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 A
Explanation
A. Try not to swallow while the pill dissolves is correct because sublingual medications are designed to be absorbed directly into the bloodstream through the mucous membranes under the tongue, and swallowing may hinder this absorption.
B. Take a big drink of water and swallow the pill is incorrect because sublingual medications should not be swallowed with water as they need to dissolve under the tongue.
C. Swallow frequently to get the best benefit is incorrect, as this can interfere with the absorption of the medication.
D. Chew the pill so it will dissolve faster is incorrect since chewing may destroy the sublingual formulation, preventing it from working as intended.
Correct Answer is D
Explanation
A. While historical context is useful, the development of antimicrobials primarily began in the early 20th century, notably with penicillin discovered by Alexander Fleming in 1928.
B. This statement is incorrect; fluoroquinolones primarily inhibit bacterial DNA synthesis rather than directly affecting the cell wall.
C. Selective toxicity is a principle of antimicrobial action but does not directly explain how a specific antimicrobial works therapeutically.
D. Penicillin specifically interferes with the synthesis of the bacterial cell wall, leading to cell lysis and death of the bacteria, which is a fundamental mechanism of action for this antibiotic.