
B. Tetracycline is a different class of antibiotics and does not have cross-sensitivity with penicillin.
C. Aminoglycosides also do not have cross-sensitivity with penicillin and can be safely administered.
D. Cephalosporins are structurally related to penicillin and have a risk of cross-sensitivity; thus, they should not be given to a client with a history of anaphylaxis to penicillin.
Correct Answer is B
Explanation
A. heart rate is not the primary concern when assessing the interaction between NSAIDs and loop diuretics.
B. blood pressure is correct; the combination of an NSAID and a loop diuretic can lead to fluid retention, potentially elevating blood pressure. Monitoring blood pressure is crucial in this context.
C. cognition is not directly impacted by the combination of these medications.
D. assessment for signs of bleeding is important when taking NSAIDs due to their effect on platelet function, but the more immediate concern is the potential fluid retention affecting blood pressure.