ch 26
A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy?
Internal and superficial bleeding
A patient with coronary artery disease asks the nurse about the “good cholesterol” laboratory values. The nurse knows that “good cholesterol” refers to which lipids?
High-density lipoproteins (HDLs)
A patient is receiving a nutritional supplement via an enteral feeding tube. The nurse will monitor for which common adverse effect?
Diarrhea
The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame?
15 minutes
Order: Begin a heparin drip per the facility’s protocol. The patient’s weight is 84 kg.
Heparin Protocol
Bolus: Heparin 70 units/kg
Infusion: Heparin 17 units/kg/h using a concentration of heparin 25,000 units in 250 mL of NS (100 units/mL)
How many mLs per hour should the patient receive for the continuous infusion?
14.3 mL/h
A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?
Vitamin K
The nurse is conducting a class about antilipemic drugs. The antilipemic drug ezetimibe (Zetia) works by which mechanism?
Inhibiting cholesterol absorption in the small intestine
An older adult patient needs to receive an enteral supplement to improve her overall nutritional status. When considering enteral supplements, the nurse notes that which formulation provides complex nutrients?
Ensure Plus
A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?
Contact the prescriber for further orders
Order: Begin a heparin drip per the facility’s protocol. The patient’s weight is 84 kg.
Heparin Protocol
Bolus: Heparin 70 units/kg
Infusion: Heparin 17 units/kg/h using a concentration of heparin 25,000 units in 250 mL of NS (100 units/mL)
How many units will the nurse give for the bolus?
5,900 units
When administering heparin subcutaneously, the nurse will follow which procedure?(needle size and length)
Using a 1/2- to 5/8-inch 25- to 27-gauge needle
A patient tells the nurse that he likes to eat large amounts of garlic “to help lower his cholesterol levels naturally.” The nurse reviews his medication history and notes that which drug has a potential interaction with the garlic?
Warfarin (Coumadin)
A woman has been receiving both radiation and chemotherapy for her cancer. Lately, she has developed anorexia caused by the treatments, so she needs short-term nutrition supplementation. The nurse anticipates that the physician will initiate which therapy?
Peripheral parenteral nutrition
The nurse knows to administer acarbose (Precose), an alpha-glucosidase inhibitor, at which time?
With the first bite of each main meal
Order: Begin a heparin drip per the facility’s protocol. The patient’s weight is 76 kg.
Heparin Protocol
Bolus: Heparin 70 units/kg
Infusion: Heparin 17 units/kg/h using a concentration of heparin 25,000 units in 250 mL of NS (100 units/mL)
How many mLs per hour should the patient receive for the continuous infusion?
12.9 mL/h
A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?
Ginkgo
A patient reports having adverse effects with nicotinic acid (niacin). The prescriber has recommended which action to minimize these undesirable effects?
Take an aspirin tablet 30 minutes before taking the drug.
A patient with type 2 diabetes will be receiving a nasogastric tube feeding for a few days. The nurse expects which type of formula to be used?
Glucerna
A patient will be taking U-500 insulin. The nurse is reviewing the use of this drug. What statements are true? (3 things)
U-500 insulin is 5 times stronger than U-100 insulin.
U-500 insulin syringes must be used when giving U-500 insulin
Each line on a U-500 syringe measures 5 units of U-500 insulin.
The physician gives orders to infuse 1,000 mL 0.9% NS at 200 mL/h for dehydration. Tubing drop factor is 10 gtt/mL. Calculate the flow rate in drops per minute
33 gtt/min
The nurse is reviewing new medication orders for a patient who has an epidural catheter for administration of pain medications. One of the orders is for enoxaparin (Lovenox), a low-molecular-weight heparin (LMWH). What is the nurse’s priority action?
Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter
A patient is concerned about the adverse effects of the fibric acid derivative she is taking to lower her cholesterol level. Which is an adverse effect of this class of medication?
Diarrhea
The nurse is administering a parenteral nutrition infusion to a patient. The nurse will implement which measures to prevent infection? (Select all that apply.)
Change the intravenous tubing set every time a new bag is added to the infusion.
Use a 1.2-micron filter with each tubing set.
Report any increase in the patient’s temperature over 100° F (37.8° C
Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?
Insulin glargine
The physician orders 500 mL of NS to infuse at 175 mL/h for a patient with vomiting. Tubing drop factor is 15 gtt/mL. Calculate the flow rate in drops per minute.
44 gtt/min