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. Taking smaller doses of decongestants several times a day may be appropriate for some medications but does not address the risk of rebound congestion associated with prolonged use.
B. Expecting relief within a few days may not be realistic if the cold symptoms persist for 2 weeks, indicating a potential need for further evaluation.
C. OTC decongestants can be effective, and many patients find relief from symptoms without requiring a prescription.
D. Using decongestants for an extended period can lead to rebound congestion, where nasal passages become more congested once the medication is stopped, making this a crucial point for the nurse to communicate.
Correct Answer is C
Explanation
A. Short-acting insulin does not cover basal needs; that is the role of long-acting insulin.
B. Intermediate-acting insulin does not primarily cover mealtime glucose spikes; it provides a more prolonged effect.
C. Short-acting insulin is used to manage blood glucose during meals, while intermediate-acting insulin helps maintain glucose control between meals and overnight, making this the correct choice.
D. Short-acting and intermediate-acting insulins have different onset and peak times; they do not share the same pharmacokinetic properties.